EMT Exam For Dummies with Online Practice
Book image
Explore Book Buy On Amazon

Several pediatric medical conditions are commonly seen by EMTs. In the majority of cases, your care is supportive — ensure that problems with airway, breathing, and circulation are identified and managed, and help maintain body temperature and oxygenation during transport. In some situations, you may need to intervene quickly.

Problem Signs and Symptoms Action Steps
Foreign body airway obstruction No air exchange; no crying or other sounds; rapid loss of consciousness, skin turns pale and then cyanotic. Infant, conscious: Five back blows and chest thrusts.
Child, conscious: Abdominal thrusts.
Child, unconscious: Perform CPR and attempt to ventilate, check airway to see whether obstruction can be removed.
Croup Fever; hoarseness; barky cough; difficulty breathing. Provide supplemental oxygen. Change in air temperature or humidity may reduce symptoms.
Epiglottitis High fever; difficult, painful swallowing; drooling; tripod positioning. Maintain patient’s position of comfort. Do not inspect or probe mouth. Provide supplemental oxygen, humidified if possible, using blow-by method.
Asthma Wheezing lung sounds; difficulty breathing, especially during exhalation; pursed lips, accessory muscle use; coughing. Maintain patient’s position of comfort. Assist with patient’s metered dose inhaler if prescribed. Administer oxygen if saturation level is low or patient is having difficulty breathing.
Fever Very warm skin, especially on the chest and abdomen; high temperature using a thermometer; may cause a febrile seizure. Dehydration may be associated with the fever. Remove most clothing. Be alert for shivering as it may cause the fever to rise. Ice chips may provide comfort.
Meningitis (inflammation of the membranes surrounding the brain and spinal cord) High fever; neck pain, tenderness, or rigidity; severe headache; hypersensitivity to bright light; nausea, vomiting. Meningitis can be highly contagious. Wear respiratory protection. Prepare to manage airway and ventilations if respiratory failure occurs.
Diarrhea and vomiting If serious, dehydration may set in and cause signs of shock: tachycardia; cool, pale skin; eyes that appear sunken; altered mental status or unconsciousness. Treat for shock: Maintain body temperature, provide supplemental oxygen, and ventilate if needed. Provide nothing by mouth.
Seizures Patients with generalized seizures are unconscious during the seizure. Tonic-clonic muscle activity; patient may be incontinent and/or have bitten the tongue. Will be postictal after seizure ends; may be hard to arouse, confused, and frightened. Most seizures only last several seconds to a minute. Care is supportive — prevent further harm during the seizure, maintain airway, and provide supplemental oxygen.
Status epilepticus are seizures that last more than a couple of minutes or a series of seizures that occur without the patient regaining consciousness. These may be life-threatening. Transport immediately, maintain airway patency, and ventilate with a bag-valve mask and oxygen. Suction may be necessary if secretions become significant.
Altered mental status (AMS) Younger children: sleepy, lethargic, difficult to arouse from sleep. Unable to maintain interest, easy to separate from caregiver. Irritated, inconsolable. Older children: confusion, lethargy, sleepy. Evaluate for underlying cause: Shock, hypoxia, hypoglycemia, drug ingestion, and head trauma are some possibilities. Maintain airway patency. Ventilate with a bag-valve mask if in respiratory failure. Use an oropharyngeal airway (OPA) and position the child’s airway carefully if unconscious. Keep suction immediately available in case vomiting occurs. Maintain body temperature and transport immediately.
Poisoning Possible causes of poisoning include medications, household chemicals, intoxicants, and other recreational drugs. Immediate concern is altered mental status (AMS) and loss of airway patency. Maintain airway, using manual maneuvers and an OPA if necessary. Ventilate if needed. If breathing is adequate, provide supplemental oxygen. Be alert for vomiting. Maintain safety precautions if a hazardous material is the cause of the poisoning.
Respiratory arrest Not breathing or agonal breaths. Cyanosis. Will cause heart rate to slow. Insert an OPA and manually position the airway to keep open. Ventilate with bag-valve mask once every 3 to 5 seconds and provide supplemental oxygen. Keep suction immediately available in case patient vomits. Assess for underlying cause. Begin immediate transport.
Cardiac arrest No pulse, no breathing or agonal breaths. Single-person CPR, infant: Use two fingers to compress.
Two-person CPR, infant: Use thumb-encircling technique.
Single-person CPR, child: Use heel of one or both hands. Compress chest to 1/3 to 1/2 depth of chest at a rate of at least 100 beats per minute. Ventilate at a ratio of 30 compressions to 2 ventilations.
Two-person CPR, child: Adjust compressions-to-breaths ratio to 15:2.
If arrest is unwitnessed, attach an automated external defibrillator (AED) with appropriate size pads after five cycles of compressions and ventilations. Analyze heart rhythm every 2 minutes and administer a shock if indicated. Transport as soon as possible.
Sudden infant death syndrome (SIDS) No pulse, no breathing. May have signs of death: pooling of blood in lower areas of body; stiffening of limbs. Generally no report of any unusual circumstances or events prior to death. In most situations where death is obvious, treatment is directed toward the family. Try not to disturb the death scene. If there are no obvious signs of death, begin CPR and transport.
Child abuse/neglect Patient may be quiet, withdrawn, fearful. Most often there are physical signs of trauma. Other abuse patterns may show signs of neglect such as poor nutrition. Provide supportive care for any injury. Do not confront caregiver on-scene. Observe the scene and take mental notes. As a mandated reporter, notify child protective services and advise hospital staff of your findings.

A 4-year-old male is sitting in a chair. The parent reports the patient stayed home from school today because of a bad cold. He is looking at you quietly, breathing quickly through his mouth, and drooling. His skin is pale and feels hot. You should

  • (A)ask him to swallow.

  • (B)gently insert a flexible suction catheter.

  • (C)suction with a rigid catheter.

  • (D)evaluate the patient further.

The best choice is (D). The patient is showing signs of epiglottitis; there is enough swelling of the soft tissues in the back of the throat that he is unable to swallow his saliva without blocking his airway.

About This Article

This article is from the book:

About the book author:

Art Hsieh, MA, NREMT-P is a highly experienced paramedic, clinician, and educator, helping hundreds of students prepare for and pass the national examination process. He is the director of a collegiate paramedic academy and editorial advisor of EMS1.com.

This article can be found in the category: