AEMCA Pediatric Emergencies 3 — Questions and Answers
Question 1: A 9-month-old is brought in with sudden onset inconsolable crying, drawing up of the legs, and 'currant jelly' stools. What condition is most likely?
- Pyloric stenosis
- Intussusception (Correct answer)
- Mesenteric adenitis
- Hirschsprung's disease
Correct answer: Intussusception
Intussusception classically presents in infants with colicky abdominal pain, legs drawn to chest, and late-stage 'currant jelly' stools (blood mixed with mucus).
Question 2: When using a length-based resuscitation tape (Broselow tape) for a pediatric patient, what does the color zone primarily determine?
- Severity of illness and transport priority
- Estimated weight and appropriate drug doses and equipment sizes (Correct answer)
- Blood pressure range and IV fluid rate
- GCS score and neurological status
Correct answer: Estimated weight and appropriate drug doses and equipment sizes
The Broselow tape estimates a child's weight by length and provides color-coded drug dosages and equipment sizes to minimize medication errors during resuscitation.
Question 3: A 7-year-old with type 1 diabetes presents with confusion, diaphoresis, pallor, and a blood glucose of 38 mg/dL. The child is unable to swallow safely. What is the appropriate treatment?
- Give oral glucose gel between the cheek and gum
- Administer 25 mL of D50W IV
- Administer glucagon IM or intranasal dextrose gel rectally
- Administer 2–4 mL/kg of D25W IV or IO (Correct answer)
Correct answer: Administer 2–4 mL/kg of D25W IV or IO
For a pediatric patient unable to swallow, IV/IO dextrose is preferred; D25W at 2–4 mL/kg is the appropriate concentration for children to avoid hypertonicity.
Question 4: A 5-year-old presents with sudden onset of high fever, drooling, tripod positioning, and muffled voice. The child appears toxic. What should the AEMCA avoid doing?
- Providing supplemental oxygen via blow-by
- Allowing the child to remain in a position of comfort
- Performing direct visualization of the oropharynx with a tongue depressor (Correct answer)
- Transporting rapidly to an appropriate facility
Correct answer: Performing direct visualization of the oropharynx with a tongue depressor
In suspected epiglottitis, examining the oropharynx can precipitate complete airway obstruction; the child should be kept calm and transported immediately.
Question 5: What is the correct intraosseous (IO) needle placement site for a 2-year-old in cardiac arrest when IV access cannot be obtained?
- Distal femur, 3 cm above the lateral condyle
- Proximal tibia, 1–2 cm below the tibial tuberosity on the anteromedial surface (Correct answer)
- Iliac crest, posterior superior spine
- Humeral head, greater tubercle
Correct answer: Proximal tibia, 1–2 cm below the tibial tuberosity on the anteromedial surface
The proximal tibia (1–2 cm below the tibial tuberosity on the anteromedial flat surface) is the preferred first-line IO site in pediatric patients.
Question 6: A 3-year-old weighing approximately 15 kg requires epinephrine for anaphylaxis. What is the correct dose of 1:1,000 epinephrine administered IM?
- 0.01 mg/kg, maximum 0.15 mg (0.15 mL)
- 0.1 mg/kg, maximum 1.0 mg (1.0 mL)
- 0.5 mg fixed dose regardless of weight
- 0.01 mg/kg, maximum 0.5 mg (0.5 mL) (Correct answer)
Correct answer: 0.01 mg/kg, maximum 0.5 mg (0.5 mL)
Pediatric epinephrine for anaphylaxis is 0.01 mg/kg of 1:1,000 solution IM, with a maximum single dose of 0.5 mg.
Question 7: Which of the following is a normal respiratory rate for a 1-year-old child at rest?
- 12–20 breaths per minute
- 20–30 breaths per minute
- 25–50 breaths per minute (Correct answer)
- 60–80 breaths per minute
Correct answer: 25–50 breaths per minute
Normal resting respiratory rate for a 1-year-old is approximately 25–50 breaths per minute; rates vary by age and decrease as children grow.
AEMCA Pediatric Emergencies 3
A 9-month-old is brought in with sudden onset inconsolable crying, drawing up of the legs, and 'currant jelly' stools.
What condition is most likely?