What is the normal heart rate for newborns?
150–180 per minute, slowing to 130–140 thereafter.
What does a pulse less than 100 indicate in newborns?
Indicates distress; ventilate at a rate of 1 breath/sec.
What is the normal respiratory rate for newborns?
40–60 per minute.
What does central cyanosis indicate?
Abnormal condition; requires immediate attention.
What is the APGAR score range for mildly distressed newborns?
7-10.
What does an APGAR score of 0-4 indicate?
Severely distressed; requires immediate resuscitation.
What should be done if the newborn is apneic or distressed?
Do not delay resuscitation to obtain APGAR.
What is the first step in establishing an airway for a newborn?
Suction only if the airway is blocked.
How should the newborn be stimulated to initiate respiration?
Flicking its feet or rubbing its back.
What is the risk of aspiration during suctioning?
Suction the mouth first, then the nose.
What is the primary cause of heat loss in newborns?
Evaporation.
What temperature should the room be maintained at for newborns?
74–76 degrees Fahrenheit.
What is the recommended action for cutting the umbilical cord?
Clamp and cut after stabilizing airway and minimizing heat loss.
What is the position of the newborn when clamping the cord?
At or above mother's vaginal level.
What is a significant problem newborns can experience due to meconium aspiration?
Can cause significant airway problems.
What is the most important vital sign indicator of neonatal distress?
Heart rate; a HR < 60 requires chest compressions.
How can success in treating at-risk newborns be improved?
Through training, ongoing practice, and proper stocking.
What is the primary requirement for most newborns after birth?
Stimulation, maintenance of airway, and body temperature.
What should EMS units carry for neonatal resuscitation?
A neonatal resuscitation kit.
What is the first step in resuscitation for newborns?
Drying, warming, positioning, suctioning, tactile stimulation.
How should a newborn be positioned to minimize heat loss?
Wrap in a blanket and position head lower than body with slight neck extension.
What is the maximum suction time for a newborn if airway obstruction is present?
No longer than 10 seconds.
What should be done if meconium is present and respiratory effort is weak?
Intubate and suction.
What type of oxygen administration is recommended for acrocyanosis?
Blow oxygen across the newborn's face.
What should be administered if persistent central cyanosis is present?
100% oxygen.
What is the ventilation rate if a newborn's heart rate is less than 100 bpm?
40-60 breaths per minute.
What should be disabled on the BVM during ventilation?
Pop-off valve.
What should you do if the heart rate is less than 100 bpm?
Initiate positive pressure ventilations.
What is the recommended compression rate for newborn CPR?
At least 100 compressions per minute.
What is the compression to ventilation ratio during CPR for newborns?
30:2 compression/ventilation ratio.
What is the Golden Minute in newborn resuscitation?
Initial steps, reevaluating, and avoiding delay in ventilations.
What is the recommended temperature range to maintain for newborns?
Between 36.5C (97.7F) and 37.5C (99.5F).
How can hypothermia be avoided in newborns?
Skin-to-skin contact, plastic wrap, or clean plastic bag.
What should be done if bradycardia is present in a newborn?
Ensure optimal assisted ventilation before starting compressions.
What technique is preferred for chest compressions in infants?
2-Thumb technique.
What is the preferred depth for chest compressions on a newborn?
1/3 anterior-posterior diameter of the chest.
What should be done if airway obstruction is suspected in a newborn?
Intubation and suction may be included.
What oxygen flow should be given to preterm newborns?
Low flow oxygen.
When should high flow oxygen be administered to newborns?
If persistent cyanosis or ventilation is required.
What is the preferred method for chest compressions on duty?
2-Thumb technique
What should be allowed during chest compressions?
Full chest recoil
What is the compression to ventilation ratio?
3 compressions / 1 ventilation
What is the compression rate during resuscitation?
120/min
How long should each breath last during resuscitation?
1/2 second
What type of oxygen should be used during resuscitation?
100% O2
When should compressions be stopped?
When pulse goes to 60+/min
When should intubation be performed?
What should be padded to avoid ventral flexion during intubation?
Shoulders
What should be monitored for during intubation?
Bradycardia
What should the patient be while checking intubation equipment?
Pre-oxygenated
What type of endotracheal tube should always be used?
Uncuffed endotracheal tube
What is the ET tube size for a newborn?
#3
What blade should be used for intubation?
Straight (Miller) blade only
Where should tube placement be checked?
What should be used to secure the tube?
Commercial device or tape
What should be used to confirm tube placement?
Capnography (or Colorimetric if unavailable)
What should be done if gastric distension occurs?
Pre-oxygenate & place oro or nasogastric tube
What should be monitored during post-resuscitation care?
What should be maintained during post-resuscitation care?
