Health and First Aid Quiz | Choking, Ingestion and Pediatric Emergencies — Set 6
Problem 1
A 10-month-old infant suddenly appears to choke while eating. The infant cannot make a sound and has only a weak cough but is still responsive. Another person is calling emergency services. Which method of removing the obstruction is most appropriate?
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A responsive infant who cannot vocalize or cough forcefully needs back blows and chest thrusts to try to remove the obstruction. Do not use abdominal thrusts on an infant. A blind finger sweep can push an unseen object deeper. If the infant becomes unresponsive, switch to pediatric basic life support.
Problem 2
A three-year-old has put a small bead into the nose, where it is visible deep inside. Breathing is normal and there is no bleeding, but household tweezers cannot easily reach it. What is the most appropriate response?
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Trying to remove a nasal object with an instrument can push it deeper or damage the lining. Forceful nose blowing may also cause the child to inhale it. Even with stable breathing, stop attempting removal at home, identify the object and time, and seek medical care. If breathing difficulty develops, call emergency services.
Problem 3
After a one-year-old plays on the floor, you find a remote control with its battery cover open and one coin cell missing. The child appears well, and no one saw the child swallow it. What is the most appropriate response?
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A button or coin cell lodged in the esophagus can damage tissue even before obvious symptoms appear. If a battery is missing and ingestion cannot be ruled out, seek care immediately rather than waiting for symptoms. Do not induce vomiting; show clinicians an identical battery, the device or packaging information.
Problem 4
At least two strong spherical magnets are missing from a set a young child was using. The child has no abdominal pain and appears normal but may have put them in the mouth. What is the most appropriate decision?
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Multiple strong magnets can attract across separate sections of the digestive tract, causing impaired blood flow, perforation or bowel obstruction. An initially symptom-free child should not simply wait for them to pass. Do not induce vomiting; promptly report how many are missing and provide product information.
Problem 5
A container of clear decorative water-expanding polymer beads spills near an infant, and several beads appear to be missing. The infant has no symptoms. Which response best includes the information clinicians particularly need?
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Water-absorbing polymer beads can expand in the intestine and cause an obstruction. They can also be difficult to detect on radiographic imaging, so care may be delayed without a clear ingestion history. Do not wait for symptoms or give large amounts of fluid; seek care and bring a matching item or package.
Problem 6
A child falls down stairs and hits the head. The child initially cries and talks, but vomits three times within an hour and is now responding sluggishly and trying to fall asleep. What is the most appropriate response?
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Repeated vomiting and reduced responsiveness after a significant blow to the head are urgent warning signs regardless of the size of an external bump. Do not dismiss the change as sleepiness or force fluids. Call emergency services, monitor breathing and responsiveness, and begin instructed life-saving measures if the condition worsens.
Problem 7
A child with a fever develops a generalized seizure. After hazards are removed and the time is recorded, the seizure is still continuing after six minutes. What is the most appropriate response?
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A seizure lasting five minutes or longer is a reason to call emergency services. Objects or medication in the mouth can cause dental injury or choking, and restraining the limbs will not stop the seizure. Keep the area safe and note the start time, eye and limb movements, side-to-side differences and breathing for the emergency team.
Problem 8
At night, a two-month-old infant has a temperature of 38.1°C. The infant has taken a small amount of breast milk and still cries strongly. What is the most appropriate response?
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A temperature of 38°C or above in an infant younger than three months requires urgent medical assessment even if the infant initially appears fairly well. Do not decide to wait solely from the temperature or feeding. Contact an emergency service or emergency department promptly; call emergency services first if breathing or responsiveness is abnormal.
Problem 9
A four-year-old has repeated vomiting and diarrhea and has produced no urine for nearly half a day. Attempts to give drinks trigger vomiting, and the child is now drowsy and less responsive than usual. What is the most appropriate response?
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Repeated vomiting and diarrhea with inability to drink, reduced urination and altered alertness indicate potentially severe dehydration and justify an emergency call. Forcing fluid when swallowing is unsafe can cause aspiration. This differs from mild illness in an alert child who can take oral rehydration solution in small amounts.
Problem 10
A young child is coughing hard, wheezing, struggling to breathe, and developing bluish lips, although the child still responds when called. What is the most appropriate first action?
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Labored breathing with bluish lips suggests inadequate oxygen and is an emergency. Do not use the absence of fever as a reason to wait. Call emergency services, avoid forcing the child flat, and monitor responsiveness and breathing. If normal breathing or responsiveness is lost, begin basic life support.