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34 objectives
Pediatric Emergencies
| Term | Definition |
|---|---|
| 34-1 Challenges inherent in providing care of pediatric Pt (Pg 1218) | - children differ anatomically, physically and emotionally from adults - child may not be able to tell you what is wrong with them - parents or caregivers may be stressed and irrational |
| 34-2 physical and cognitive development stages of infants (1 month to 1 year) (Pg 1219-1220) | - 0-2 months -> sleeps (up to 16hrs) and eats -2-6 months -> more active (70%) sleep at night -6-12 months -> babble and say first words, crawling - sucking reflex, limited head ctrl, bad temp regulation, large head - explain to parent before doing |
| 34-3 physical and cognitive development stages of a toddler (1-3) (Pg 1220-1221) | 12-18 months: Walk and explore, eating stuff and getting injured no molars = increased risk of choking 18-24 months: Vocab increase from 15 to 100 words. cling to parents, comfort objects Assessment: stranger anxiety, demonstrate assessment on a doll |
| 34-4 physical and cognitive development stages of pre-school (3-6) (Pg 1221-1222) | Ages 3 to 6 years Toilet training is mastered Health risks: Foreign body aspiration Assessment: Communicate simply and directly Do assessment from feet to head |
| 34-5 physical and cognitive development stages of a school aged child (6-12) (Pg 1222) | Age 6-12 Concerns about popularity/peer pressure begin Assessment: More like an adult assessment |
| 34-6 physical and cognitive development stages of an adolescent (12-18) (Pg 1222-1223) | Age 12-18 Health risks: High risk behavior, mood swings or depression Pregnancy Assessment: Treat like an adult, same-gendere Physical exam |
| 34-7 differences in anatomy and physiology of pediatrics vs adults (Pg 1223-1226) | Airway is shorter in diameter and length (Infant airway is size of a drinking straw) Lungs smaller, HR is higher Tongue and epiglottis can block airway RR of 30-60 breaths/min normal for a newborn O2 demand twice that of an adult, increasing risk of |
| 34-8 difference in pathophysiology of pediatrics vs adults (Pg 1224-1226) | |
| 34-9 steps primary assessment in pediatrics (Pg 1227-1236) | PAT:apearance, Work of Breathing, Circulation to the skin - Use TICLS: Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry ABCDE (Disability + Exposure) Airway: Breathing: Circulation: Deformities: Excessive Bleeds: |
| 34-10 steps of second assessment of a pediatrics (Pg 1236-1240) | -Hx from parent caregiver if under 8y/o - focused exam lungs sounds and HR, hand on belly for breathing -vitals For Vitals, do 70+(PT's age x 2) to figure out what systolic should be (for pts aged 1-10) -rapid/detailed exam |
| 34-11 steps of emergency care of pediatrics (Pg 1228-1229) and (Pg 1240 1253) | -pt in resp. Distress: combativeness, restlessness, and anxiety -s/s of increased work breathing: nasal flaring, abnormal breath sounds, accessory use, tripod -HR slower than 60 bpm->CPR -bradycardia -> cardiopulmonary arrest -blow-by or nasal cannula |
| 34-12 cause of upper and lower airway obstruction in pediatrics (Pg 1241-1243) | -toddlers put everything in mouth toys, objects and big food = choking hazard -infection or trauma Pneumonia, croup, epiglottitis, bacterial trachetis |
| 34-13 asthma causes and management in pediatrics (Pg 1243-1244) | triggers: upper resp. infection, exercise, exposure to cold air or smoke, and emotional stress - asthma=wheeze as they exhale - may be able to hear wheezing w/o stethoscope. -NRM O2 high flow -(MDI) -prolonged asthma attack= status asthmaticus. |
| 34-14 how to determine correct size of an airway adjunct in pediatrics (Pg 1245-1249) | - length-based resuscitation tape length-based resuscitation tape -OPA-> ear tip to corner mouth -NPA-> ear tip to nose tip |
| 34-15 different O2 delivery devices that are available for pediatrics (Pg 1249-1253) | -Blow-By kids who don't tolerate NRM 6 L/min more than 21% oxygen - Nasal Canula 1 to 6 L/min 24% to 44% oxygen -NRM up to 95% oxygen allows the patient to exhale all CO2 w/o rebreathing it. -BVM at 15 L/min provides nearly 100% oxygen |
| 34-16 emergency care of a pediatric patient with shock in pediatrics (Pg 1253-1255) | -do not waste time in the field -ensure adequate airway -control bleeding -give O2 -place child in position of comfort -keep him or her warm -provide rapid transport -call for ALS backup if needed |
