Smo - Chapter 800

Front 1

The most important parameter when assessing a child ?

Back 1

the child's general appearance

Front 2

where can the best assessment be taken of a child

Back 2

from a distance, ideally while in a parent's arms

-Assessments from a distance are necessary because a stranger can have dramatic influence on a child’s appearance.

Front 3

How would you assess a child's alertness?

Back 3

1. How responsive/perceptive is the child to others?
2. Distractibility: How readily does someone/something draw the child’s attention?
3. Consolability: Can a distressed child be comforted?
4. Speech/Cry: Strong/weak? Absent unless stimulated?
5. Spontaneous Activity: Responds only to stimuli? Appear flaccid?
6. Color: Pallor, flushing, cyanosis, or mottling? Centrally vs. peripherally.
7. Respiratory Effort: Accessory muscle use?
8. Eye Contact: Able to maintain contact with people/objects? Gaze aimlessly?

Front 4

what are the components of general appearance of a child?

Back 4

alertness
airway
breathing
circulation

Front 5

Airway management of the pediatric patient differs significantly from that of one adult. What are the differences?

Back 5

The trachea and larynx are soft and cartilaginous and will collapse with flexion or hyperextension.

Front 6

Cuffed ET tubes are generally not used in children < _____________ years because why?

Back 6

< 6 years of age

Narrowest portion of the airway is at the cricoid ring, forming a “physiological” cuff with the ET tube

Front 7

Assessment of respiratory status in children relies on what?

Back 7

general appearance
-Note resp rate, level of consciousness, and use of accessory muscles

Front 8

_______________ is seen with extreme Hypoxia?

Back 8

Bradycardia

Front 9

As most masks are not tolerated by children, what is best method to provide Supplemental oxygen to a child?

Back 9

Supplemental oxygen is best provided with “blow-by” since masks are not well tolerated by children.

Front 10

gastric inflation occurs frequently in children during assisted or controlled ventilations with a face mask, especially when?

Back 10

especially in the presence of partial airway obstruction.

Front 11

You can minimize gastric distention during ventilations on a child by applying what?

Back 11

applying Cricoid Pressure

-Infants- use (1) one fingertip
-Children- use the thumb and index finger with children.

Front 12

what is the biggest red flag in a pediatric patient
and is most indicative of shock?

Back 12

Sustained Tachycardia
- This is b/c children have a limited capacity to vary stroke volume, so they must increase the heart rate to increase cardiac output

Front 13

If the child is Tachycardic, a _____________ _____________ is necessary to determine the cause.

Back 13

Complete Assessment

Front 14

why is Blood pressure extremely difficult to measure in children?.

Back 14

The proper cuff size is often not available, making blood pressure measurement extremely inaccurate. Blood pressure is a poor indicator of shock because children have a great ability to constrict their blood vessels at the expense of peripheral perfusion.

Front 15

Blood pressure is a poor indicator of shock in children because the have a great ability to do what?

Back 15

constrict their blood vessels at the expense of peripheral perfusion.

Front 16

Hypotension is a late and often ominous sign of cardiovascular collapse, as pediatric patients will generally not become hypotensive until when?

Back 16

they have lost approximately 20% of their circulating volume.

Front 17

All IV/IO’s established on Pediatrics < 8 y/o, must be administered with a desired amount prefilled into what?

Back 17

a Soluset or 100cc Saline Bag.

Front 18

Consider the use of a Aeromedical Service when presented with the following:

Back 18

1. Multiple-system trauma patient with prolonged extrication and/or where a lengthy transport time may be required due to the hospital diversion status.

2. Multiple casualty incidents, where ground transport units are unable to manage and transport all patients in a timely manner.

3. Specific pediatric trauma patients who meet the following criteria:
a. are required to be transported to a Pediatric Trauma Center
b. may have a lengthy transport time.

4. Ventilation dependent or special needs children requiring transport to a specialized Pediatric Center.

Front 19

Transport decisions:
Specific pediatric trauma patients identified by Region III Guidelines (Section 814.000) must meet what criteria in order to consider the use of Aeromedical Service?

Back 19

a. are required to be transported to a Pediatric Trauma Center
b. may have a lengthy transport time.

Front 20

Transport Decisions:
who should you notify to request for air transport?

-And what additional apparatus will be utilized?

Back 20

the Medical Supervisor and Battalion Chief

-Additional Engine to set up a LZ

Front 21

Transport Decisions:
What should you continue while waiting for helicopter arrival or rendezvous?

Back 21

Continue patient care and stabilization per SMO's

Front 22

Transport Decisions:
Do not compromise time for invasive procedures other than airway. Most invasive procedures can be done when?

Back 22

while enroute to the trauma center.

Front 23

For PEDIATRIC ALTERED MENTAL STATUS: What are the steps for treatment?

Back 23

A) Level of consciousness and ABC’s
B) Provide Oxygen as needed.
C) Suction as necessary.
D) Assess circulation and perfusion.
E) Perform glucose check.
F) Begin Cardiac Monitoring, and evaluate EKG strip.
G) Establish IV Normal Saline.
H) Consider Narcan for any unconscious patient.
I) Narcan 0.1mg/kg IV/IO/ETT ( 2mg max. >2yrs or 1mg max. < 2yrs )
J) Recheck glucose level after Five min

Front 24

Pediatric Altered Mental Status:
If blood sugar Less Than 60 mg/dl or Glucometer is unavailable and patient is symptomatic of Hypoglycemia: what do you give to a child in the age range of newborn to 2yrs old?

Back 24

5ml/kg of Dextrose 10% (Mix 2ml of Dextrose 50% with 8ml of Normal Saline)

Front 25

Pediatric Altered Mental Status:
If blood sugar Less Than 60 mg/dl or Glucometer is unavailable and patient is symptomatic of Hypoglycemia: what do you give to a child in the age range of 2yr to 8yrs?

Back 25

2ml/kg of Dextrose 25% (Mix 10ml of Dextrose 50% with 10ml of Normal Saline)

Front 26

Pediatric Altered Mental Status:
If blood sugar Less Than 60 mg/dl or Glucometer is unavailable and patient is symptomatic of Hypoglycemia: what do you give to a child in the age range of greater than 8yrs old?

Back 26

1ml/kg of Dextrose 50%

Front 27

If blood sugar Less Than 60 mg/dl or Glucometer is unavailable and patient is symptomatic of Hypoglycemia, And you CANNOT get an IV, what should you do for the patient?

Back 27

Glucagon 0.1ml/kg IM up to 1mg

Front 28

Pediatric Altered Mental Status:
what medication should you consider for any unconscious patient?

