Nokea
A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child's age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury?
- A. Lower leg injury
- B. Head injury
- C. Upper thorax injury
- D. Pelvic injury
Correct Answer: D
Rationale: Given the mechanism of injury and the distance the child was thrown, a primary pelvic injury should be suspected due to the high impact and force. The pelvis is a common site for significant injury in such cases, and the distance the child was thrown indicates a high-energy impact that could lead to pelvic fractures or injuries.
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When performing CPR on an infant with suspected sudden infant death syndrome (SIDS), an important aspect to consider is:
- A. Focusing all of your attention on the infant, with minimal parental interaction.
- B. Carefully inspecting the environment in which the infant was found.
- C. Understanding that most infants with SIDS can be successfully resuscitated.
- D. Encouraging the presence of the parents during your resuscitation attempt.
Correct Answer: B
Rationale: When dealing with a suspected case of SIDS, it is crucial to carefully inspect the environment in which the infant was found. This inspection can provide valuable information that may help determine the cause and support further investigation into the incident. By examining the surroundings, potential hazards or clues related to the sudden event may be identified, aiding in understanding the circumstances and potentially preventing similar incidents in the future.
Which of the following is a sign of altered mental status in a small child?
- A. Fear of the EMT's presence.
- B. Recognition of the parents.
- C. Inattention to the EMT's presence.
- D. Consistent eye contact with the EMT.
Correct Answer: C
Rationale: Inattention to the EMT's presence is a sign of altered mental status in a small child. When a child is not responsive or does not acknowledge the presence of the EMT, it could indicate a change in their mental status. This lack of attention or awareness may signify a neurological issue or other medical condition affecting the child's cognitive function.
A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should:
- A. administer 1 g/kg of activated charcoal.
- B. give 15 mL of ipecac and contact medical control.
- C. contact poison control and give him oxygen.
- D. give oxygen and perform a head-to-toe exam.
Correct Answer: C
Rationale: When a child ingests a harmful substance like drain cleaner and remains alert with a patent airway and adequate breathing, the initial steps involve contacting poison control to guide further management. In this scenario, providing oxygen to support respiratory function is essential until definitive care is established. Activated charcoal and ipecac are not recommended in the management of ingested caustic substances like drain cleaner. Performing a head-to-toe exam can wait until the child's immediate respiratory needs are addressed and the poison control center has provided guidance on further management.
When is it MOST appropriate to clamp and cut the umbilical cord?
- A. Before the newborn has taken its first breath
- B. After the placenta has completely delivered
- C. As soon as the cord has stopped pulsating
- D. Immediately following delivery of the newborn
Correct Answer: C
Rationale: The ideal time to clamp and cut the umbilical cord is when it has stopped pulsating. This allows for the transfer of remaining blood from the placenta to the newborn, which can be beneficial for the baby's health and iron stores. Clamping the cord too early can deprive the newborn of this essential blood volume. Waiting for the pulsations to cease ensures that the baby receives the maximum benefits from delayed cord clamping.
Which of the following statements regarding two-rescuer child CPR is correct?
- A. The chest should be compressed with one hand, and a compression-to-ventilation ratio of 30:2 should be delivered.
- B. A compression-to-ventilation ratio of 15:2 should be delivered with pauses in compressions to give ventilations.
- C. The chest should be allowed to fully recoil between compressions to optimize venous return.
- D. Compress the chest with one or two hands to a depth equal to one third the diameter of the chest.
Correct Answer: D
Rationale: In two-rescuer child CPR, the correct compression depth is one third the diameter of the chest. This depth can be achieved by compressing the chest with one or two hands. It is crucial to follow the correct compression depth guideline to ensure effective chest compressions and circulation during CPR for a child.