Pediatric Emergencies Flashcards

A 10-year-old with Type 1 diabetes presents with Kussmaul respirations, fruity breath, blood glucose of 480 mg/dL, and pH 7.18. What is the priority treatment?

Answer: IV fluid resuscitation with normal saline followed by insulin infusion

Fluid resuscitation with NS is the first priority in pediatric DKA to correct dehydration and restore perfusion; insulin infusion is started after fluids.

What is the most common cause of cardiac arrest in pediatric patients?

Answer: Respiratory failure or shock leading to asystole

Unlike adults, pediatric cardiac arrests are rarely due to primary cardiac arrhythmia; they are most commonly caused by respiratory failure or shock that progresses to asystole.

A 7-year-old is in anaphylaxis with urticaria, stridor, and hypotension. What is the priority intervention?

Answer: Epinephrine 0.01 mg/kg IM (1:1000 solution) in the anterolateral thigh

Epinephrine IM is the only drug proven to reverse anaphylaxis and is the first-line treatment; all other medications are adjuncts.

Which size endotracheal tube is appropriate for a 5-year-old undergoing emergency intubation?

Answer: 4.5–5.0 mm cuffed or uncuffed

The formula (age/4 + 4) estimates uncuffed ETT size; for a 5-year-old, this gives 5.25, so a 4.5–5.0 mm tube is appropriate.

A 3-year-old presents with a temperature of 39.5°C, petechiae spreading rapidly, and altered mental status. What diagnosis requires immediate action?

Answer: Meningococcal septicemia

Rapidly spreading petechiae or purpura with fever and altered mental status is meningococcal septicemia until proven otherwise, requiring immediate IV ceftriaxone and ICU care.

Which intraosseous (IO) site is preferred in a child under 6 years of age requiring emergent vascular access?

Answer: Proximal tibia, 2 cm below the tibial tuberosity

The proximal tibia (2 cm below the tibial tuberosity on the flat anteromedial surface) is the preferred IO access site in children under 6 due to the flat, accessible bone surface.