Back 28

NARCAN

Narcan 0.1mg/kg IV/IO/ETT ( 2mg max. >2yrs or 1mg max. < 2yrs )

Front 29

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 4 response in the EYE OPENING Category?

Back 29

SPONTANEOUS eye opening

Front 30

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 3 response in the EYE OPENING Category?

Back 30

TO SPEECH

Front 31

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 2 response in the EYE OPENING Category?

Back 31

TO PAIN

Front 32

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 1 response in the EYE OPENING Category?

Back 32

NO RESPONSE FOR EYE OPENING

Front 33

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 4 response in the EYE OPENING Category?

Back 33

SPONTANEOUS eye opening

Front 34

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 3 response in the EYE OPENING Category?

Back 34

TO SPEECH

Front 35

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 2 response in the EYE OPENING Category?

Back 35

TO PAIN

Front 36

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 1 response in the EYE OPENING Category?

Back 36

NO RESPONSE FOR EYE OPENING

Front 37

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 5 response in the VERBAL Category?

Back 37

oriented

Front 38

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 4 response in the VERBAL Category?

Back 38

CONFUSED

Front 39

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 3 response in the VERBAL Category?

Back 39

INAPPROPRIATE WORDS

Front 40

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 2 response in the VERBAL Category?

Back 40

NON SPECIFIC SOUNDS

Front 41

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 1 response in the VERBAL Category?

Back 41

NO VERBAL RESPONSE

Front 42

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 5 response in the VERBAL Category?

Back 42

COOS, BABBLES

Front 43

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 4 response in the VERBAL Category?

Back 43

IRRITABLE

Front 44

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 3 response in the VERBAL Category?

Back 44

CRIES TO PAIN

Front 45

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 2 response in the VERBAL Category?

Back 45

MOANS TO PAIN

Front 46

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 1 response in the VERBAL Category?

Back 46

NO VERBAL RESPONSE

Front 47

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 6 response in the MOTOR Category?

Back 47

FOLLOWS COMMAND

Front 48

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 5 response in the MOTOR Category?

Back 48

LOCALIZES PAIN

Front 49

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 4 response in the MOTOR Category?

Back 49

WITHDRAWS TO PAIN

Front 50

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 3 response in the MOTOR Category?

Back 50

ABNORMAL FLEXION

Front 51

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 2 response in the MOTOR Category?

Back 51

ABNORMAL EXTENSION

Front 52

When determining the GCS for a VERBAL PEDIATRIC PATIENT, How would a patient receive a 1 response in the MOTOR Category?

Back 52

NO MOTOR RESPONSE

Front 53

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 6 response in the MOTOR Category?

Back 53

NORMAL SPONTANEOUS MOVEMENTS

Front 54

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 5 response in the MOTOR Category?

Back 54

WITHDRAWS TO TOUCH

Front 55

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 4 response in the MOTOR Category?

Back 55

WITHDRAWS TO PAIN

Front 56

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 3 response in the MOTOR Category?

Back 56

ABNORMAL FLEXION

Front 57

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 2 response in the MOTOR Category?

Back 57

ABNORMAL EXTENSION

Front 58

When determining the GCS for a PRE-VERBAL PEDIATRIC PATIENT, How would a patient receive a 1 response in the MOTOR Category?

Back 58

NO MOTOR RESPONSE

Front 59

Pediatric Obstructed Airway
If obstructed:
1 - 8 years what do you perform ?

Back 59

(5) five abdominal thrusts (Heimlich maneuver).

Front 60

Pediatric Obstructed Airway
If obstructed:
Less than 1 year perform what?

Back 60

(5) five back blows and (5) five chest thrusts

Front 61

for Pediatric obstruction, what should you perform if a child is greater than 8 years?

Back 61

Perform tongue-jaw-lift if child is greater than 8 years.

Front 62

For Pediatric Obstruction (< 8 years old), you should perform a finger sweep only if __________________.

Back 62

perform finger sweep only if object is visualized.

Front 63

For Paramedics Only: Treating Pediatric Airway Obstruction,
If ventilation remains inadequate, what should you perform?

Back 63

perform direct laryngoscope and attempt to remove foreign body with suction and/or forceps.

Front 64

Paramedic Only: treating pediatric airway obstruction,

-If the airway remains obstructed and/or patient is cyanotic, then perform what?

Back 64

ENDOTRACHEAL INTUBATION, Pre-Oxygenate and pretreat with Atropine 0.02 mg/kg IV and ventilate with BVM/100% Oxygen.

Front 65

Pediatric Obstructed Airway:
What are the steps you should take if you are unable to intubate a pediatric patient?

Back 65

-Contact Medical Control for orders for needle
-Cricothyroidotomy.
-Immediate Transport to NEAREST FACILITY
-Establish IV with 20cc/kg bolus, if needed
-IO if patient is less than 6 y/o and IV access cannot be obtained!

Front 66

Below what age should you put an IO in a pediatric patient when IV access cannot be established?

Back 66

<6 years old

Front 67

Is it ok to delay other assessment, treatment, or stay on the scene to secure an advanced airway?

Back 67

NO, Absolutely Not

Front 68

Pediatric advanced airway management:

-If the airway cannot be maintained by other means, including attempts at assisted ventilations, or if prolonged assisted ventilations are anticipated, what do you need perform ?

Back 68

Endotracheal Intubation

Front 69

Pediatric Advanced Airway Management:

-ET tube size estimates can be based upon what?

Back 69

Broselow Tape, the size of the child’s little finger, or nares.

Front 70

Pediatric Advanced Airway Management:

-What is the equation for the ET TUBE sizes?

Back 70

(16 + Age) divided by 4 = tube size

tube size x 3 = tube depth

Front 71

How would you PRE-TREAT a patient <2 years old thats about to have an advanced airway placed?

Back 71

Atropine 0.02 mg/kg

Front 72

Pediatric Advanced Airway Management:

-Proper ET tube placement should be confirmed by what?

Back 72

1. Listen to breath sounds (5 points).
2. Check pulse ox, ECG, and B/P for significant changes pre/post intubation and document.
3. Units that are equipped with LP12/15 monitors shall utilize the continuous End-Tidal CO² monitoring for all intubated patients. Pts should maintain Continuous End-Tidal CO2 levels of 35-45mmHg.

Front 73

Pediatric Advanced Airway Management:

If the patient has a suspected head injury, you should maintain an ETCO2 of _________________?

Back 73

Maintain ETCO2 (End Tidal CO2) of 30mmHg.

Front 74

Pediatric Advanced Airway Management:

What should be utilized when failure to receive a capnography reading.

Back 74

the Encor CO2 detector should be utilized. The Encor detector must remain on the tube and confirmed by a physician before transfer of patient from our stretcher.

