Nokea
When inserting an oropharyngeal airway in a small child, what is the preferred method?
- A. Insert the airway with the curvature towards the roof of the mouth and then rotate it 180 degrees.
- B. Insert the airway as you would in an adult, but use an airway that is one size smaller than usual.
- C. Depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue.
- D. Open the airway with the tongue-jaw lift maneuver and insert the airway until slight resistance is met.
Correct Answer: C
Rationale: When inserting an oropharyngeal airway in a small child, it is crucial to depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. This technique helps in maintaining an open airway and preventing obstruction by the tongue. Placing the airway with the curve facing the roof of the mouth or using a smaller size is not recommended for small children, as it may not effectively keep the airway patent. The tongue-jaw lift maneuver is not the preferred method for inserting an oropharyngeal airway in small children.
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Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. In addition to administering high-flow oxygen, treatment should include:
- A. treating for shock and uterine massage during transport.
- B. uterine massage and transport.
- C. placing her on her left side and transport.
- D. internal vaginal pads and treating for shock during transport.
Correct Answer: A
Rationale: In this scenario, the mother is showing signs of postpartum hemorrhage with increased heart rate, diaphoresis, and mild vaginal bleeding. The correct approach involves treating for shock by addressing hypovolemia and providing uterine massage to help control bleeding. Administering high-flow oxygen is essential. Therefore, the most appropriate option is to treat for shock and perform uterine massage during transport to manage the postpartum hemorrhage effectively.
Physical abuse of a 4-year-old child should be suspected if you observe:
- A. purple and yellow bruises on the thighs.
- B. bruises on the anterior tibial area.
- C. the child clinging to his or her parent.
- D. curious siblings watching you.
Correct Answer: A
Rationale: Purple and yellow bruises on protected areas like the thighs are concerning as they indicate bruises in various stages of healing, which is a red flag for physical abuse. Bruises on the anterior tibial area or a child clinging to a parent are not specific signs of physical abuse. Siblings watching you is unrelated to the suspicion of physical abuse in this scenario.
A 3-year-old female presents with respiratory distress. She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves:
- A. gently restraining her and assisting with ventilations.
- B. ventilations with a flow-restricted, oxygen-powered device.
- C. a non-rebreathing mask with the flow rate set at 6 to 8 L/min.
- D. asking the mother to hold an oxygen mask near her face.
Correct Answer: C
Rationale: In a pediatric patient with respiratory distress, a non-rebreathing mask with a flow rate set at 6 to 8 L/min is the most effective way to deliver oxygen. This method ensures a high concentration of oxygen is delivered to the child, aiding in improving oxygen saturation levels. In this scenario, the mother can assist in holding the mask to maintain comfort and cooperation in the child while ensuring proper oxygen delivery.
When you attempt to assess a 22-year-old woman who has been sexually assaulted, she orders you not to touch her. Your MOST appropriate initial action should be to:
- A. obtain a signed refusal and return to service.
- B. transport the patient without performing an assessment.
- C. explain to the patient that she must be examined.
- D. ask a female EMT to attempt to assess the patient.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-old child?
- A. Capillary refill time
- B. Presence of peripheral pulses
- C. Skin color and temperature
- D. Systolic blood pressure
Correct Answer: D
Rationale: Systolic blood pressure is the least reliable parameter when assessing perfusion status in a 2-year-old child. In young children, blood pressure measurements can be variable, affected by factors like anxiety or crying. Capillary refill time, presence of peripheral pulses, and skin color and temperature are more reliable indicators of perfusion status in this age group.