| 34-17 emergency care of a pediatric patient with AMS in pediatrics (Pg 12550 | The mnemonic AEIOU-TIPS reflects the major causes of altered mental status. -altered LOC could range from confusion to coma -consider that the airway may not be patent in a low LOC |
| 34-18 emergency care of a pediatric patient with seizures in pediatrics (Pg 1255-1256) | open the airway. -suction -recovery position if vomiting -Provide 100% oxygen by nonrebreathing mask or blow-by method. -no signs of improvement, begin BVM ventilations w/ supplemental oxygen. -Transport appropriate facility. |
| 34-19 emergency care of a pediatric patient with meningitis in pediatrics (Pg 1255-1256) | -fever, altered LOC, seizure, pain with bending of neck or back, infants are irritable, small, pinpoint, red spots or purple rash -standard precautions -provide O2 -assist vents if needed -reassess vitals frequently -transport highest service lvl |
| 34-20 emergency care of a pediatric patient with gastrointestinal emergencies in pediatrics (Pg1257-1258) | -liver and splenic injuries are most common -causes: --ingestion of certain foods or unknown substances --appendicitis -symptoms: --nausea, vomiting, diarrhea --can lead to dehydration transport these pts |
| 34-21 emergency care of a pediatric patient with poisoning in pediatrics (Pg 1258-1259) | -external decon -Remove tablets or fragments from mouth + wash or brush poison from the skin. -Assess/ maintain ABCs and monitor breathing. -O2 w/ ventilations if needed -If S/S of shock: POWT to nearest appropriate hospital. -activated charcoal? |
| 34-22 emergency care of a pediatric patient with dehydration in pediatrics (Pg 1259-1260) | most common cause=vomiting and diarrhea. - greater risk bc smaller fluid reserves -mild: dry lips+gums, decreased saliva, and fewer wet diapers -moderately to severely: mottled, cool, clammy skin and delayed cap refill -Tx: ABCs, vitals. transport. |
| 34-23 emergency care of a pediatric patient with a fever emergency in pediatrics (Pg 1260-1261) | fibral seizures- sudden high fevers -provide cooling measures -Fever w/ rash=meningitis -body temp 100.4°F (38°C) causes: Infection, Status epilepticus, Cancer, Drug ingestion (aspirin), Arthritis, systemic lupus erythematosus, high environmental tem |
| 34-24 emergency care of a pediatric patient with drowning emergencies in pediatrics (Pg 1261) | icy water = hypothermia drowning emergency: coughing, choking, airway obstruction, difficulty breathing, altered mental status, seizure activity, unresponsiveness, fast slow or no pulse, pale or cyanotic skin -suction -ABCs -CPR -High flow O2 -POWT |
| 34-25 common causes of pediatric trauma emergencies for pediatrics (Pg 1261-1267)_ | Head injuries Chest injuries -soft, flexible ribs compressed w/o breaking. Abdominal injuries Burns Injuries of the extremities -greenstick (incomplete) fractures |
| 34-26 significance of burns in pediatrics (Pg 1266-1267) | minor- partial-thickness burns less than 10% of the body moderate- partial-thickness burns10% to 20% of the body severe- any full thickness burn, partial-thickness burn more than 20% of the body surface, any burn hands, feet, face, airway, or genitalia |
| 34-27 four triage categories (Pg 1267-1268) | -ability to walk ( except infants) -presence of spontaneous breathing ; less than 15 or greater than 45bpm -palpable peripheral pulse -appropriate response to painful stimuli in AVPU |
| 34-28 indicators of child abuse or neglect (Pg 1268-1271) | Consistency of injury w age Hx inconsistent w injury Inappropriate concerns Lack of supervision Delay in care Affect Bruises of various healing Unusual injury pattern Suspicious circumstances Enviornmental clues |
| 34-29 SIDS risk factors, assessment and management (Pg 1271-1272) | risk -mom <20 -smoker mom -premature assessment -Assessment of the scene -Assessment and management of the patient -Communication and support of the family |
| 34-30 communicating to family during death of a child (Pg 1272-1273) | |
| 34-31 positive ways EMTs might cope with death of pediatric Pt (Pg 1273) | - take time before going back - work through your feelings and to talk about the event w colleagues. -Consider professional help if these S/S continue. -Arrange for a proper debriefing after your involvement with the case comes to a close. |
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emt2023deal
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