Chapter 32, Pediatric Emergencies (NOTES).ppt Chapter 32 Pediatric Emergencies Pediatric Emergencies...

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Transcript of Chapter 32, Pediatric Emergencies (NOTES).ppt Chapter 32 Pediatric Emergencies Pediatric Emergencies...

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    Chapter 32 Pediatric Emergencies

    Pediatric Emergencies Caring for sick and injured children presents

    _______________________ challenges. EMT-Bs may find themselves anxious when dealing with

    critically ill or injured children. Treatment is the same as that for adults in

    _______________________ emergency situations.

    Communication With the Patient and the Family You may have more than _______________________

    patient. – Caregiver may need help and support.

    A calm parent contributes to a calm child. – An agitated parent means child will act same way.

    Remain _______________________ , efficient, professional, and sensitive.

    Growth and Development Thoughts and behaviors of children usually grouped into

    stages – _______________________ – Toddler years – _______________________ age – School age – _______________________

    Infant First _______________________ of life They respond mainly to physical stimuli. _______________________ is a way of expression. They may prefer to be with _______________________






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    Assessment of Infants Observe infant from a _______________________ . Caregiver should hold baby during assessment. Provide _______________________ comfort.

    – Warm hands and end of stethoscope. Do painful procedures at _______________________ of


    Toddler ____________ to ___________ years of age They begin to walk and explore the environment. They may resist _______________________ from

    caregivers. Start to learn body systems Vocabulary grows rapidly

    Assessment of Toddlers May have stranger anxiety May resist separation from caregiver May have a hard time describing

    _______________________ Can be _______________________ Persistent _______________________ can be a

    symptom of serious illness or injury.

    Preschool Age Children ___________ to ___________ years of age They can use simple language effectively. They can understand _______________________ . They can identify painful areas when questioned. They can _______________________ when you explain

    what you are going to do using simple descriptions.





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    Assessment of Preschool Children Much _______________________ must still be

    obtained from caregivers. Appeal to child’s imagination to facilitate examination. Never _______________________ to the patient. Patient may be easily distracted.

    School Age Children __________ to __________ years of age Beginning to act more like adults Can think in concrete terms Can respond sensibly to questions Can help take care of themselves _______________________ is important. Children begin to understand death

    Assessment of School Age Children (1 of 2) Assessment begins to be more like adults’. Talk to the child, not just the caregiver. Start with head and move to the

    _______________________ . Give the child _______________________ if possible. Ask only questions that let you control the answer:

    – Would you like me to take the BP on the right or left arm?

    Assessment of School Age Children (2 of 2) Allow the child to listen to his or her heartbeat through

    the stethoscope. Can understand difference between physical and

    emotional pain Give them simple _______________________ about

    what is causing pain and what will be done about it.





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    Ask the parent’s or caregiver’s advice about which _______________________ will work best.

    Adolescents __________to __________years of age They are very concerned about body image. They may have strong feelings about being observed. Puberty begins Feel “_______________________ ” They understand _______________________ .

    Assessment of Adolescents (1 of 3) Respect an adolescent’s _______________________ . Explain any procedure that you are doing. Can often understand complex concepts and treatment

    _______________________ Allow them to be involved in their own care. Provide _______________________ , while lending


    Assessment of Adolescents (2 of 3) EMT of same _______________________ should do

    assessment, if possible. Allow them to speak openly and ask questions. Risk-taking behaviors are common.

    – Can ultimately facilitate development and judgment, and shape identity

    – Can also result in _______________________ , dangerous sexual practices, and teen pregnancy

    Assessment of Adolescents (3 of 3) Female patients may be _______________________ :  Important to report this information to receiving facility. Adolescent may not want parents to know this





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    information. Try to interview _______________________ the

    caregiver/parent present.

    Differences Between Pediatrics and Adults

    Airway Differences  Larger, rounder _______________________  Larger tongue relative to the mouth  Larger _______________________  Less well-developed rings of cartilage in the trachea Narrower, lower _______________________

    Breathing Differences (1 of 2)  Infants breathe _______________________ than

    children or adults.  Infants use the diaphragm when they breathe. Sustained, labored breathing may lead to respiratory

    _______________________ . Respiratory problems are the leading cause of

    cardiopulmonary arrest in the pediatric population.

    Breathing Differences (2 of 2) During respiratory _______________________ , the

    pediatric patient is working harder to breathe and will eventually go into respiratory failure.

    Respiratory failure occurs when the pediatric patient has exhausted all _______________________ mechanisms.

    Waste products collect, leading to respiratory arrest, a total _______________________ .

    Circulation Differences (1 of 2) The normal heart rate is faster than adults.

    – Infants heart can beat __________ beats/min or more.






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    The heart rate increases for _______________________ and injury.

    Primary method used to compensate for decreased perfusion

    _______________________ keeps vital organs nourished.

    Constriction of the blood vessels can affect blood flow to the extremities.

    Circulation Differences (2 of 2) Pediatrics are more dependent on actual cardiac output.

    – Blood being pumped out of heart in __________ minute

    May be in shock despite normal blood pressure A small amount of blood loss can lead to

    _______________________ .

    Gastrointestinal System (1 of 3) _______________________ muscles are less

    developed.  Less protection from trauma.  Liver, spleen, kidneys are proportionally larger and

    situated more anteriorly and close to one another. – Prone to bleeding and injury – There is a higher risk for multiple

    _______________________ injury.

    Gastrointestinal System (2 of 3) Signs and symptoms of acute abdomen may be vague. Abdominal walls are underdeveloped. May not be able to _______________________ origin

    of pain Take complaints of abdominal pain seriously.

    – Large amount of _______________________ may




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    occur within abdominal cavity, without signs of shock.

    Gastrointestinal System (3 of 3)  Liver and _______________________ injuries are

    common in this age group. Needs to be monitored for shock; may include AMS,

    _______________________ , tachycardia, and bradycardia

    Musculoskeletal System (1 of 4) Open growth _______________________ allow bones

    to grow. As a result of growth plates, children’s bones are softer

    and more flexible, making them prone to stress fracture.

    Bone _______________________ discrepancies can occur if injury to growth plate occurs. – Immobilize all strains and sprains.

    Musculoskeletal System (2 of 4) Bones of an infant’s head are

    _______________________ and soft. Fontanelles (soft spots) are located at front and back of

    head. – Will close at particular _______________________ of


    Musculoskeletal System (3 of 4) _______________________ can be a useful

    assessment tools – Bulging indicates intracranial pressure

    Thoracic cage is highly elastic and pliable. – Composed of cartilaginous connective tissue – Ribs and vital organs are less protected.





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    Muscles and bones grow into _______________________ .

    Musculoskeletal System (4 of 4) The younger the child, the more

    _______________________ the bone structures. – Sprains are uncommon and femur fractures rare.

    Older children are prone to _______________________ bone fractures due to more risks and activity.

    Integumentary System (1 of 2) _______________________ skin and less subcutaneous

    fat Higher ratio of body surface area to body mass leads to

    larger fluid and heat losses. Composition of skin is thinner and tends to

    _______________________ more easily