In a school, children are gathering on the playground surrounding a child who is unconscious and.....By the history reveals that child had raisins. What would be the priority nursing action?

1. A

   Do nothing

2. B

   Five abdominal thrusts and perform Heimlich maneuver

3. C

   Encourage child to talk

4. D

   Instruct the teacher to call 108

Appeared in: NORCET-5 Prelims (Shift-1)

Explanation

Listen in Hindi

• The first and most critical step in any out-of-hospital emergency with an unresponsive person is to activate the Emergency Medical Services (EMS).
• Instructing a bystander (the teacher) to call for help (108) ensures that advanced medical support is dispatched to the scene immediately.
• This action is a key component of the 'Chain of Survival' and is prioritized before initiating other interventions like CPR, as it minimizes the time to definitive care.
• While the nurse prepares to start CPR, delegating the call for help is the most efficient and correct use of resources in an emergency.

Why Other Options Were Wrong

• Option A: Doing nothing is never an acceptable action in a medical emergency and constitutes negligence.
• Option B: Abdominal thrusts (Heimlich maneuver) are the correct intervention for a conscious child with an airway obstruction. For an unconscious child, the protocol is to start CPR.
• Option C: The child is described as unconscious and therefore cannot respond to verbal commands or be encouraged to talk.

Related Visual

Clinical Relevance

• Nursing practice connection: Safe nursing care depends on performing Emergency management of an unconscious choking child in the correct sequence, documenting the action clearly, and monitoring for the expected response.
• In any emergency, especially outside a hospital, a nurse's first role is often to direct the scene. This includes ensuring scene safety and delegating critical tasks like calling for an ambulance.
• The 'Chain of Survival' is a critical concept: 1. Early recognition and call for help, 2. Early CPR, 3. Early defibrillation, 4. Early advanced care. This question tests the very first link in that chain.
• What if? If the child was conscious and coughing forcefully, the priority action would be to encourage them to continue coughing and monitor them closely, while still being prepared to intervene if their condition worsens.

How to Approach the Question

• First, identify the key elements of the scenario: a child, unconscious, with a history suggesting choking.
• Recognize this as a priority-setting question. You need to determine the single most important first action.
• Recall the Basic Life Support (BLS) algorithm. For any unresponsive victim, the first step after ensuring scene safety is to activate the emergency response system.
• Evaluate the options based on the BLS protocol. 'Do nothing' and 'encourage to talk' are illogical. 'Abdominal thrusts' are for a conscious victim.
• Conclude that activating the emergency response system ('Instruct the teacher to call 108') is the correct priority action.

Concept Tested & Keywords

• Concept Tested: Emergency management of an unconscious choking child.
• Stem keywords: unconscious, child, raisins, priority nursing action
• Lead-in keywords: priority
• Clinical cues: The child is unconscious, which changes the first aid protocol from the Heimlich maneuver to CPR.

Question ID

QpwdwHJIbhRvLxlnOOewzm

Copy ID

Reference Book

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 602-604

E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart B (pp 276-535 of 550) p. 181-183