The Whole of PEM

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Question 1 of 3

1. Question
Lucy is four. What best describes the airway differences?
- Children are just little adults – there are no significant airway anatomy differences.
- Proportionally the same size and diameter as an adult’s in the same position with right mainstem bronchus foreign body more likely. The vertical cords are more horizontal so coin is more likely to stick at this level.
- Proportionally the same size and diameter as an adult’s in the same position – but less likely to occlude as pharyngeus muscle less likely to spasm.
- Shorter, narrower, higher and more anterior than an adult’s with a funnel shape rather than a cylinder so less likely to obstruct and occlude.
- Shorter, narrower, higher and more anterior than an adult’s with a funnel shape rather than a cylinder so more likely to obstruct and occlude.
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Question 2 of 3

2. Question
Eimear is eight months. She’s attended with difficulty breathing, and bronchiolitis is suspected. She fed 15 minutes ago, taking 6oz (150ml) of milk and has become more short of breath since then. Her observations are RR 60, subcostal recession, saturations 92% on air.

What is the most useful next management step?
- Ask for a swallow assessment, as Eimear may have aspirated.
- Insert an NG tube to empty the stomach and to stop splinting of the diaphragm.
- Keep a fluid intake diary and see if Eimear is drinking enough.
- Observe the next feed before you create a plan.
- Perform an RSI as you anticipate an occluded airway.
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Question 3 of 3

3. Question
Your patient has a fever of 38.2. In which circumstance is this considered a red flag?
- Always, regardless of clinical symptoms.
- Child less than 3 months, regardless of clinical symptoms.
- Child 3 – 9 month, if associated with amber symptoms.
- Only if the child has associated NICE traffic light red symptoms, e.g. mottling or dyspnoea.
- If it persists after antipyretics.
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The Whole of PEM

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