ch 38 – Flashcard
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Explain the special considerations in dealing with the caregiver of a sick or injured child
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Emotionally distressed caregivers need to see that you are competant, calm, and confident
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Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups: Neonate
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A child from birth to 1 month of age Birth defects and unintentional injuries are common causes for emergencies in this group
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Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups: Infants
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1 month to 1 year of age Complete your scene size up and primary assessment as thoroughly as possible while you view the infant from across the room. Then if possible allow a familiar person to hold the baby while you complete your examination unless the baby is critically injured or ill. Start your assessment from the feet to the head
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Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups: Toddlers
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1 to 3 years of age Children this age do not like to be seperated from their caregiver, have their clothing removed, wearing a oxygen mask, and are afraid of needles Respect their space and think of your exam as an intrusion. Earn their respect and they will help you. Never disrespect a child.
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Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups: Preschoolers
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3-6 years of age You should explain medical procedures to them slowly and in simple terms that they can understand. Let them see your equipment that you will use and if possible to touch it If necessary sit ground rules. "Its okay to cry but biting and kicking is not okay"
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Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups: School age children
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6-12 years of age Be honest and respectful Explain things gently but firmly to them
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Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups: Adolescents
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12-18 years of age Most will be reluctant to give you information about drug use, sexual history, and illegal activities; ask only for the information you need and explain why you need it
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Describe the major anatomical and physiological differences in children with regard to the following: Airway
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Children have smaller airways with more soft tissue and a narrowing at the cricoid cartilage The openings of the trachea and esophagus are closer together
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Describe the major anatomical and physiological differences in children with regard to the following: Head
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Childrens heads are proportionally larger than adults Place padding underneath the patients shoulders to keep the airway and spine in proper alignment (age 8-9)
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Describe the major anatomical and physiological differences in children with regard to the following: Chest and lungs
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The ribs are more pliable than an adults and cant protect the organs as well Their lungs are more prone to collapse Children rely on their diaphram for changes in breathing
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Describe the major anatomical and physiological differences in children with regard to the following: Respiratory system
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More than 60 breaths per minute is inadequate breathing Muscles in the diaphragm are more prone to fatigue
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Describe the major anatomical and physiological differences in children with regard to the following: Cardiovascular system
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Children have faster heart rates Children have less blood circulating
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Describe the major anatomical and physiological differences in children with regard to the following: Abdomen
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A childs abdominal musulature is less developed than an adults, increasing the likelihood of internal organ damage Until a child reaches puberty their liver and spleen are less protected by their ribs
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Describe the major anatomical and physiological differences in children with regard to the following: Extermities
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The bones and extremities in a child fracture more often by bending and splintering
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Describe the major anatomical and physiological differences in children with regard to the following: Metabolic Rate
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Infants and children have a much faster metabolic rate, even at rest, injuries affecting respiration or poor oxygenation are more serious than in adults resulting in central nervous damage that occurs more quickly Pediatric patients are at a significant risk for development of acute hypoglycemia
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Describe the major anatomical and physiological differences in children with regard to the following: Skin and body surface area
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Children are more susceptable to hypthermia in cold enviorments The skin is thinner and more delicate than an adults
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Vital signs: Newborn to 1 year
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Heart rate 140 bpm Respiratory rate 40/minute
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Vital signs: 1-4 years
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Heart rate 120 bpm Respiratory rate 30/minute
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Vital signs: 4-12 years
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Heart rate 100 bpm Respiratory rate 20/ minute
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Vital signs: 12 years and over
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Heart rate 80 bpm Respiratory rate 15/ minute
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Use the pediatric assessment triangle to determine a pediatric status
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The pediatric assessment triangle is used as a visual assessment that is made as you approach the child without any palpation or auscultation 3 sides of triangle Appearance Work of breathing Circulation to skin
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Discuss special considerations for the following elements of the pediatric secondary assessment Physical exam
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Assess the child from toe to head or trunk to head
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Discuss special considerations for the following elements of the pediatric secondary assessment Vital sign assessment
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Pay close attention to the childs appearance of sickness or wellness Assess pulse by checking the radial pulse in a child and the brachial pulse in infants Do not attempt to take blood pressure of a child under 3 years instead rely on indicators of perfusion
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Discuss special considerations for the following elements of the pediatric secondary assessment History taking
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Involve the parents and caregiver as much as possible
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Recognize the signs of respiratory distress, respiratory failure, and respiratory arrest in pediatric patients
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Nasal flaring Neck muscle use Audible breathing noises Sesaw respirations
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Discuss the guidelines for emergency care of the following Respiratory emergencies
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Establish and maintain a patent airway Suction any secretions, vomit, and blood Initiate positive pressure ventilation Maintain oxygen therapy Position the patient Transport
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Discuss the guidelines for emergency care of the following Foreign body airway obstruction
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Mild foreign body obsturction: Encourage the child to keep coughing Severe foreign body obstruction: Position the patient prone on your forearm Deliever 5 back slaps between the shoulder blades Continue to repeat the steps until the object is dislodged or the patient becomes unresponsive Unresponsive Infant with foreign body obstruction: Open the air way with a head tilt chin lift Open the mouth and look for the foreign object. If the object can be seen attempt to remove it Provide 2 ventilations over a 1 second period 30 chest compressions at a rate of 100 per minute After the compressions look for the object and attempt to remove it if it is seen 2 ventilations and 30 compressions Continue this sequence until the object is removed
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Croup
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Administer oxgen, humidified is preferred, to maintain a SpO2 rating over 94% Keep the patient in a position of comfort either propped up or in the caregivers arms Transport
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Epiglottitis
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Do not put anything in the childs mouth because it can cause swelling of the airway Allow the patient to position themselves in the position of comfort Provide oxygen at 15lpm by nonbreather mask. If the airway is completely blocked use a bag valve mask and apply positive pressure ventillation Transport
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Asthama
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Administer oxygen, humidified if possible, to maintain a SpO2 rating over 94% Allow the child to be in the position of comfort If the child is prescribed an inhaler assist or consult medical direction for permission to administer it Transport
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Bronchiolitis
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Administer oxygen, humidified if possible, to maintain a SpO2 rating over 94% Let the child assume the position of comfort or place in a fowlers position with his neck slightly extended Monitor the pulse rate and mental status while you transport the child to the hospital
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Pneumonia
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Administer oxygen, humidified if possible, to maintain a SpO2 rating over 94% Let the child assume the position of comfort Transport the patient for further care
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Congential heart failure
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Establish and maintain an open airway. Administer oxygen to maintain an SpO2 rating of 94% or better If the breathing is or becomes inadequate begin positive pressure ventilation with supplemental oxygen Support the cardiovascular system as necessary. Consider ALS support
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Shock
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Establish and maintain an open airway. Administer oxygen to maintain an SpO2 rating of 94% or better If the breathing is or becomes inadequate begin positive pressure ventilation with supplemental oxygen Control bleeding if present Place the patient in the supine position Keep the patient warm and as calm as possible. If it is a baby cover its head Transport
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Describe the presentation and emergency medical care for pediatric patients with the following conditions Cardiac arrest
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Provide positive pressure ventilation with supplemental oxygen Perform CPR. Use an AED Call for AlS back up Transport
