Pediatric Patients
What ages require pediatric AED pads?
<8
A patient is unresponsive with a strong pulse, slow respirations, pinpoint pupils, and cyanosis around the lips. You arrive with SPCs and a close friend of the patients says they are concerned about a possible opioid overdose. What is the immediate next step?
Code 3, AR
You respond to a 17 year-old that has fallen down 8 flights of stairs who is sitting against the wall when you arrive and complaining of delayed onset neck pain. Pt is GCS 15 with stable vitals. Can you rule-out c-spine? Why?
No. Dangerous mechanisms include fall from > 1m/5 stairs.
What exactly are you looking for when ocular tracking?
Unequal eye movement, inability to follow, abnormal jerking/nystagmus, worsening of Sx
What is Cushing's triad?
Increasing/widening BP, lowered heart rate, irregular and often deep breathing (Cheyne-Stokes respirations).
What are the indications for neonatal AR (+100) and CPR (+100)?
AR: ineffective gasping/apnea or HR in between 60 and 100
CPR: HR less than 60
You respond to someone complaining of a bad headache (6/10) and are requesting Tylenol. They have also recently gotten their wisdom teeth taken out. Does the Pt qualify for Tylenol administration?
Yes
What is the GCS: You respond to a patient that opens their eyes when you talk to them, is confused when answering questions but is able to follow commands.
E3 + V4 + M6 = 13
Explain orthostatic hypotension (Syncope calls)
Systolic drop of or more. Diastolic drop of 10 or more.
What are indications of sepsis?
Fever, hypotension, tachycardia (all or 2 w/ poor pt presentation)
CPR compression ratios for neonates, infants, and children for 1 person and 2 people?
1 person: neonates = 3:1, infants/children = 30:2
2 people: neonates = 3:1, infants/children = 15:2
If a Pt is under 35, what are the 2 things they need to meet to be considered for ASA administration?
Family history of MI or chronic/acute use of non-prescription sympathomimetic drugs
You respond to someone who passed out after exercising at the pulse. They seem to be dizzy and their skin appears to be red and flushed. AMPLE gives you nothing except, when asked about what they ate last they said they hadn’t eaten in a while and the last thing they ate was breakfast at a new restaurant they have not tried before. What are two things you should consider and rule out?
Metabolic syncope, anaphylaxis.
A patient appears intoxicated but has low BP, high HR, and pale/clammy skin. What else should you consider (what are these trends symbolic of)?
Any one of: Shock/poor perfusion, overdose, trauma, bleeding.
What are the classic triad of meningitis symptoms?
Stiff neck, high fever >38, altered LOC
How do the following vitals for peds compare to adults? HR, BP, Resp, Pupils, Temp (higher, lower, variable, similar)?
HR: Higher
BP: Lower
RR: Higher
Pupils: Variable
Temp: Similar
What category of emergency do you need to rule out for a patient you are giving zofran code?
Abdo: need to have a likely benign cause of nausea.
You respond to a female presenting patient complaining of abdominal pain, nausea, fatigue and a “fullness” sensation in the upper stomach. Upon visual inspection, you see some bloating. What can this be an indication of?
MI (soft signs include, unusual fatigue, shortness of breath, indigestion, LH/Dz, even without chest pain).
Explain when you would auscultate the Pt and what to look for (+100 if you demonstrate how).
Any breathing emergency. Assess lower respiratory symptoms. Listen for wheezing, crackles, decreased air entry, and equal air entry.
What are the concerning categories of syncopes?
Cardiac, metabolic, and neurological