1. The elements of the observational assessment of children according to EMSC are?
a b c d
a. general appearance
b. work of breathing
c. circulation to the skin
d.   all of the above

2.     In the acutely distressed child who is unconscious, unresponsive or with altered mental status, the priority assessment would be the:
a b c
a. primary survey
b. secondary survey
c. observational assessment

3.When assessing the work of breathing, which of the following is NOT part of the observational assessment?
a b c d
a. altered speech or cry
b.   stridor
c.   grunting
d.  breath sounds

4. Which of the following vital signs is the LEAST useful in pediatric assessment?
a b c d
a.  blood pressure
b. pulse rate
c. respiratory rate
d. pulse oximetry

5. The usually expected age range within which febrile seizures occur is:
a b c d
a.   1-3 months old
b.  under 1 month old
c.   6 months to 5 years old
d.   5-10 years old

6. What are some other causes of pediatric seizures?
a b c d
a. poisoning
b. occult head trauma
c. hypoxia
d. all of the above

7. In the following scenario, is this child at higher or lower risk for serious underlying bacterial illness?  The child is a 2 month old male with a fever and report of a brief seizure, now awake but uninterested in external stimuli.  He reportedly received an intramuscular antibiotic injection for a “stomach infection” two days ago at a community clinic.  
a b
a.  higher risk (ALS transport)
b.   lower risk (BLS or private transport)

8. How about this one?  A 15-month-old female had a brief seizure at home, which completely freaked out her parents.  She has a high fever, but now is alert, interactive and cautiously playful.  She has a cough, but normal appearance, breathing, skin color and capillary refill.  Pulse ox is 99%.  She is on no medications, in fact mom didn’t even know she was sick, has no medical problems, was a full term delivery with no perinatal complications.  
a b
a.   higher risk (ALS transport)
b.   lower risk (BLS or private transport)

9.   OK, last one.  This 9-month-old male has a fever, had a brief seizure and is now awake, with a weak cry, floppy muscle tone and is inattentive to external stimuli.  The parents tell you he gets sick often, was hospitalized for 2 months after birth for a lung problem and has had pneumonia.  Pulse ox is 98%.  There are no retractions, nasal flaring or grunting.  He has had a prior febrile seizure and is on steroids and inhalers for his lung problem.
a b
a.   higher risk (ALS transport)
b.   lower risk (BLS or private transport)

And for the paramedics and MICN's among you ………

10.The child in the previous scenario has another generalized tonic-clonic seizure while the assessment is underway.  BLS measures are instituted.  His weight is 20 lb, or 9 kg.  What is the intramuscular dose of midazolam for this weight? 

a b c
a. 0.9mg
b. 1.8mg
c.  4.5mg