Managing Respiratory Emergencies Flashcards

During bag-mask ventilation of a 4-year-old, you notice the abdomen is rising but the chest is not. What is the most likely problem?

Answer: Air is entering the stomach due to improper mask seal or head position

Abdominal rise during ventilation indicates gastric insufflation, caused by an inadequate mask seal, poor head positioning, or excessive ventilation pressure.

A child in respiratory distress suddenly becomes silent and limp with absent breath sounds on the right. What should you suspect?

Answer: Tension pneumothorax

Sudden silence, limpness, absent breath sounds on one side, and deterioration suggest tension pneumothorax requiring immediate needle decompression.

Which oxygen delivery device provides the highest concentration of oxygen for a spontaneously breathing pediatric patient in severe respiratory distress?

Answer: Nonrebreather mask at 10-15 L/min

A nonrebreather mask with flow rate of 10-15 L/min delivers approximately 95% FiO2, the highest concentration available for spontaneously breathing patients.

A 7-year-old with croup has moderate stridor at rest. After racemic epinephrine, symptoms improve. Why must this child be observed for at least 2-4 hours?

Answer: Rebound stridor may occur as epinephrine effect wears off

Racemic epinephrine causes transient vasoconstriction; rebound edema and worsening stridor can recur as the drug effect wanes, necessitating observation.

Which is the most important initial action when a child with a foreign body airway obstruction becomes unconscious?

Answer: Call for help and begin CPR starting with chest compressions

When an FBAO victim becomes unconscious, CPR is initiated immediately, and each time the airway is opened for ventilation, look for and remove any visible object.

In a pediatric patient with respiratory failure, which combination of findings indicates impending respiratory arrest?

Answer: Bradypnea, absent breath sounds, decreased consciousness

Bradypnea (slowing respiratory rate), absent breath sounds, and decreased consciousness indicate respiratory muscle fatigue and impending arrest.

Which medication route is preferred for epinephrine administration in pediatric anaphylaxis with severe respiratory compromise?

Answer: Intramuscular into the anterolateral thigh

Intramuscular epinephrine in the anterolateral thigh provides faster absorption and more reliable peak plasma levels than subcutaneous injection.