ENPC Respiratory Emergencies Flashcards

A 3-year-old with severe croup (high Westley score) requires which treatment combination?

Answer: Racemic epinephrine nebulization plus dexamethasone with observation for rebound

Severe croup requires racemic epinephrine for immediate bronchodilation plus dexamethasone, with monitoring for rebound phenomenon.

When applying bag-mask ventilation to an infant, which technique is CORRECT?

Answer: Maintain the sniffing position with a neutral neck and create an airtight mask seal

The sniffing position aligns airway axes in older children, while a neutral neck position is optimal for infants, along with an airtight mask seal.

An asthmatic child in distress has a 'silent chest' on auscultation. This finding indicates:

Answer: Severe bronchospasm with minimal airflow, signaling impending respiratory failure

A silent chest in an asthmatic child means air movement is so severely reduced that wheezing cannot be generated, indicating critical obstruction.

Which capnography finding indicates hypoventilation in an intubated pediatric patient?

Answer: EtCO2 of 55 mmHg

An EtCO2 greater than 45 mmHg indicates CO2 retention and inadequate ventilation, requiring ventilator parameter adjustment.

A 7-year-old with severe pneumonia develops worsening hypoxemia and bilateral infiltrates. This presentation is consistent with:

Answer: Acute respiratory distress syndrome (ARDS)

Refractory hypoxemia with bilateral infiltrates following pneumonia in a child meets the criteria for pediatric ARDS.

For a child requiring RSI, which preoxygenation strategy is MOST effective?

Answer: High-flow non-rebreather mask at 15 L/min combined with apneic oxygenation via nasal cannula

High-flow non-rebreather mask combined with apneic nasal cannula oxygenation maximizes oxygen reserve and extends safe apnea time before RSI.