A 15-year-old boy is brought to the Emergency Department after sustaining a head injury while riding his bicycle. He was un-helmeted and sustained a loss of consciousness after his fall. EMS transported him after they placed a cervical collar on him and placed him on a backboard. His initial vital signs are as follows: heart rate 45 beats/minute, respiratory rate 11 breaths/minute, blood pressure 80/50 mm Hg, and oxygen saturation 97% on room air. The airway is patent; the patient is breathing well, but has diminished pulses in all 4 extremities. The patient is unable to move any of his extremities during the examination. Packed red blood cells are ordered, and 1 liter of 0.9% normal saline is given without improvement in the blood pressure. The most appropriate vasopressor for this condition is:

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Care During Pediatric Emergencies Questions

Question 1 of 5

A 15-year-old boy is brought to the Emergency Department after sustaining a head injury while riding his bicycle. He was un-helmeted and sustained a loss of consciousness after his fall. EMS transported him after they placed a cervical collar on him and placed him on a backboard. His initial vital signs are as follows: heart rate 45 beats/minute, respiratory rate 11 breaths/minute, blood pressure 80/50 mm Hg, and oxygen saturation 97% on room air. The airway is patent; the patient is breathing well, but has diminished pulses in all 4 extremities. The patient is unable to move any of his extremities during the examination. Packed red blood cells are ordered, and 1 liter of 0.9% normal saline is given without improvement in the blood pressure. The most appropriate vasopressor for this condition is:

Correct Answer: A

Rationale: Suspected spinal shock from cervical injury (bradycardia, hypotension, paralysis) requires epinephrine for its vasopressor and inotropic effects.

Question 2 of 5

You are responsible for the online medical control EMS phone during your work shift and receive a phone call from a prehospital provider who is called in by a minor with no adult or legal guardian available to accompany this minor. In which of the following situations does the minor need consent for treatment from a legal guardian/parent?

Correct Answer: D

Rationale: Minors typically need parental consent unless emancipated (A), deemed mature (B), or seeking STD treatment (C). D requires consent.

Question 3 of 5

You are reviewing the protocols implemented during your department's care for pediatric trauma patients. You would like to standardize the process your ambulance crews use to determine which facility to go to. You have one local level 2 pediatric trauma center that is relatively distant from your area and one local and much closer adult trauma center. What is of paramount importance when you recommend patient transport?

Correct Answer: C

Rationale: High mechanism injuries require rapid transport to the nearest suitable trauma center, balancing proximity and capability.

Question 4 of 5

A 3-year-old girl had a near-drowning incident when she fell into a wading pool. Which intervention would be of the highest priority?

Correct Answer: C

Rationale: Ensuring airway patency is the highest priority in a near-drowning incident to restore oxygenation.

Question 5 of 5

A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding which of the following?

Correct Answer: D

Rationale: Lead poisoning in children often results from ingesting flaking lead-based paint, so removing or covering it is critical.

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