Certified Pediatric Emergency Nurse (CPEN) Practice Exam

In pediatric patients, what should be done first in cases of severe trauma?

1. Check for fractures

2. Control external bleeding

3. Establish airway

4. Administer pain relief

The correct answer is: Establish airway

In pediatric patients experiencing severe trauma, the establishment of an airway is the priority because maintaining adequate oxygenation and ventilation is critical. In cases of trauma, there is a potential for airway compromise due to various factors, including potential neck injuries, altered levels of consciousness, or the presence of blood or other obstructions. Ensuring an open and patent airway addresses the immediate risk of hypoxia, which can lead to irreversible organ damage or death within minutes if not corrected. If the airway is not secured first, subsequent interventions may be less effective or could even exacerbate the situation, especially if the child becomes unable to breathe adequately. While controlling external bleeding is also very important, and injuries may involve significant hemorrhage, managing the airway takes precedence as a failure to do so can quickly become life-threatening. The other interventions, such as checking for fractures or administering pain relief, are also crucial but are considered after ensuring that the airway is secure.