SAEM M4 Study Guide Updated 2026 - Updated for Current Exam

SAEM M4 Study Guide Updated 2026 - Updated for Current Exam True or False: gastric distension due to excessive volume or rate of ventilation impairing ventilatory function is a reason to intubate a neonate - answer - False management for nursemaid elbow injury - answer - apply pressure to the radial head while flexing and supinating elbow A 17 year old boy injured his right shoulder playing football. He tried to arm-tackle a player when his right arm was pulled away from his body and back (abducted and extended). He felt a sudden pain in his shoulder. He presents to the emergency department holding his arm in slight abduction and external rotation by his good arm. He has severe pain with adduction or internal rotation. What is the most common fracture associated with this injury? - answer - compression fracture of the posteriolateral aspect of the humeral head (Hill-Sachs deformity) What are most common heart rhythms seen in pediatric arrest? - answer - bradycardia or asystole risk factors for neonatal resuscitation - answer - prematurity IUGR multiple gestation thick meconium In the post-arrest setting, which of the following is the drug of choice in treating hypotension in a child: - answer - epi Low body temperatures in newborns can lead to severe physiologic consequences, which include all EXCEPT: Answers: 1. metabolic acidosis 2. increased oxygen consumption 3. hypoglycemia 4. apnea 5. hyperglycemia - answer - 3. hypoglycemia In a newborn, bradycardia is most commonly an indicator of: - answer - hypoxemia All the following are signs of hypoxemia in a newborn, EXCEPT: Answers: sis rgy cardia ponsiveness cardia - answer - 3. tachycardia A newborn presents to the emergency department a few days after hospital discharge. The infant has been noted to be drooling, choking, and coughing, and the mother reports seeing bubbles at the baby's mouth. Which is the most likely explanation? Answers: genesis imperfecta n error of metabolism nital diaphragmatic hernia gn body eoesophageal fistula - answer - 5. tracheoesophageal fistula Which of the following pairs of maneuvers are consistent with current recommendations for emergency care for a choking 5-month-old infant? Answers: blow then blind finger sweep blow then chest thrust thrust then Heimlich maneuver 4.Heimlich maneuver then blind finger sweep 5.Heimlich maneuver then chest thrust - answer - blow then chest thrust All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT: Answers: 1.If administering succinylcholine, pretreatment with atropine is always indicated in children under age 10. 2.Lidocaine pretreatment is usually provided to children with head trauma. 3.When deciding which size endotracheal tube to use, one may approximate by using the size of the small finger or nares as a reference. 4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to intubation for children under age ten. 5.Uncuffed endotracheal tubes are the preferred devices used in children under 6-8 years of age. - answer - 4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to intubation for children under age ten. A 23 year old woman is dropped off by her boyfriend after an unknown overdose. You notice that she is has very large pupils and is sweating profusely. Her respiratory rate, blood pressure and heart rate are elevated. Which of the following is the most likely agent to have caused her symptoms? Answers: 1.Jimson weed 2.Cocaine 3.Heroin 4.Insulin - answer - 2. cocaine A mother brings in her 4 year old child who was happily eating "blackberries" from weeds in the garden and is now acting strangely. She has identified them as Belladonna from a quick internet search. Which physical examination finding might you also expect to find in this child? Answers: 1.Diaphoresis 2.Fl