ethic/palliative

Question 1

Boy with CP was in a motor vehicle accident and has had a GCS of 4 for the last week. Parents want to withdraw. What do you do?

a. Consult ethics
b. Call CAS
c. Withdraw if the parents are reasonable and understand the situation

Answer 1

Withdraw if the parents are reasonable and understand the situation

Question 2

Criteria for brain death?
1-EEG (ancillary testing)
2-Two examiners 24 hours apart
3-No response to hypercapnea test

Answer 2

hypercapnea test

EEG (ancillary testing)
Two examiners 24 hours apart (not necessary if have ancillary or if >1mo old)
No response to hypercapnea test

criteria-

1) physiolical normal parameters (normotensive, normothermic)
2) coma (no purseposful, except spinal reflex)
30) absent brain stem pupilary, gag, corneal, vestibule/ocular)
4) apnea - no resp with PaC03>60/>20 from baseline

Question 3

Baby born at 42 weeks after placental abruption, asystolic since birth and ongoing appropriate resus. After how long can you stop resuscitating?
15 minutes
10 minutes
20 minutes
30 minutes

Answer 3

10 minutes

Question 4

What size does a child need to be to switch from a booster seat to a normal seat belt?

a. 18 kg, 120 cm
b. 36 kg, 120 cm
c. 36kg, 145 cm
d. 45 kg, 150 cm

Answer 4

36kg -145cm
Children must ride in a car seat until they are a minimum of 5 years old or more than 40 lb (18 kg). Children 8 years old and under must ride in a booster seat until they are at least 4 feet 9 inches (145 cm) tall or 80 lb (36 kg).

Question 5

A 14y boy presents with his third relapse of ALL. An experimental form of chemotherapy is proposed as a potential treatment. He refuses the treatment. Which is true?

a. He can refuse the treatment if he is deemed capable
b. Treatment must proceed
c. Parents should decide if treatment should proceed
d. An ethics committee should decide if treatment should proceed

Answer 5

He can refuse the treatment if he is deemed capable

Question 6

Boy involved in MVA intubated. Pedestrian killed. EtOH smell. Police asked you for alcohol levels report

a) give it to them
b) ask for a warrant
c) Call CMPA
d) Call CAS

Answer 6

b) ask for a warrant

Question 7

Age of consent to sexual activity (non-coercive); oldest individual a 13 year-old child can have consenting sex with? [from Canadian Department of Justice Website]

Answer 7

AGE OF CONSENT:
Non-exploitative sexual activity: 16 years
Exploitative sexual activity: 18 years
• Exploitation: child pornography, trade sex for money, drugs, food, etc

“Close in age” exception:
12 - 13yr olds can consent if partner ≤2yrs older
14 - 15yr olds can consent if partner ≤5yrs older

NB. Does not apply to relationship of trust (e.g. coach)