Front 75

Pediatric Advanced Airway Management:

You must document depth of ETT at what level?

Back 75

at the level at the teeth

Front 76

Pediatric Advanced Airway Management:

Units that are not equipped with LP12’s shall first utilize the Encor CO² detector then utilize what?

Back 76

The LP12 continuous End tidal CO² monitoring.

Front 77

What should the Encor CO2 detector reflect when placed on the tube?

-When documenting this value, what else should you document?

Back 77

2-5% YELLOW

-Depth at the Teeth, LEMON, & Cormack-Lehane Grade View

Front 78

If all other attempts to resuscitate the patient have failed and the patient still displays respiratory depression, consider ______________________.

Back 78

NARCAN

- 0.1mg/kg IV/IO/ETT ( 1mg max. less than 2yrs or 2mg max. greater than 2yrs) for continued respiratory depression

Front 79

In a Pediatric Patient with Respiratory Arrest, __________________ may develop after resuscitative efforts have begun.

Back 79

Tension Pneumothorax

Front 80

Pediatric Advanced Airway Management:

-If Tension Pneumothorax is suspected, What should you consider?

Back 80

Needle Decompression

Front 81

Pediatric – (SAI) Sedation Assisted Intubation:

-If unable to intubate a conscious medical or trauma patient that meets the following criteria, you may administer Sedation Assisted Intubation.

Back 81

1. Patient who cannot maintain their airway
2. Patient who cannot protect their airway
3. Patient who cannot be appropriately ventilated or be oxygenated with BVM or other means

Front 82

Pediatric – (SAI) Sedation Assisted Intubation: (TRAUMA)

What is the order of drug administration for SAI?

Back 82

1. Atropine (<2 y/o) = 0.02 mg/kg -> 2 mins before intubation.

2. Lidocaine (1 mg/kg IVP/IO) -> Must circulate for 2 minutes and can be given at same time as Atropine.

3. Fentanyl (2 mcg/kg SLOW IO/IVP)

4. Etomidate (0.3 mg/kg SLOW IO/IVP) -> OVER 30 SECONDS

Front 83

Pediatric – (SAI) Sedation Assisted Intubation: (TRAUMA)

-Pediatric TRAUMA: What dose of Atropine is given to a child less than 2 years of age?

Back 83

Atropine - (less than 2 years of age) - 0.02mg/kg IVP/IO (Must be given AT LEAST 2 minutes prior to intubation) Minimum dose 0.1mg

Front 84

Pediatric – (SAI) Sedation Assisted Intubation: (TRAUMA)

-What dose of Lidocaine should be given ?

Back 84

Lidocaine - 1 mg/kg IVP/IO (Given 2minutes prior to intubation and can be given at same time as Atropine)

Front 85

Pediatric – (SAI) Sedation Assisted Intubation: (TRAUMA)

-What dose of Fentanyl should be given?

Back 85

Fentanyl - 2mcg/kg SLOW IVP/IO

Front 86

Pediatric – (SAI) Sedation Assisted Intubation: (TRAUMA)

-What dose of Etomidate should be administered?

Back 86

Etomidate: 0.3 mg/kg SLOW IVP/IO ( over 30 seconds)
*post intubation sedation (hemodynamic stable)

Front 87

Pediatric – (SAI) Sedation Assisted Intubation: (MEDICAL)

What is the order of drug administration for SAI?

Back 87

1. Atropine (less than 2 years of age) -0.02mg/kg IVP/IO (Must be given at least 2 minutes prior to intubation) Minimum dose 0.1mg.

2. Fentanyl 2mcg/kg slow IVP/IO

3. Etomidate 0.3mg/kg slow IVP/IO (Over 30 seconds)

Front 88

Pediatric – (SAI) Sedation Assisted Intubation: (MEDICAL)

-What dose of Atropine should be given to a child less than 2 years of age?

Back 88

Atropine (less than 2 years of age) -0.02mg/kg IVP/IO (Must be given at least 2 minutes prior to intubation) Minimum dose 0.1mg

Front 89

Pediatric – (SAI) Sedation Assisted Intubation: (MEDICAL)

-What dose of Fentanyl should be given to a child?

Back 89

Fentanyl 2mcg/kg SLOW IVP/IO

Front 90

Pediatric – (SAI) Sedation Assisted Intubation: (MEDICAL)

-What dose of Etomiate should be given to a child?

Back 90

Etomidate 0.3mg/kg SLOW IVP/IO (Over 30 seconds)
*post intubation sedation (hemodynamic stable)

Front 91

For Medical and Trauma SAI -

-How do you perform (Post Intubation Sedation) for a patient that is Hemodynamically Stable / Hemodynamically Unstable?

Back 91

Hemodynamically Stable - 0.1 mg/kg VERSED IVP/IO (1 DOSE ONLY)

Hemodynamically Unstable - Contact Med Control

Front 92

Pediatric – (SAI) Sedation Assisted Intubation:

-Etomidate is not recommended for routine use in
pediatric patients with evidence of what?

Back 92

Septic shock

Front 93

Describe Croup Symptoms

Back 93

• 3 months to 3 years
• Rapid Onset
• Child may lie or sit upright
• Barking cough
• Lack of drooling
• Temperature Less Than 104 F

Front 94

Pediatric Croup:

-If the patient is still Ventilating Adequately, should you attempt to visualize the airway of the Child?

Back 94

NO, LEAVE HIM BE!

-you will upset the patient and exacerbate the s/s

Front 95

Pediatric Croup:

-What should you administer 1st by blow by mask at 10 LPM unless it provoke agitation?

Back 95

Nebulized treatment of 6 ml of Normal Saline

Front 96

Pediatric Croup:

-What do you NOT ATTEMPT in a patient with croup?

Back 96

DO NOT ATTEMPT IV ACCESS!

Front 97

Pediatric Croup:

-Prepare appropriate size airway equipment and observe for pending respiratory failure. What are the 8 signs to observe for?

Back 97

1. Sleepy, intermittently combative, or agitated.
2. Increased respiratory effort at sternal notch.
3. Marked use of accessory muscles.
4. Retraction, head bobbing, grunting.
5. Central Cyanosis.
6. Marked Tachycardia.
7. Poor Peripheral perfusion.
8. Decreased muscle tone.

Front 98

Pediatric Croup:

-For a Patient with Croup, When would you consider assisting ventilations with 100% Oxygen via BVM

Back 98

When the Child becomes:

-Exhausted
-Bradycardic and/or
-Respirations Decrease

Front 99

Pediatric Croup:

-What medication is given to a child who has SEVERE CROUP?

Back 99

For severe Croup administer 0.5 mg/5ml Aerosolized Epinephrine (1:10,000)

Front 100

Pediatric Croup:

-If a child progresses to Respiratory Arrest, you should do what?

