In transporting a critically ill neonatal or pediatric patient, the priority of care should be
A. Airway management
B. Neuroprotection
C. Thermoregulation
A
Which of the following is the most common symptomatic cardiac dysrhythmia observed in infants and young children?
A. SVT
B. 3rd degree block
C. Ventricular fibrillation
A
Monitoring every 5-10 minutes, both visually and by palpation, is recommend for an intraosseous infusion site in order to:
A. Confirm the medication being administered is being absorbed
B. Detect signs of extravasation that could lead to compartment syndrome
C. Identify any signs of bruising developing around the growth plate region
B
Maintaining appropriate temperature is particularly important in the pediatric/neonatal patient because of a predisposition to heat loss due to:
A. Increased norepinephrine production
B. Large body surface area to weight ratio
C. Rapid depletion of fat stores
B
In infants and children, the major cause of bronchiolitis is:
A. Asthma
B. Croup
C. RSV
C
To minimize the adverse effects of vibration during ground or air transport, an important intervention would be to:
A. Apply and maintain restraints properly
B. Assure adequate hydration
C. Use noise cancelling headset for patient
A
Increasing altitude in a pressurized aircraft predisposes the transport patient to:
A. Cardiac decompensation
B. Dehydration
C. Venous stasis
B
Disturbances in the middle ear during air transport are most likely a result of changes in:
A. Barometric pressure
B. Fluid dynamics
C. Gravitational forces
A
In neonates and children, a sign often noted in the early stages of compensated shock is:
A. Lethargy
B. Metabolic acidosis
C. Tachycardia
C
Diffuse opacity with air bronchograms on a CXR is a classic finding of:
A. Early CF
B. Neonatal RDS
C. Pneumonia on a 2yo
B
Increased intrathoracic pressure secondary to overzealous BMV contributes to:
A. A reduction in cardiac output (Q)
B. Increased PVR
C. Spikes in cerebral blood flow
A
With return of ROSC following resuscitation of the pediatric patient, it is recommended that the oxyhemoglobin saturation be:
A. Accepted at 90% in order to avoid hyperoxemia
B. Maintained at 100% to avoid hypoxemia
C. Targeted for less than 100% but at least 94%
C
A 34wk preterm neonate currently being maintained on conventional ventilation following vigorous resuscitation efforts at birth is being referred to a tertiary center. The team notes stable vital signs and lab findings at time of departure. Approx 15 min into ground transport, the neo becomes irritable and experiences sudden drop in HR and onset of cyanosis. Equipment function and presence of ETCO2 is confirmed. Based on history and clinical findings, the neonate’s current status is indicative of:
A. Developing tension pneumo
B. Partial plugging of the ETT
C. Worsening of underlying respiratory condition
A
A 2 day old neonate is referred to tertiary center for follow up of persistent bile-stained vomiting and minimal passage of meconium stool. Abdominal XR shows double bubble sign. In addition to need for stabilization based on GI obstruction, team will be aware of the need to:
A. Admit directly to OR for emergency surgery
B. Assess for signs of other congenital abnormalities
C. Prepare for possible emergent paracentesis
B
An 8 yo child has recently experienced unexplained weight loss and moderate fatigue without medical follow up. Child is vomiting and lethargic. He then faints and can’t be easily awakened and seems confused. The child is taken to local ER and based on assessment prepared to transfer to center 100 miles away. Based on history, the team’s interventions should focus on:
A. Development of progressive DKA
B. Enlargement of a space-occupying lesion
C. Infection of West Nile virus
A
Antiarrhythmic of choice for Torsades de Pointes?
Magnesium
Which drugs may be given via ETT in a pediatric code?
A. epi, atropine, lidocaine, and narcan
B. vaso, atropine, lidocaine, and narcan
c. epi, atropine, amiodarone, and narcan
D. adenosine, atropine, lidocaine and narcan
A
At what age are pathways for metabolizing morphine mature?
A. 6 months
B. 5 months
C. 3 months
D. 2 months
A
Why is etomidate preferred?
Neuroprotectant
Versed causes:
Tremors
What other medication would you give with vec?
Fentanyl
Baby goes home and comes in sick - has a coarc; what is first line of tx?
Start PGE
A pediatric patient sustained a pelvic fracture. What is the most likely secondary complication associated with this?
Retroperitoneal hemorrhage
