Child Reduced LOC Scenario

Question 1 of 16

1. Question

You made this initial assessment using an aide memoire. Which one was it?

Paediatric Assessment Triangle

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DR C AcBCDE

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Paediatric Analysis Tool

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Sick or Not Sick

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Question 2 of 16

2. Question

From your initial impression, should you be clinically concerned?

Yes

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No

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Question 3 of 16

3. Question

Concerned about the patient, you update control requesting backup as soon as possible. They confirm the Ambulance will continue on blue lights but is still 10 minutes away. You begin your primary survey. The airway is clear, and there is no bleeding. As you assess breathing, what signs should you inspect for?

Equal chest rise and fall

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Sternal or intercostal recession

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Tracheal tug

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Use of accessory muscles

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Abdominal breathing

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Question 4 of 16

4. Question

The patient is using accessory muscles, with a respiratory rate of 40 and SpO₂ of 92%. What should you do next?

Apply a simple face mask at 5–10 L/min to correct acute hypoxia

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Apply nasal cannula at 2 L/min

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Auscultate the chest

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Complete the primary survey before any interventions

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Question 5 of 16

5. Question

You apply a simple face mask. On auscultation, you hear no adventitious sounds. As you assess circulation, what should you include in your primary survey?

Heart rate

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Central capillary refill

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Peripheral capillary refill

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Skin colour

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Blood pressure

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Palpate pulse

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Question 6 of 16

6. Question

The patient remains pale with mottling on the arms. Cap refill is 3 seconds, BP 85/49, HR 145. What is the normal heart rate range for a 5-year-old?

80–120

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110–150

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95–130

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60–100

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Question 7 of 16

7. Question

Temperature is 38.1°C, BM 3.8 mmol/L, GCS 9 (E2 V2 M5). You expose the patient and find a blotchy rash on her lower back. What test can you use to check if it is blanching or non-blanching?

Tumbler test

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Kernig’s sign

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Brudzinski’s sign

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Pinprick test

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Question 8 of 16

8. Question

The tumbler test confirms the rash is non-blanching. What other red flags are associated with meningitis?

Neck stiffness

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Photophobia

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Headache

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Flu-like symptoms

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Irritability

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General body or joint pain

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Question 9 of 16

9. Question

You are unable to confirm other symptoms due to the patient’s GCS. The mother offers little additional history, stating the child has been unwell for a few days. Should you discount meningitis if not all typical signs and symptoms are present?

False

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True

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Question 10 of 16

10. Question

According to JRCALC, does suspected meningococcal septicaemia fall under critical illness requiring 15 L/min oxygen via a non-rebreather mask?

True

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False

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Question 11 of 16

11. Question

What medication is crucial for pre-hospital administration in suspected meningitis?

Benzylpenicillin

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Hydrocortisone

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Salbutamol

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TXA

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Question 12 of 16

12. Question

Are meningitis and meningococcal septicaemia the same in definition, pathophysiology, and presentation?

No, they are different

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Yes, they are the same

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Question 13 of 16

13. Question

You ask about immunisations and receive a defensive reply: “There’s no chance I’m putting that fake stuff in my daughter.” When should children in the UK receive meningitis immunisations?

At 8 weeks, 16 weeks, and 1 year

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At 15 years

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At 6 years

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At 11 years

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Question 14 of 16

14. Question

The mother continues to express strong views against immunisations and explains that she provides alternative treatments for her daughter — some of which are extreme and potentially harmful. You are concerned that the child is not receiving appropriate medical care and is at risk due to missed vaccinations and unsafe treatments. What category of maltreatment does this situation most likely indicate?

Neglect

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Emotional abuse

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Financial abuse

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Child in need

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Question 15 of 16

15. Question

When giving ASHICE to the crew, what additional information would be important?

Safeguarding concerns

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Possible lack of immunisations

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The mother’s responses

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Reduced feeding and drinking

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Question 16 of 16

16. Question

After benzylpenicillin is given, the crew prepares for rapid transport. They will inform the hospital about safeguarding concerns. How should you proceed?

Report concerns using the appropriate safeguarding referral service

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Call the police

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No need to duplicate — leave it to the crew and hospital

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Child Reduced LOC Scenario

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