Back 100

1. Attempt to intubate
2. If intubation is unsuccessful and the child cannot be adequately ventilated with a BVM:

*Contact Medical Control TO PERFORM NEEDLE CRICOTHYROTOMY - (RARE).

Front 101

Pediatric Epiglottitis:

-What are Epiglottitis symptoms?

Back 101

• 3 to 7 years
• Slow onset
• Child prefers to sit up, leaning forward
• No barking cough, possible inspiratory strider
• Drooling, pain during swallowing
• Temperature Greater Than 104 F

Front 102

Pediatric Epiglottitis:

-If the patient is still Ventilating Adequately, should you attempt to visualize the airway of the Child?

Back 102

NO, LEAVE HIM BE!

-you will upset the patient and exacerbate the s/s

Front 103

Pediatric Epiglottitis:

-Who should you contact when a child is suspected epiglottitis?

-And what should you do first?

Back 103

Contact Medical Control - so that appropriate personnel and resources can be made available

-Administer supplemental Oxygen by mask at 15 LPM unless it provokes agitation. Consider “blow-by” Oxygen while child sits.

Front 104

Pediatric Epiglottitis:

-Is it ok to attempt an IV on a patient with suspected Epiglottitis?

Back 104

NO!

-You will upset the patient and exacerbate the s/s

Front 105

Pediatric Epiglottitis:

-Prepare appropriate size airway equipment for a child with epiglottitis and observe for PENDING RESPIRATORY FAILURE: what are the 8 signs to observe for?

Back 105

1. Sleepy, intermittently combative, or agitated.
2. Increased respiratory effort at sternal notch.
3. Marked use of accessory muscles.
4. Retraction, head bobbing, grunting.
5. Central Cyanosis.
6. Marked Tachycardia.
7. Poor Peripheral Perfusion.
8. Decreased muscle tone.

Front 106

Pediatric Epiglottitis:

-For a Patient with EPIGLOTTITIS, When would you consider assisting ventilations with 100% Oxygen via BVM

Back 106

When the Child becomes:

-Exhausted
-Bradycardic and/or
-Respirations Decrease

Front 107

Treating a child with Epiglottitis, a paramedic should do what 2 things if a child progresses to Respiratory Arrest?

Back 107

1. Attempt to intubate

2. If intubation is unsuccessful and the child cannot be adequately ventilated with a BVM
*CONTACT MEDICAL CONTROL to perform Needle Cricothyrotomy - (RARE)

Front 108

Pediatric Asthma:

-What do you do if breathing is adequate?

Back 108

Provide Oxygen as needed.

a. Use a NRB mask or BLOW-BY as tolerated.
b. Monitor Pulse Oximetry.
c. If Level of Consciousness is decreased, then provide 100% Oxygen / BVM with assisted ventilations as needed.
d. Consider need for EARLY INTUBATION
e. To prevent barotrauma secondary to hyperinflation, deliver decreased tidal volumes at a rate 12 to 20/min and allow for prolonged expiratory time.

Front 109

For Pediatric Asthma :

-What are the steps taken to treat this patient?

Back 109

A) If breathing is adequate:
• Provide Oxygen as needed.
B) Assess Circulation and Perfusion.
C) Assess Mental Status.

Front 110

Pediatric Asthma:

-EMT-I Function- For MILD Exacerbation, what meds should be given?

Back 110

Administer

-Nebulized Albuterol 5.0 mg & Atrovent 0.5 mg.
*May repeat x2 every 15mins

Front 111

Pediatric Asthma:

-EMT-I Function - for MODERATE to SEVERE Exacerbation, what meds should be given?

Back 111

Administer nebulized Albuterol 5.0mg & Atrovent 0.5mg

Front 112

Pediatric Asthma:

-Paramedic Function - what should a Paramedic administer for MILD Exacerbation?

Back 112

Administer Solu-Medrol 1mg/kg up to 125mg.

Front 113

Pediatric Asthma:

-Paramedic Function - what should a Paramedic administer for SEVERE cases when Albuterol is not effective?

Back 113

Administer Aerosolized Epinephrine 1:10,000, 0.5mg/5ml

Front 114

Pediatric Asthma:

-If a patient is UNABLE TO COOPERATE with aerosol treatment and shows signs of Respiratory Failure what are the next steps for treatment?

Back 114

1. Administer Epinephrine 0.01mg/kg (1:1,000) IM.
2. May repeat x 1 in 20 minutes

3. MEDICAL CONTROL OPTION - Mag Sulfate 40 mg/kg

4. Cardiac Monitor

5. Expose the patient only as necessary to perform further assessment

6. Maintain body temperature

7. perform focused history and detailed exam en route.

8. Contact Medical Control if additional instructions are needed.

Front 115

Pediatric Asthma:
What is a Medical Control option for treatment?

Back 115

Magnesium Sulfate 40mg/kg

Front 116

Pediatric Allergic Reaction:

-If a patients breathing is adequate you should what?

Back 116

Provide Oxygen as needed.

1. Use a NRB mask or blow-by as tolerated.
2. Monitor Pulse Oximetry.

Front 117

Pediatric Allergic Reaction:

-What steps should you take in treating a pediatric patient with an allergic reaction?

Back 117

1. Assess Circulation and Perfusion.
2. Establish IV Normal Saline and 20ml/kg bolus as needed.
3. Begin Cardiac Monitoring, record, and evaluate EKG strip.
4. Expose the patient only as necessary to perform further assessments.
5. Maintain the patient’s body temperature throughout the examination.

Front 118

Pediatric Allergic Reaction:

-What medications can an EMT-I administer to a pediatric pt w/ allergic reaction?

Back 118

- Epi Auto Injector 0.15cc - Adult & Pedi IM 1:1000.

-May repeat after 10 minutes with Medical Control Orders.

Front 119

Pediatric Allergic Reaction:
What 3 medications are generally given by a paramedic to a pediatric with an allergic reaction?

Back 119

Epinephrine
Benadryl
Solu-Medrol

Front 120

Pediatric Allergic Reaction:

-Paramedic - what is the dose of Epi that can be administered?

Back 120

Administer Epinephrine 0.01mg/kg (1:1,000) IM
1. Massage injection site vigorously for 30-60 sec.
2. If intubated, administer Epinephrine 0.1mg/kg (1:1,000) ETT.

Front 121

Pediatric Allergic Reaction:

-Paramedic - What is the dose of Benadryl that can be administered?

-What can be administered after Benadryl?

Back 121

-Benadryl 1mg/kg
-(MAX. Individual dose - 50mg) IV or DEEP IM.

