PEARS Emergency Recognition 3 — Questions and Answers
Question 1: Which clinical sign indicates upper airway obstruction in a pediatric patient?
- Wheezing
- Stridor (Correct answer)
- Crackles
- Grunting
Correct answer: Stridor
Stridor is a high-pitched sound caused by turbulent airflow through a narrowed upper airway, indicating obstruction at or above the larynx.
Question 2: A 10-month-old suddenly chokes while eating and now has no audible cry and poor air exchange. What is the priority intervention?
- Blind finger sweep
- Back blows and chest thrusts (Correct answer)
- Abdominal thrusts
- Immediate cricothyrotomy
Correct answer: Back blows and chest thrusts
For an infant with complete foreign body airway obstruction, the recommended intervention is five back blows followed by five chest thrusts, not abdominal thrusts.
Question 3: In the PEARS assessment, what does a 'look' component of the primary assessment include?
- Auscultating breath sounds
- Observing chest rise, color, and mental status (Correct answer)
- Measuring oxygen saturation
- Palpating the abdomen
Correct answer: Observing chest rise, color, and mental status
The 'look' component involves visual observation of chest movement, skin color, and level of consciousness without touching the patient.
Question 4: Which pulse location is preferred when checking circulation in an infant during emergency assessment?
- Radial
- Carotid
- Brachial (Correct answer)
- Femoral
Correct answer: Brachial
The brachial artery is the preferred pulse check site in infants because the neck is short and fat, making the carotid difficult to palpate.
Question 5: A child presents with grunting respirations. What does grunting indicate in a pediatric patient?
- Upper airway obstruction
- Attempt to maintain functional residual capacity (Correct answer)
- Bronchospasm
- Normal expiratory sound in toddlers
Correct answer: Attempt to maintain functional residual capacity
Grunting is the child's attempt to create auto-PEEP by exhaling against a partially closed glottis, trying to maintain alveolar volume and oxygenation.
Question 6: Which AVPU level describes a child who only responds to painful stimuli?
- Alert
- Voice
- Pain (Correct answer)
- Unresponsive
Correct answer: Pain
In the AVPU scale, 'P' (Pain) indicates the patient responds only to painful stimuli, reflecting significant neurological compromise.
Question 7: A 4-year-old with altered mental status, pinpoint pupils, and slow, irregular breathing most likely has which type of emergency?
- Hypoglycemia
- Opioid toxidrome (Correct answer)
- Hypertensive emergency
- Meningitis
Correct answer: Opioid toxidrome
Pinpoint pupils, CNS depression, and respiratory depression form the classic opioid toxidrome, which can be confirmed and treated with naloxone.
PEARS Emergency Recognition 3
Which clinical sign indicates upper airway obstruction in a pediatric patient?