Normal body temperature
What should be rechecked during post-resuscitation care?
Blood sugar
What should complications of resuscitation be detected during?
Post-resuscitation care
How should hypotension be treated?
With volume expanders and vasopressors
What is meconium?
Thick, sticky, greenish/black substance in the fetal digestive tract.
What does meconium aspiration indicate?
What are the leading causes of pediatric deaths in the U.S.?
What type of education is important for paramedics in pediatric care?
Pediatric centered education
What should be documented during post-resuscitation care?
Observations and actions
What does PEPP stand for?
Pediatric Education for Paramedic Professionals
What is APLS?
Advanced Pediatric Life Support
What is PPC?
Prehospital Pediatric Care
What is the goal of EMSC?
To improve the health of pediatric patients
What are key areas of concern in pediatric health care?
What percentage of children treated by EMS need basic life support?
85%
What should be considered in pediatric emergencies?
What is essential for responding to parents or caregivers during emergencies?
Communication
What is the APGAR scoring system used for?
To assess newborns in the first hours after birth
What is a common illness in neonates?
Jaundice
What is a key developmental milestone for infants by 5 to 6 months?
Double their birth weight
What is a serious concern for infants aged 6 to 12 months?
Risk of foreign body airway obstruction (FBAO)
What is the leading cause of injury in toddlers?
Accidents
How should you examine toddlers?
From toe-to-head if stable
What developmental skills increase in preschoolers?
Fine and gross motor skills
What is a common reaction of children to emergencies?
Fear of separation
What should be maintained during communication with children in emergencies?
Honesty
What is a common reaction of parents during emergencies?
Shock, grief, denial, anger
What should caregivers do during a child's emergency?
Remain with the child
What is the primary focus when treating infants?
Gather information from parents or caregivers
What is the typical weight loss for neonates in their first week?
10% of birth weight
What is the treatment approach for neonates?
Follows the inverted pyramid
What is a key aspect of pediatric emergency treatment?
Communication and psychological support
What is the focus of community programs in pediatric care?
Injury prevention and health care
What is one way to comfort a child during medical procedures?
Allow the child to hold a favorite blanket or item.
What is a common fear in preschoolers?
Fear of mutilation.
What should be avoided when communicating with preschoolers?
Avoid frightening or misleading comments.
What are common illnesses in preschoolers?
What is important in the treatment of preschoolers?
What age group is referred to as school-age children?
Ages 6 to 12 years.
What are common injuries in school-age children?
What is a key characteristic of adolescents?
They are very 'body conscious'.
What common issues do adolescents face?
What is true about children's anatomy compared to adults?
Children are not simply small adults; they have healthier organs and softer tissues.
What is a significant feature of a child's head?
Large head relative to body size increases risk of trauma.
What airway positioning technique is used for patients under 3?
Pad between shoulders.
What is a common airway issue in pediatric patients?
Narrower airways that are easily blocked by secretions.
What is the characteristic of a child's trachea?
Softer and more flexible than in adults.
What is unique about infants' breathing?
Infants are obligate nose breathers.
What should be kept clear in infants under 6 months?
Nares.
What is a common respiratory issue in pediatric patients?
Lungs are more prone to pneumothorax following barotrauma.
What is true about the abdominal organs in children?
The liver and spleen are proportionately larger and more vascular.
What should be considered when treating pediatric bone injuries?
Treat sprains and strains as fractures due to softer bones.
What are the three distinguishing features of children's skin?
What is a risk for children regarding temperature?
Children risk greater injury from extremes in temperature.
What is the effect of subcutaneous fat in children?
Increased BSA to weight ratio. Children risk greater injury from extremes in temperature or thermal exposure.
How does the respiratory system of infants compare to adults?
Tidal volume is similar, but metabolic needs demand double the oxygen. Infants have proportionately smaller oxygen reserves and are at high risk for hypoxia.
What is the dependence of cardiac output in children?
Cardiac output is rate dependent. They have vigorous but limited cardiovascular reserves.
What is a risk factor for children regarding blood volume?
Children possess a smaller absolute blood volume but can maintain blood pressure longer than adults.
How does the nervous system develop in children?
It develops continually throughout childhood and remains fragile, with bony structures offering less protection.
What metabolic difference is seen in infants and children?
They have a limited store of glycogen and glucose and are prone to hypothermia due to a greater BSA-to-weight ratio.
What can significant volume loss in children result from?
Vomiting and diarrhea.
What ability do newborns and neonates lack?
The ability to shiver.
What is a basic consideration in pediatric assessment?
Much of the initial assessment can be done visually, and caregivers should be involved as much as possible.
What should be included in the scene size-up?
Look for clues to the mechanism of injury, presence of dangerous substances, environmental hazards, and evidence of child abuse.