-Solu-Medrol 1 mg/kg or up to 125 mg Slow IVP

Front 122

Pediatric Allergic Reaction:

-If bronchospasm is present in a patient with adequate ventilation, you should administer what?

Back 122

-Albuterol 5.0mg & Atrovent 0.5 mg via Nebulizer
-Over 10-15 minutes.
-May Repeat x 1.

Front 123

Pediatric Seizures:

-What steps should be taken to treat the patient?

Back 123

A) LOC and ABC’s
B) Perform glucose check.
C) Begin Cardiac Monitoring, record, and evaluate EKG strip.
D) Establish IV Normal Saline / INT
E) Obtain focused history:
F) Perform auxiliary temperature check.

Front 124

Pediatric Seizure:

-When is it ok to obtain an IO on a Seizing Patient?

Back 124

-Nasal Versed does not control the seizure activity.

-Patient is HYPOXIC, less than 6 years old and IV access can not be obtained

Front 125

Pediatric Seizures:
if a pediatric patients temperature is greater than 102 degrees, you should administer what?

Back 125

Acetaminophen (Tylenol) - 15 mg/kg PO if patient is awake and cooperative.

Front 126

What should you do for evidence of fever in a Seizing patient?

-What is the Initial Care?

Back 126

For evidence of fever, remove excessive clothing and begin gradual cooling. Place moistened towels in axilla and groin but avoid excessive cooling and shivering.

Front 127

Pediatric Seizures: (STATUS EPILEPTICUS)

-Paramedic Function - If the pt has 2 or more seizures WITHOUT a lucid interval or continuous seizure lasting greater than 5 minutes, what should you give?

Back 127

-Administer Ativan 0.1 mg/kg slow IV push
-(Up to 2 mg.)
- If seizures persist, administer Ativan 0.1mg/kg slow IV push up to 2mg

Front 128

Pediatric Seizures:
Paramedic Function - What is the administration procedure of medication if NO IV is established?

Back 128

Load syringe with appropriate milliliter volume of Versed (use only 5 mg/ml concentration) and attach MAD Nasal Atomizer. Administer Versed 0.2 mg/kg IN

Front 129

Pediatric Seizures:
Paramedic Function - How do you administer an MAD Nasal Atomizer of Versed?

Back 129

1) Place atomizer within the nostril and briskly compress syringe to administer 1/2 of the volume as atomized spray.

2) Remove and repeat in other nostril, so all the medication is administered.

3) If seizures persist 5 minutes after treating, consider repeating 1/2 dose of Versed either intranasally or intravenously.

Front 130

Pediatric Drug Overdose and Poisoning.

-What is the first thing you should do?

Back 130

Contact Poison Control (1-800-222-1222).

Front 131

Is it ok to expose a patient that is suspected of Child Abuse and/or Neglect?

-How should your treatment for this patient be performed?

Back 131

Only as necessary to perform assessments

-Treat obvious injuries

Front 132

Suspected Child Abuse and Neglect:

-Physical abuse and neglect is often difficult to determined. You should do what to treat the patent?

Back 132

Note and document unexplained injuries, discrepant history, delays in seeking medical care, and repeated episodes of suspicious injuries.

Front 133

Suspected Child Abuse and Neglect:

-What are the indicators of possible abused?

Back 133

1. Any obvious or suspected fracture in a child less than 2 years of age.
2. Injuries in various stages of healing, especially burns and bruises.
3. More injuries than are usually seen in other children of the same age.
4. Injuries scattered on many areas of the body.

Front 134

Suspected Child Abuse and Neglect:

-If abuse is suspected, who should you contact ?

Back 134

Contact a Medical Supervisor

Front 135

Suspected Child Abuse and Neglect:

-If a patient has not changed clothes, transport the child in clothes in which the child was assaulted.

-If clothes have been removed but unwashed, what do you do?

Back 135

Bring clothes and underwear with child in a PAPER BAG, (not plastic).

Do not delay transport to search for evidence.

Front 136

Suspected Child Abuse and Neglect:

-If a parent refuses to let you transport the child after treatment is given, what professional steps should you take?

Back 136

1. Remain at the scene and notify law enforcement.
2. Request law enforcement place the child in protective custody.
3. Contact Medical Control and advise Doctor of questionable injuries but DO NOT report CHILD ABUSE AND NEGLECT over the radio.

Front 137

Suspected Child Abuse and Neglect:

-ARE YOU ARE LEGALLY RESPONSIBLE for reporting your suspicions?

Back 137

YES

Front 138

Suspected Child Abuse and Neglect:

-While treating a patient with suspected abuse, you should document what?

Back 138

-Document any statement the child makes in the child’s own words.

-Document history, physical exam findings, environmental surroundings, and ED notification in the Patient Care Report.

Front 139

Pediatric Trauma and Management:

-The general approach to the pediatric trauma patient Is the same as for adult trauma. what does the approach include?

Back 139

-Cervical Spine Control
-ABCD
-Head-to-Toe Examination.

Front 140

Where should Pediatric Trauma Patient be transported and according to what guidelines?

Back 140

-Pediatric Trauma Patients should be transported to Pediatric Trauma Centers.
-Per Georgia Region III Guidelines.

Front 141

Scottish Rite does not accept patients with what type
of trauma?

Back 141

Thoracic trauma

Front 142

What are the 2 Metro Atlanta Pediatric trauma center?

Back 142

a. Children’s Healthcare of Atlanta at Egleston

b. Children’s Healthcare of Atlanta at Scottish Rite

Front 143

Pediatric Trauma and Management:

Cervical spine fractures are uncommon in children. What steps should be taken to treat a child with this condition?

Back 143

1. The cervical spine of the pediatric patient is best immobilized with the Pediatric Immobilization Device (PID). You must fill all void spaces to secure the cervical alignment.
2. The cervical spine of the awake, frightened toddler, must be immobilized with great care to avoid further damage resulting from the child’s resistance to the procedure.
3. If the mechanism of injury meets any criteria listed in Section 814.001 the patient must be treated as having a suspected cervical injury and must be immobilized.
4. If an infant is stable and no cervical injury is suspected, the child may be transported in his/her car seat secured to the stretcher.

Front 144

What is the Age Limit for the usage of the Pediatric Field Triage Guide?

Back 144

Up to the 15th Birthday

Front 145

Section 814.001- Pediatric Field Triage Guide (up to the 15th birthday) - STEP 1 Consists of 16 different criteria. If yes to any of them, transport patient to a pediatric trauma center. Name these criteria.

