PALS MC Pediatric Poisoning/Overdose – FirstAidWeb Certifications

Pediatric Poisoning/Overdose

A 4-year-old child is brought to the emergency department after ingesting an unknown medication. The child appears lethargic and has shallow breathing, with signs of respiratory depression. Their oxygen saturation is dropping despite supplemental oxygen. Pupils are pinpoint, and the child has minimal response to stimuli. Their heart rate is low-normal, and blood pressure is on the lower end of normal limits, with delayed capillary refill. Immediate intervention is required to manage the suspected opioid overdose or toxic ingestion.

What addresses the most immediate threat in poisoning?

A 4-year-old is brought to the ED after ingesting an unknown medication. They are lethargic with shallow breathing. What is your first priority?

Administer naloxone 0.1 mg/kg IV.

Administer activated charcoal.

Ensure airway patency and provide oxygen.

Obtain a detailed history of the ingested substance.

What antidote is used for opioid-induced respiratory depression?

The child’s SpO2 is 85% despite oxygen. Bag-mask ventilation is initiated. What is the next step?

Perform endotracheal intubation.

Administer atropine 0.02 mg/kg IV.

Administer epinephrine 0.01 mg/kg IV.

Administer naloxone 0.1 mg/kg IV.

What test evaluates the need for treatment in acetaminophen overdose?

The child’s parents mention ingestion of acetaminophen. The child appears stable. What lab test is most critical to order?

Liver function tests (LFTs).

Serum creatinine.

Arterial blood gas (ABG).

Serum acetaminophen level.

What medication prevents liver injury in acetaminophen overdose?

The serum acetaminophen level indicates potential toxicity. What is the next appropriate treatment?

Start continuous renal replacement therapy (CRRT).

Administer epinephrine 0.01 mg/kg IV.

Administer activated charcoal orally.

Administer N-acetylcysteine (NAC) IV.

What prevents aspiration in a patient with altered mental status?

The child develops vomiting and altered mental status. What is the next best intervention?

Administer activated charcoal orally.

Secure the airway to prevent aspiration.

Administer antiemetic medication.

Place the child in a prone position.

What is the most common cause of bradycardia in children?

A 3-year-old presents after ingesting an unknown substance and is bradycardic. What is your first intervention?

Provide oxygen and ventilation support.

Administer atropine 0.02 mg/kg IV.

Administer naloxone 0.1 mg/kg IV.

Perform chest compressions.

What type of poisoning causes pinpoint pupils and respiratory depression?

A child presents with pinpoint pupils, decreased respiratory rate, and altered mental status. What is the likely cause of poisoning?

Opioid ingestion.

Acetaminophen overdose.

Salicylate poisoning.

Organophosphate poisoning.

How should naloxone-induced symptoms be managed?

After administering naloxone, the child becomes agitated and tachycardic. What is the most appropriate next step?

Initiate mechanical ventilation.

Administer a sedative immediately.

Administer a second dose of naloxone.

Provide supportive care and monitor closely.

What treats both acidosis and salicylate elimination?

The child develops metabolic acidosis following suspected salicylate poisoning. What is the next appropriate intervention?

Administer sodium bicarbonate IV.

Administer magnesium sulfate IV.

Administer N-acetylcysteine (NAC).

Perform gastric lavage.

What helps prevent future poisoning incidents?

Post-treatment, the child remains stable. What is the most important step in discharge planning?

Advise the family to dispose of all medications immediately.

Provide poison prevention education to the family.

Prescribe a one-week course of antibiotics.

Schedule a follow-up appointment with a neurologist.

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