What does the Pediatric Assessment Triangle evaluate?
It evaluates the level of severity and the need for immediate intervention based on appearance, breathing, and circulation.
What are the vital functions to assess in pediatrics?
Level of consciousness, airway, breathing, circulation.
What indicates compromised breathing in children?
Signs include respiratory distress, trauma, burns, cyanosis, altered consciousness, and seizures.
What is the transport priority for pediatric patients?
Urgent for rapid trauma assessment and immediate transport; non-urgent for focused history and physical exam at the scene.
What is the APGAR score used for?
To assess the health of newborns based on appearance, pulse rate, grimace, activity, and respiratory effort.
What should be done as soon as the baby's head is delivered?
Thoroughly suction the mouth, oropharynx, and hypopharynx using a 10 Fr. DeLee suction catheter.
What is the correct neck position for newborns during resuscitation?
Neck should be slightly extended; avoid hyperextension or underextension to ensure proper air entry.
How should you encircle the chest of a very small newborn?
Encircle the chest with fingers and overlap thumbs.
What is the position of the neck for resuscitation?
How to perform chest compressions on a very small newborn?
How to perform chest compressions on an average-size newborn?
How to perform chest compressions on an older or larger infant?
What is the Neonatal Resuscitation Algorithm timeline for oxygen saturation?
What happens to an infant's head in the supine position?
What should be placed under an infant's back and shoulders?
How does a child's head differ from an adult's head?
What are the temperature control characteristics of babies?
What is a significant airway difference in children?
What is the significance of the trachea and esophagus in children?
What is a major risk for children regarding blood volume?
What are the characteristics of respiratory rates in children?
What is the dehydration risk in children?
What might mottled extremities in young children indicate?
What are some anatomical characteristics of infants?
What are the fontanelle characteristics in young infants?
What is the trachea like in infants?
How do infants primarily breathe?
What is a potential airway obstruction issue in infants?
What is a challenge with obtaining a good face mask seal on infants?
What is a sign of increased intracranial pressure in infants?
What may indicate dehydration in infants regarding fontanelles?
What happens to the trachea with neck hyperextension?
What is a risk associated with the flexibility of infant bones?
What can traumatic forces cause to internal organs?
Injury without fracturing the ribs
What organs are easily damaged with trauma?
Lungs
What is likely with significant force to the abdomen?
Organ injury
What are the components of the Pediatric Assessment Triangle?
What does abnormal work of breathing include?
What are signs of abnormal appearance in pediatric assessment?
What are signs of poor circulation to the skin?
What indicates altered mental status in children?
What abnormal breathing sounds might indicate distress?
What is a concerning breathing rate for children?
Greater than 60 breaths/min
What physical signs indicate increased work of breathing?
What does decreased muscle tone indicate in pediatric assessment?
Potential respiratory distress
What does poor peripheral perfusion suggest?
Possible circulatory compromise
What does a pulse less than 100 indicate in newborns?
Indicates distress; ventilate at a rate of 1 breath/sec.
What should be done if the newborn is apneic or distressed?
Do not delay resuscitation to obtain APGAR.
What is the first step in establishing an airway for a newborn?
Suction only if the airway is blocked.
How should the newborn be stimulated to initiate respiration?
Flicking its feet or rubbing its back.
What is the recommended action for cutting the umbilical cord?
Clamp and cut after stabilizing airway and minimizing heat loss.
What is a significant problem newborns can experience due to meconium aspiration?
Can cause significant airway problems.
What is the most important vital sign indicator of neonatal distress?
Heart rate; a HR < 60 requires chest compressions.
How can success in treating at-risk newborns be improved?
Through training, ongoing practice, and proper stocking.
What is the primary requirement for most newborns after birth?
Stimulation, maintenance of airway, and body temperature.
What is the first step in resuscitation for newborns?
Drying, warming, positioning, suctioning, tactile stimulation.
How should a newborn be positioned to minimize heat loss?
Wrap in a blanket and position head lower than body with slight neck extension.
What is the maximum suction time for a newborn if airway obstruction is present?
No longer than 10 seconds.
What type of oxygen administration is recommended for acrocyanosis?
Blow oxygen across the newborn's face.
What is the ventilation rate if a newborn's heart rate is less than 100 bpm?
40-60 breaths per minute.
What is the compression to ventilation ratio during CPR for newborns?
30:2 compression/ventilation ratio.
What is the Golden Minute in newborn resuscitation?
Initial steps, reevaluating, and avoiding delay in ventilations.
What is the recommended temperature range to maintain for newborns?
Between 36.5C (97.7F) and 37.5C (99.5F).
How can hypothermia be avoided in newborns?
Skin-to-skin contact, plastic wrap, or clean plastic bag.
