Module 27: Special Patient Populations

Question 1

Describe the timeline for the following stages of development
infancy
toddler
preschool-age
school-age
adolescent

Answer 1

infancy: first year of life
toddler: 1 to 3 years
preschool-age: 3 to 6 years
school-age: 6 to 12 years
adolescent: 12 to 18 years

Question 2

Describe differences in pediatric respiratory system

Answer 2

occiput larger (back of head)
airway less deeply curved
tongue proportionally larger
airways is smaller and not developed
diaphragmatic breathers

Question 3

If children are breathing on their own, an EMT should look at their _____. If pediatric patients are being ventilated, EMTs should watch their _____.

Answer 3

belly
chest

Question 4

Pediatric patients are rate dependent, meaning…

Answer 4

they have a higher heart rate than adults

Question 5

Children are more likely to have ____ and ____ fractures

Answer 5

greenstick and growth plate

Question 6

TorF: Children have thinner skin and less subcutaneous fat

Answer 6

True

Question 7

What layer of skin absorbs trauma?

Answer 7

dermis

Question 8

Describe the ABCs of the pediatric assessment triangle.

Answer 8

Appearance
Work of breathing
Circulation to skin

Question 9

CRT should be obsessed up until age of

Answer 9

five

Question 10

CPR should begin if children’s HR is less than ___bpm

Answer 10

60

Question 11

TorF: When looking at breathing, EMTs should make sure the child’s shirt is off

Answer 11

True

Question 12

What are some additional questions an EMT should ask caregivers of pediatric patients?

Answer 12

change in bowel/bladder habits
vomiting, diarrhea, abdominal pain
rashes

Question 13

TorF: BP should be taken on patients one year and older

Answer 13

False, three years and above is the limit

Question 14

What is a good systolic BP for a child?

Answer 14

70 + (2 x child’s age)

Question 15

How does stridor differ from wheezing?

Answer 15

Stridor: upper airway, inhalation
Wheezing: lower airway, exhalation

Question 16

Your pediatric pt presents with swelling in the upper airway and inspiratory stridor. Should you administer albuterol?

Answer 16

No, that is only for wheezing which is expiratory and in the lower airway. You can try to put in position of comfort and humidified oxygen.

Question 17

How do epiglottitis and croup differ?

Answer 17

NOTE: BOTH HAVE STRIDOR

epiglottitis: bacterial, fever, inflammation of epiglottis, pt often drools because they can’t swallow

Croup: viral, inflammation of upper airway, seal-bark cough

Question 18

TorF: If a pt with RSV is wheezing, you can treat with a bronchodilator like albuterol

Answer 18

true

Question 19

TorF: dehydration is a common symptom of pertussis

Answer 19

true

Question 20

Describe the state of the pop-off valve when using a BVM

Answer 20

the pop-off valve should be disengaged when using a BVM

Question 21

Over ventilation in pediatric pts can cause

Answer 21

barotrauma and gastric distention

Question 22

What is meningitis? What are the signs and symptoms of meningitis?

Answer 22

Inflammation of meninges
fever
neck stiffness
inability to look at light

Question 23

If a pediatric pt is suffering from a febrile seizure, is it appropriate to remove their clothes?

Answer 23

Yes, EMTs should attempt to get the heat off them (no ice packs)

Question 24

What are the maternal risk factors of SIDS?

Answer 24

younger than 20
smokes cigarettes
uses drugs/alcohol
inadequate prenatal care

Question 25

Name other, non-maternal risk factors for SIDS?

Answer 25

sleeping on stomach/side
sleeping on soft surface
sharing a bed

Question 26

What are ALTE/BRUEs? Describe what they look like

Answer 26

ALTE: apparent life-threatening event
BRUE: Brief Resolved Unexplained Events
Apnea
Skin color change
Marked change in muscle tone (went limp)
Choking or gagging not associated w FBAO
seizure-like activity

Question 27

How do atherosclerosis and arteriosclerosis differ?

Answer 27

atherosclerosis: FATherosclerosis, buildup of fat
Arterioscleorsis: Layers of artery harden, risk of aneurysm

Question 28

TorF: When presented with a DNR/MOLST/DNR bracelet before examining pt, an EMT can cease treatment

Answer 28

FALSE. EMT must examine pt to determine cardiac arrest (pulseless and apneic).

Question 29

TorF: Autistic people and people with cerebral palsy have a higher risk of epilepsy

Answer 29

true

Question 30

Describe the anatomical differences in patients with down syndrome

Answer 30

Round head with flat occiput, large tongues with smaller jaw. This makes it difficult to open airway and EMT may have to use jaw thrust rather than head-tilt chin-lift

Question 31

Can you use suction on any mucus in a tracheotomy?

Answer 31

Yes, but use soft suction, do not deeply penetrate opening

Question 32

Can you use a BVM on a patient with a ventilator on their tracheostomy?

Answer 32

Yes, if the ventilator is needs to be detached or is not broken

Question 33

Compare subclavian to PICC lanes

Answer 33

The subclavian line goes into the IVC, common in interfacility transport. Biggest risk is infection.

Picc lines are typically in upper arm. Goes into SVC.

Question 34

What device is placed directly into the stomach to feed patients?

Answer 34

gastrostomy tube

Question 35

When a small child falls from a significant height, the ______ MOST often strikes the ground first.
feet
side
back
head

Answer 35

head

Question 36

You respond to a sick child late at night. The child appears very ill, has a high fever, and is drooling. He is sitting in a tripod position, struggling to breathe. You should suspect:
pneumonia
epiglottitis
croup
severe asthma

Answer 36

epiglottitis

Question 37

A 71-year-old man with a history of hypertension and vascular disease presents with tearing abdominal pain. His blood pressure is 80/60 mm Hg, his heart rate is 120 beats/min, and his respirations are 28 breaths/min. Your assessment reveals that his abdomen is rigid and distended. Considering his medical history and vital signs, you should be MOST suspicious for a(n):
acute MI
infarction of large intestine
aortic aneurysm
hemorrhagic stroke

Answer 37

aortic aneurysm