-STEP 1

Back 145

A) Glascow Coma Scale (modified for pre-verbal children) less than 14
B) Systolic Blood Pressure Less Than 90
C) Respiratory Rate Less Than 10 or in distress
D) Pediatric Trauma Score Less Than 8
E) Need for any airway adjunct
F) Need for fluid resuscitation to support heart rate, peripheral perfusion and/or central pulses
G) Cardiac arrest or CPR performed prior to arrival with return of spontaneous circulation
H) All penetrating injuries to the head, neck, torso, and extremities proximal to elbow or knee
I) Open/Sucking chest wound
J) Combination trauma with burns
K) Two or more proximal long bone fractures
L) Pelvic Fractures
M) Open and depressed skull fractures
N) Spinal injury with paralysis or any neurologic deficit
O) Amputation proximal to wrist and ankle
P) Burns greater than 15% BSA or with airway involvement, greater than 20 minute transport time to Grady
**If answers to the above are no, go to SMO section 814.002 step 2

Front 146

Section 814.002 - Pediatric Field Triage Guide (up to the 15th birthday) STEP 2 consists of 16 different criteria. If yes to any of them contact PCT for on-line Medical Control and determination of destination.

-STEP 2

Back 146

A) Head injury with any loss or alteration of consciousness
B) Spinal injury with risk of paralysis or neurologic deficit
C) Blunt chest trauma with contusion or tenderness, or with potential for
D) Hemo/Pneumothorax
E) Blunt abdominal trauma with contusion, tenderness, or distention
F) De-gloving injury of extremity or laceration greater than 7cm
G) Penetrating wound involving joint and/or significant vascular injury
H) Ejection from automobile
I) Death in passenger compartment
J) Extrication time greater than 20 minutes
K) Falls greater than 20 feet
L) Rollover
M) High speed auto crash: initial speed greater than 40mph, major auto deformity greater than 20 inches
N) Passenger space intrusion greater than 12 inches
O) Auto-Pedestrian/auto-bicycle injury with significant impact greater than 20 mph
P) Motorcycle crash greater than 20 mph or with separation of rider from bike

Front 147

What are the Pediatric Field Triage Guide EXCEPTIONS?

Back 147

Presence of one of the following conditions requires transport to the nearest facility:

A) continuing cardiac arrest due to penetrating
trauma
B) continuing cardiac arrest due to blunt trauma
C) inability to establish patent airway
D) unstable blood pressure

Front 148

What are the steps to follow for Pediatric
Bradycardia ALS Care?

Back 148

Pediatric Bradycardia ALS Care
A) LOC and ABC’s
B) Manage Airway and Oxygen
C) IV/IO Normal Saline KVO
D) Begin Cardiac Monitoring, record, and evaluate EKG strip.
E) Evaluate for severe cardio-respiratory compromise.
F) Perform chest compressions, if despite oxygenation and ventilation heart rate remains less than 60/min. infant or child.
G) If asystole develops, see SMO Section 816.000
H) Consider treatment of specific cause if persists despite:
1. Adequate ventilation and oxygenation:
2. Hypoglycemia
3. Severe acidosis
4. Consider fluid challenge, NS 20cc/kg
I) Review history

Front 149

What medication should you administer for Pediatric Bradycardia ALS care and what dose?

Back 149

-Epinephrine 0.1ml/kg, 0.01mg/kg (1:10,000) IV/IO OR -

-Epinephrine 0.1ml/kg, 0.1mg/kg (1:1,000) ETT with 5ml flush.
-Repeat every 3-5 minutes

-Atropine 0.2ml/kg - (0.02mg/kg) - IV/IO OR Atropine 0.4ml/kg (0.04mg/kg) ETT with 5ml flush.
-Repeat every 3-5 minutes

-Atropine Minimum dose – 1ml (0.1mg) Atropine -Maximum dose – 5ml (0.5mg) for child and 10ml (1mg) for adolescent
-May repeat x 1

Front 150

You should consider treatment of specific cause, if what conditions should persist regarding ALS care?

Back 150

1. Adequate ventilation and oxygenation:
2. Hypoglycemia
3. Severe acidosis
4. Consider fluid challenge, NS 20cc/kg

Front 151

what steps would you take or treating Asystole / Pulseless electrical Activity?

Back 151

A) LOC and ABC’s
B) Manage Airway and Oxygen
C) Begin CPR, per ASHI Guidelines
D) Begin Cardiac Monitoring, record, and evaluate
EKG strip.
E) IV/IO Normal Saline KVO
*Consider Normal Saline 20cc/kg Bolus

Front 152

identify and treat the cause of Asystole/Pulseless electrical activity What steps ?

Back 152

1. Severe Hypoxemia- Oxygen / BVM
2. Severe Acidosis- Sodium Bicarb
3. Severe Hypovolemia- Fluids
4. Tension Pneumothorax - Decompress
5. Profound Hypothermia - Rewarm
6. Cardiac Tamponade - Pericardiocentesis

Front 153

What medications are give for a patient with Asystole?

Back 153

Epinephrine 0.01mg/kg (1:10,000) IV/IO OR

-ETT -First Dose Epinephrine 0.1ml/kg, 0.1mg/kg (1:1,000) ETT with 5ml flush.

Front 154

Pedi Asystole/PEA:

What is the second & subsequent dose of Epinephrine?

Back 154

Second and subsequent doses Epinephrine 0.1ml/kg, 0.1mg/kg (1:1,000) IV/IO or ETT with 5ml flush.

• Repeat every 3-5 minutes

Front 155

What are the steps in Managing and Treatment of Pediatric VFIB and Pulseless VTAC?

Back 155

A) LOC and ABC’s
B) Manage Airway and Oxygen
C) CPR for 2 minutes
D) Begin Cardiac Monitoring, record, & evaluate
EKG strip.
E) Defibrillate at 2 joules/kg
F) CPR for 2 minutes
G) Pulse check
H) IV/IO Normal Saline KVO
I) Epinephrine 0.1ml/kg, 0.01mg/kg (1:10,000)
IV/IO OR
J) Epinephrine 0.1ml/kg, 0.1mg/kg (1:1,000) ETT
with 5ml flush
• Repeat every 3-5 minutes
K) Defibrillate at 4 joules/kg
L) Cordarone 5 mg/kg IV/IO with 300 mg maximum
M) Continue CPR
N) Defibrillate at 4 joules/kg
O) Epinephrine 0.1ml/kg, 0.01mg/kg (1:10,000) IV/IO
P) Continue CPR
Q) Defibrillate at 4 joules/kg
R) Cordarone 2.5mg/kg IV/IO with 150mg
maximum
S) Continue CPR
T) Defibrillate at 4 joules/kg
U) Epinephrine 0.1ml/kg, 0.01mg/kg (1:10,000) IV/IO
V) Continue CPR
W) Defibrillate at 4 joules/kg
X) Consider other Anti-Fibrillatory Measures:
(Lidocaine 1mg/kg)

Front 156

In Pediatric Nausea/Vomiting:

-If breathing is adequate what should be done?