What should be done if bradycardia is present in a newborn?
Ensure optimal assisted ventilation before starting compressions.
What is the preferred depth for chest compressions on a newborn?
1/3 anterior-posterior diameter of the chest.
What should be done if airway obstruction is suspected in a newborn?
Intubation and suction may be included.
When should high flow oxygen be administered to newborns?
If persistent cyanosis or ventilation is required.
When should intubation be performed?
What should be monitored during post-resuscitation care?
What does meconium aspiration indicate?
What are the leading causes of pediatric deaths in the U.S.?
What are key areas of concern in pediatric health care?
What should be considered in pediatric emergencies?
What is a serious concern for infants aged 6 to 12 months?
Risk of foreign body airway obstruction (FBAO)
What is one way to comfort a child during medical procedures?
Allow the child to hold a favorite blanket or item.
What should be avoided when communicating with preschoolers?
Avoid frightening or misleading comments.
What is important in the treatment of preschoolers?
What are common injuries in school-age children?
What common issues do adolescents face?
What is true about children's anatomy compared to adults?
Children are not simply small adults; they have healthier organs and softer tissues.
What is a significant feature of a child's head?
Large head relative to body size increases risk of trauma.
What is a common airway issue in pediatric patients?
Narrower airways that are easily blocked by secretions.
What is a common respiratory issue in pediatric patients?
Lungs are more prone to pneumothorax following barotrauma.
What is true about the abdominal organs in children?
The liver and spleen are proportionately larger and more vascular.
What should be considered when treating pediatric bone injuries?
Treat sprains and strains as fractures due to softer bones.
What are the three distinguishing features of children's skin?
What is a risk for children regarding temperature?
Children risk greater injury from extremes in temperature.
What is the effect of subcutaneous fat in children?
Increased BSA to weight ratio. Children risk greater injury from extremes in temperature or thermal exposure.
How does the respiratory system of infants compare to adults?
Tidal volume is similar, but metabolic needs demand double the oxygen. Infants have proportionately smaller oxygen reserves and are at high risk for hypoxia.
What is the dependence of cardiac output in children?
Cardiac output is rate dependent. They have vigorous but limited cardiovascular reserves.
What is a risk factor for children regarding blood volume?
Children possess a smaller absolute blood volume but can maintain blood pressure longer than adults.
How does the nervous system develop in children?
It develops continually throughout childhood and remains fragile, with bony structures offering less protection.
What metabolic difference is seen in infants and children?
They have a limited store of glycogen and glucose and are prone to hypothermia due to a greater BSA-to-weight ratio.
What is a basic consideration in pediatric assessment?
Much of the initial assessment can be done visually, and caregivers should be involved as much as possible.
What should be included in the scene size-up?
Look for clues to the mechanism of injury, presence of dangerous substances, environmental hazards, and evidence of child abuse.
What does the Pediatric Assessment Triangle evaluate?
It evaluates the level of severity and the need for immediate intervention based on appearance, breathing, and circulation.
What are the vital functions to assess in pediatrics?
Level of consciousness, airway, breathing, circulation.
What indicates compromised breathing in children?
Signs include respiratory distress, trauma, burns, cyanosis, altered consciousness, and seizures.
What is the transport priority for pediatric patients?
Urgent for rapid trauma assessment and immediate transport; non-urgent for focused history and physical exam at the scene.
What is the APGAR score used for?
To assess the health of newborns based on appearance, pulse rate, grimace, activity, and respiratory effort.
What should be done as soon as the baby's head is delivered?
Thoroughly suction the mouth, oropharynx, and hypopharynx using a 10 Fr. DeLee suction catheter.
What is the correct neck position for newborns during resuscitation?
Neck should be slightly extended; avoid hyperextension or underextension to ensure proper air entry.
How should you encircle the chest of a very small newborn?
Encircle the chest with fingers and overlap thumbs.
What is the position of the neck for resuscitation?
How to perform chest compressions on a very small newborn?
How to perform chest compressions on an average-size newborn?
How to perform chest compressions on an older or larger infant?
What is the Neonatal Resuscitation Algorithm timeline for oxygen saturation?
What happens to an infant's head in the supine position?
What should be placed under an infant's back and shoulders?
How does a child's head differ from an adult's head?
What is a significant airway difference in children?
What is a major risk for children regarding blood volume?
What might mottled extremities in young children indicate?
What are some anatomical characteristics of infants?
What is a challenge with obtaining a good face mask seal on infants?
What is a risk associated with the flexibility of infant bones?
What are the components of the Pediatric Assessment Triangle?
What does abnormal work of breathing include?
What are signs of abnormal appearance in pediatric assessment?
What physical signs indicate increased work of breathing?
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