Question: A child was found unresponsive under the monkey bars during recess and arrives with the following assessment: eyes open only with supraorbital pressure stimulus, no verbal response is elicited, and withdraws arms and legs when a swab is inserted in the nose. Which of the following is the priority intervention for this child?

This question is a part of the ENPC 6th Edition Test Answers.

Answer

Prepare for immediate intubation.

In the case of a child found unresponsive under the monkey bars during recess, who only opens their eyes to supraorbital pressure, does not verbally respond, and only withdraws arms and legs to a nasal swab stimulus, the priority intervention is to prepare for immediate intubation.

This response is due to the child’s apparent inability to protect their own airway, as indicated by the lack of verbal response and only minimal physical reactions to stimuli.

The Glasgow Coma Scale (GCS), a clinical tool used to assess consciousness level, would likely score low in this scenario, indicating a severe level of consciousness impairment. Immediate intubation is critical to ensure that the airway is secured to prevent aspiration and to facilitate adequate ventilation, especially in a pediatric patient with signs of significant neurological compromise.

This intervention is a lifesaving measure aimed at maintaining open airways and ensuring proper oxygenation and ventilation in a child who is at high risk for respiratory failure.