Back 156

• Provide Oxygen as needed.
1. Use a NRB mask or blow-by as tolerated.
2. Monitor Pulse Oximetry.

Front 157

After providing treatment for adequate breathing what should the next 7 steps taken in treating
Pediatric Nausea/vomiting?

Back 157

1 Assess circulation and perfusion.
2 Establish IV Normal Saline and 20ml/kg bolus as
needed.
3 Begin Cardiac Monitoring, record, and evaluate
EKG strip.
4 Expose the patient only as necessary to perform
further assessments.
5 Maintain the patient’s body temperature
throughout the examination.
6 Perform glucose check.
7 Consider causes

Front 158

what can a paramedic administer to a Pediatric Patient who is experiencing Nausea/Vomiting?

Back 158

-For cases of severe Nausea/Vomiting with patient’s ≥ 2 years of age:

-Administer 0.1mg/kg Zofran IVP (max dose 4mg).

Front 159

What can the **MEDICAL CONTROL** advise you to administer to a patient less than 2 years old?

Back 159

Zofran Administration for patients < 2 yrs. Old.

Front 160

When establishing an IV on a pediatric patient under the age of 8 you must utilize a ____________.
A. 60 gtts set
B. Solu-Set
C. pressure infusion bag
D. 22 or 24 gauge needle

SMO 801.000 D3

Back 160

B. Solu-Set

Front 161

What is the proper mixture for Dextrose 10%?

A. 10 mL D50 with 20 mL NS
B. 10 mL D50 with 10 mL NS
C. 8 mL D50 with 2 mL NS
D. 2 mL D50 with 8 mL NS

SMO 803.000 E1

Back 161

D. 2 mL D50 with 8 mL NS

-Use a flush and spray out 2 ml of Saline; you should then fill up that remaining 2 ml with D50

Front 162

What is the pediatric dose for Narcan?

A. 0.1 mg/kg
B. 0.2 mg/kg
C. 1 mg/kg
D. 2 mg/kg

SMO 803.000 I

Back 162

A. 0.1 mg/kg

Front 163

What are the four ways to determine ETT size in a pediatric patient?

_
_
_
_
SMO 806.002 B

Back 163

-Age + 16 / 4
-Broselow Tape
-Nare Size
-Pinky Size

Front 164

What is the max dose of Narcan in a child less than 2 years old?

A. 1 mg
B. 2 mg
C. 3 mg/kg
D. 0.4 mg

SMO 806.002 G

Back 164

A. 1 mg

Front 165

When performing SAI on the pediatric patient you must pre-treat with Atropine at what dose?

A. 0.5 mg/kg
B. 0.01 mg/kg
C. 0.02 mg/kg
D. 0.75 mg/kg

SMO 806.003 B1

Back 165

C. 0.02 mg/kg

Front 166

What is your treatment for a patient suffering from severe croup?

A. 1 mg/kg Benadryl IV
B. 1 mg/k Solu Medrol IV
C. 0.5 mg Aerosolized Epinephrine 1:10,000
D. 0.5 mg Aerosolized Epinephrine 1:1,000

SMO 807.000

Back 166

C. 0.5 mg Aerosolized Epinephrine 1:10,000

Front 167

What is the dose of Albuterol for a 10 YOM asthma patient?

A. 1 mg/kg
B. 0.5 mg/kg
C. 2.5 mg
D. 5 mg

SMO 808.000 D1

Back 167

D. 5 mg

Front 168

You are on scene with a 6 YOF patient suffering from an allergic reaction from a bee sting. After establishing an IV, what is the dose of Benadryl you would administer?

A. 0.5 mg/kg
B. 1 mg/kg
C. 25 mg
D. call medical control

SMO 809.000 J

Back 168

B. 1 mg/kg

Front 169

You are on scene with a 3 YOM patient with an axillary temperature of 104˚F. What is the dose of Acetaminophen you would administer this patient?

A. 1 mg/kg
B. 5 mg/kg
C. 10 mg/kg
D. 15 mg/kg

SMO 810.000 G

Back 169

D. 15 mg/kg

-325 mg in 10.15 ml
-325 / 10.15 = 32mg's per 1 mL

-Example:
-Pt weighs 25 lbs = 11.4 Kg's
-15 x 11.4 = 171 mg's needed
- 171 / 32 = 5.3 mL's Administered

Front 170

You are on scene with an 8 YOF patient suffering from recurrent seizures. You are unable to establish IV or IO access. What drug would administer and at what dose Intra Nasal?

A. Versed 0.2 mg/kg
B. Tylenol 10 mg/kg
C. Ativan 0.1 mg/kg
D. none of the above

SMO 810.000 H4

Back 170

A. Versed 0.2 mg/kg

Front 171

Does Scottish Rite accept patients with thoracic trauma? If Not, Why???

A. Yes
B. No

SMO 813.000 B

Back 171

B. They don't accept Thoracic Trauma Patients

-They ARE NOT the Designated Pedi Hospital in Metro Atlanta

Front 172

Does Egleston accept patients with thoracic trauma? If no, why???

A. Yes
B. No

Back 172

A. Yes

-Egleston will accept all patients, because THEY ARE THE DESIGNATED PEDI TRAUMA HOSPITAL IN METRO ATLANTA.

Front 173

The Pediatric Field Triage Guide is valid up to the pediatric patient’s____________ birthday.

A. 15th
B. 16th
C. 17th
D. 18th

SMO 814.001

Back 173

A. 15th

Front 174

You are working a 4 YOM in cardiac arrest. The patient is on the cardiac monitor showing asystole. CPR is in progress and ventilations are being performed. IO access is established. What is your dose of Epinephrine 1:10,000?

A. 0.2 mg/kg
B. 0.02 mg/kg
C. 0.1 mg/kg
D. 0.01 mg/kg

SMO 816.000 G

Back 174

D. 0.01 mg/kg of 1:10,000 Epi

Front 175

You are working a pediatric arrest on a 7 YOF that weighs 50 pounds. You note the cardiac monitor is showing V-Fib. Your partner placed the pads on the patient. How many joules do you defibrillate for your initial shock?

A. 50
B. 45
C. 120
D. 90

SMO 817.000 E

Back 175

-Dose of Joules = 2 joules/kg #1
-Dose of Joules = 4 joules/kg #2,3,4…
-50 lbs = 22.5 kg's
Dose

Front 176

What is the dose of Cordarone in a pediatric patient showing pulseless V-Tach on the monitor.

