Med Emergencies
This color-coded tool is used to help prepare for a pediatric arrest coming to the ED.
Broselow tape
Based on the following pediatric assessment triangle findings, which patient will the triage nurse choose to triage first?
A). 2 year old lying quietly in her mother's arms. She is pale and there is little movement noted to extremities. Respirations are rapid and shallow.
B). 3 year old female, screaming loudly with a blood soaked paper towel dressing on her left middle finger. Skin color appears normal, and there is no obvious sign respiratory distress noted.
C). 14 year old with dry heaves. Color is pale and there is no increased work of breathing.
D). 1 year old wearing a blanket sleeper clinging to his mother's arm as she holds him on her hip. His face is flushed and breathing rapid with no other signs of increased work of breathing.
A. 2 year old lying quietly in her mother's arms
Most reliable method to obtain temp under age 3
What is a rectal temperature?
This quick tool is an "across the room assessment" with 3 components - Airway, Work of Breathing, Circulation
Pediatric Assessment Triangle
A 2 year old requires cerebrospinal fluid specimen collection. What is the safest position for this procedure?
Side lying with the head flexed forward and the knees drawn up to the abdomen
A six year old girl with a history of epilepsy presents limp in her father's arms with complaints of seizures. Her eyes are open with no response to verbal stimuli. What is the nurse's initial response?
Which of the following patients would be triaged at an urgent acuity level?
A. 2 year old complaining of joint pain with a temperature of 101 F
B. 3 year old with a temp of 102.4 and right ear pain; the child grabs on to his mother when examined
C. A 2 year old with a closed finger injury that is swollen and bruised
D. A 4 year old with a 1.2 inch laceration to the lower leg; bleeding is controlled
A. 2 year old complaining of joint pain with a temp of 101 F
Removing secretions from nose and airway
What is bulb suctioning?
Using the pediatric assessment triangle (PAT), which finding would the triage nurse use to determine the triage category?
A). 10 day old infant who is pale with mottled extremities
B). 2 year old with poor skin turgor
C). 3 month old with capillary refill of 4 seconds
D). 6 month old sitting calmly with a heart rate of 188 beats/minute
A). 10 day old infant who is pale with mottled extremities
A 5 year old male presents complaining of chest pain, rated 8 on the FACES pain rating scale. The vital signs are 97.8 F, HR 218 bpm, RR 24 breaths per minute, BP 105/64 mmHg, and SpO2 100%. What interventions should be performed first?
What is Vagal maneuvers
Racemic EPI
What is the treatment for croup?
The triage nurse has several patients present at the same time. Which patient is of the highest acuity and should be triaged first?
A). 2 year old with audible wheezing and mild retractions
B). 5 day old whose parents report a temperature of 36.0 (96.8 F)
C). 6 year old who swallowed a coin yesterday and has a history of sickle cell disease
D). 5 year old patient with a ventriculo-peritoneal (VP) shunt who has a forearm laceration
B). 5 day old with reported temperature of 36.0
pink, pale, mottled, dusky, gray, cyanotic
What is circulation on the PAT?
The following patients are assessed when walking into the ED, based on your assessment which patient is the highest priority:
A). 2 year old who is drooling and has positioned herself with her neck extended
B). 8 year old who is holding an obviously deformed arm close to his abdomen; he is sobbing and sniffling
C). 14 year old with red, flat, pinpoint lesions on her face; she is texting with her cell phone
D). 6 month old who is crying loudly and inconsolably and has a purple, blotchy face
A). 2 year old who is drooling and has positioned herself with her neck extended
A 5 year old with a history of anaphylaxis presents with acute onset of generalized hives, dyspnea, and bronchospasm. What is the first pharmacological intervention for this patient?
IM epinephrine
A 9 year old male presents to the ED with a chief complaint of fever that started this morning, severe sore throat, and difficulty swallowing. The nurse notes that the patient is leaning forward while sitting and drooling. What is the suspected diagnosis of this patient?
Epiglottitis
Which one of the following patients should be triaged and assessed first?
A). 10 year old with audible wheezing, moderate retractions, and initial oxygen saturation of 89%
B). 8 year old with a deformity to the forearm who is crying inconsolably and gripping the mother's hand
C). 12 year old with a penetrating abdominal injury who is crying and staring at her hands while holding her oxygen
D). 5 year old with a large hematoma on forehead, history of brief loss of consciousness, and who is talking to his father
A). 10 year old with audible wheezing, moderate retractions and initial oxygen saturation of 89%
Best place to give an infant/child an injection
What is the vastus lateralis aka thigh muscle?
Which breathing assessment would be noted using the pediatric assessment triangle (PAT)?
A. Patient's mother states patient has had a nonproductive cough for the past 2 weeks
B. Patient is sitting upright, leaning forward, using both arms to support herself
C. Wheezing auscultated in both lower lung fields
D. Pulse oximetry reading is 88% on room air
B. Patient sitting upright, leaning forward, using both arms to support herself
A 4 year old boy presents to the ED with new onset of diarrhea, vomiting and lethargy that developed after playing in the garage. Exam reveals T 98.6 F, HR 100 bpm, RR 30 breaths per minute and BP 100/60. He arouses to questions, has constricted pupils and is tearing and drooling profusely. What is the most likely cause of his symptoms?
What is insecticide poisoning
Epi, Benadryl, steroids
What are meds given for anaphylaxis?
Which of the following patients should be triaged next?
A). 3 year old boy who is holding his head in his hands; has dry, cracked lips; and is slightly pale
B). 3 year old girl who is crying intermittently but is otherwise content in her mother's arms, throwing her blanket on the floor
C). 4 year old boy talking to his parents with an occasional nonproductive cough and red cheeks
D). 2 year old girl asleep in her parent's arms with flushed cheeks and a sweaty forehead
A). 3 year old boy holding his head in his hands; has dry, cracked lips; and is slightly pale
A 4 month old infant is brought to the ED by her mother. Her mother reports fever at home of 102 immediately PTA and no medications were given. Her face is flushed. She is fully clothed and bundled up in a blanket. What is a non-pharmacological intervention can the nurse perform?
What is undress the infant?
Early signs and symptoms of increased intracranial pressure in a neonate with a fever being evaluated for suspected meningitis.
What is restlessness and inconsolability?
The nurse is assessing a 2 year old child who presents with a 1 week history of cold symptoms. During the assessment the nurse finds the patient is experiencing bradycardia episodes. Her current vital signs are 99 F, HR 63 bpm, RR 44 breaths per minute, SpO2 90%, and BP 92/63. What intervention will most likely correct the bradycardia?
Oxygen via non-rebreather mask at 100%