A. 1 mg/kg
B. 2 mg/kg
C. 5 mg/kg
D. 150 mg

SMO 817.000 L

Back 176

C. 5 mg/kg

Front 177

You are working a pediatric arrest showing PEA on the monitor at a rate of 70 bpm. What is your dose of Atropine?

A. 1 mg
B. 0.02 mg/kg
C. 0.01 mg/kg
D. you do not administer Atropine in pediatric PEA

SMO 816.000

Back 177

B. 0.02 mg/kg

Front 178

You have gained IV access in a 10 YOM patient suffering from recurrent seizures. What medication and dose are you going to administer?

A. Ativan 0.1 mg/kg SIVP
B. Versed 0.1 mg/kg IN
C. Ativan 0.1 mg/kg RIVP
D. Ativan 0.2 mg/kg SIVP

SMO 810.000 H1

Back 178

A. Ativan 0.1 mg/kg SIVP

Front 179

You have a 6 YOF patient suffering from a moderate case of croup. What is your first-line treatment?

A. 5 mL Aerosolized Epinephrine 1:10,000
B. 6 mL Aerosolized Normal Saline
C. 5 mL Aerosolized Epinephrine 1:1,000
D. 0.01 mg/kg Epinephrine 1:1,000 IM

SMO 807.000 B

Back 179

B. 6 mL Aerosolized Normal Saline

Front 180

You are on scene with a 7 YOM patient suffering from low blood sugar. He exhibits an altered mental status with a D-stick of 32. You are able to obtain IV access. What would your most appropriate medication be?

A. 5 mL/kg D10
B. 2 mL/kg D25
C. 1 mL/kg D50
D. 0.1 mg/kg Glucagon

SMO 803.000 E

Back 180

B. 2 mL/kg D25

Front 181

ETT depth is calculated by multiplying the tube length by_____________.
A. 1
B. 2
C. 3
D. 4

SMO 806.002 B2

Back 181

C. 3

Front 182

Personnel must receive orders from Medical Control for needle cricothyroidotomy.

A. True
B. False

SMO 806.002 E2

Back 182

A. True

Front 183

The ideal end-tidal CO2 readings for an intubated pediatric patient are between __________and__________.

A. 35-50
B. 30-40
C. 25-45
D. 35-45

SMO 806.002 C3

Back 183

D. 35-45

Front 184

. If you transport a pediatric to the hospital who is the first person you should notify if you suspect child abuse?

A. ER nurse
B. TAC 2 operator
C. MS officer
D. the parent

SMO 812.000 G3

Back 184

A. ER nurse

Front 185

Perform chest compressions, if despite oxygenation and ventilation heart rate remains less than _________ bpm in infant or child.

A. 100
B. 60
C. 120
D. 80

SMO 815.000 F

Back 185

B. 60

Front 186

Fill in the blanks for traumatic pediatric SAI patient.

Atropine ________mg/kg if <2 y/o
Given_________minutes prior to intubation
Minimum dose __________mg

___________1 mg/kg – IVP/IO
Given 2 minutes prior to intubation and can be given at the same time as Atropine

Fentanyl __________mcg/kg- IVP/IO

________________0.3 mg/kg SIVP/IO

Post Intubation sedation (hemodynamic stable)
0.1 mg/kg __________IVP/IO X 1 dose

What should you do for Post Intubation sedation (hemodynamic unstable)?

SMO 806.003

Back 186

-0.02 mg/kg
-2 minutes
-0.01 mg
-Lidocaine
-2 Mcg/kg
-Etomidate
-Versed
-Contact Med Control

Front 187

What are the components of the Pediatric Trauma Score?

Back 187

-Weight
-Airway
-Systolic B/P
-Level of Consciousness
-Open Wounds
-Fractures

Front 188

Pediatric Trauma Score

How would you get a +2 in the Weight Category?

Back 188

> 20 kg or ( > 44lb)

Same thing

Front 189

Pediatric Trauma Score

How would you get a +1 in the Weight Category?

Back 189

10 - 20 kg or (22 - 44 lbs)

Same thing

Front 190

Pediatric Trauma Score

How would you get a -1 in the Weight Category?

Back 190

< 10 kg or (<22 lbs)

Same thing

Front 191

Pediatric Trauma Score

How would you get a +2 in the Airway Category?

Back 191

Normal Airway

Front 192

Pediatric Trauma Score

How would you get a +1 in the Airway Category?

Back 192

Assisted Airway or Breathing

Front 193

Pediatric Trauma Score

How would you get a -1 in the Airway Category?

Back 193

Advanced Airway

Front 194

Pediatric Trauma Score

How would you get a +2 in the Systolic B/P Category?

Back 194

>90 mm Hg

-Good peripheral pulses and perfusion

Front 195

Pediatric Trauma Score

How would you get a +1 in the Systolic B/P Category?

Back 195

-50-90 mmHg

-Central pulses present
-Peripheral pulses thready or absent

Front 196

Pediatric Trauma Score

How would you get a -1 in the Systolic B/P Category?

Back 196

<50mmHg

-Thready to absent central pulses

Front 197

Pediatric Trauma Score

How would you get a +2 in the Level of Consciousness Category?

Back 197

Awake, alert

-Peds GCS = 15

Front 198

Pediatric Trauma Score

How would you get a +1 in the Level of Consciousness Category?

Back 198

-Less than fully awake, but not comatose

-Peds GCS = 9-14

-Any History of LOC

Front 199

Pediatric Trauma Score

How would you get a -1 in the Level of Consciousness Category?

Back 199

Comatose

-Peds GCS <8

Front 200

Pediatric Trauma Score

How would you get a +2 in the Open Wounds Category?

Back 200

None

Front 201

Pediatric Trauma Score

How would you get a +1 in the Open Wounds Category?

Back 201

-Contusions
-Abrasions
-Lacerations <7cm

Front 202

Pediatric Trauma Score

How would you get a -1 in the Open Wounds Category?

Back 202

Tissue loss, exposed, muscle/fascia or any penetrating injury.

Front 203

Pediatric Trauma Score

How would you get a +2 in the Fractures Category?

Back 203

None

Front 204

Pediatric Trauma Score

How would you get a +2 in the Fractures Category?

Back 204

Single Closed Fracture

Front 205

Pediatric Trauma Score

How would you get a +2 in the Fractures Category?

Back 205

Open and/or MULTIPLE

Front 206

On the Pediatric Pain Score (Smiley Faces - Wong Baker Scale) -

-What do each of the values represent?

Back 206

0- NO HURT
2- HURTS A LITTLE BIT
4- HURTS LITTLE MORE
6- HURTS EVEN MORE
8- HURTS WHOLE LOT
10- HURTS WORST