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Explain the special considerations in dealing with the caregiver of a sick or injured child
Emotionally distressed caregivers need to see that you are competant, calm, and confident
Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups:

Neonate

A child from birth to 1 month of age

Birth defects and unintentional injuries are common causes for emergencies in this group

Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups:

Infants

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

Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups:

Toddlers

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.

Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups:

Preschoolers

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”

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

6-12 years of age

Be honest and respectful

Explain things gently but firmly to them

Describe major developmental chracteristics and modifications of patient assessment and management techiniques recommended for patients in each of the following age groups:

Adolescents

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

Describe the major anatomical and physiological differences in children with regard to the following:

Airway

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

Describe the major anatomical and physiological differences in children with regard to the following:

Head

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)

Describe the major anatomical and physiological differences in children with regard to the following:

Chest and lungs

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

Describe the major anatomical and physiological differences in children with regard to the following:

Respiratory system

More than 60 breaths per minute is inadequate breathing

Muscles in the diaphragm are more prone to fatigue

Describe the major anatomical and physiological differences in children with regard to the following:

Cardiovascular system

Children have faster heart rates

Children have less blood circulating

Describe the major anatomical and physiological differences in children with regard to the following:

Abdomen

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

Describe the major anatomical and physiological differences in children with regard to the following:

Extermities

The bones and extremities in a child fracture more often by bending and splintering
Describe the major anatomical and physiological differences in children with regard to the following:

Metabolic Rate

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

Describe the major anatomical and physiological differences in children with regard to the following:

Skin and body surface area

Children are more susceptable to hypthermia in cold enviorments

The skin is thinner and more delicate than an adults

Vital signs:

Newborn to 1 year

Heart rate 140 bpm

Respiratory rate 40/minute

Vital signs:

1-4 years

Heart rate 120 bpm

Respiratory rate 30/minute

Vital signs:

4-12 years

Heart rate 100 bpm

Respiratory rate 20/ minute

Vital signs:
12 years and over
Heart rate 80 bpm

Respiratory rate 15/ minute

Use the pediatric assessment triangle to determine a pediatric status
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

Discuss special considerations for the following elements of the pediatric secondary assessment

Physical exam

Assess the child from toe to head or trunk to head
Discuss special considerations for the following elements of the pediatric secondary assessment

Vital sign assessment

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

Discuss special considerations for the following elements of the pediatric secondary assessment

History taking

Involve the parents and caregiver as much as possible
Recognize the signs of respiratory distress, respiratory failure, and respiratory arrest in pediatric patients
Nasal flaring

Neck muscle use

Audible breathing noises

Sesaw respirations

Discuss the guidelines for emergency care of the following

Respiratory emergencies

Establish and maintain a patent airway

Suction any secretions, vomit, and blood

Initiate positive pressure ventilation

Maintain oxygen therapy

Position the patient

Transport

Discuss the guidelines for emergency care of the following

Foreign body airway obstruction

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Croup

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Epiglottitis

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Asthama

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Bronchiolitis

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Pneumonia

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Congential heart failure

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Shock

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

Describe the presentation and emergency medical care for pediatric patients with the following conditions

Cardiac arrest

Provide positive pressure ventilation with supplemental oxygen

Perform CPR. Use an AED

Call for AlS back up

Transport

Explain the assessment steps and emergency care protocol for resiratory or cardiopulmonary emergency in the pediatric patient
Describe the presentation and emergency medical care for pediactric patients with the following conditions

Seizures, including epilepticus

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Altered mental status

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Drowning

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Fever

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Meningitis

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Gastrointestinal disorders

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Poisoning

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Apparent life threatening emergencies

Describe the presentation and emergency medical care for pediactric patients with the following conditions

Sudden infant death syndrome

Describe special considerations in the scene size up, emergency medical care, and assisting family members in case of suspected SIDS and the importance of the presence of parents during pediatric resuscitation
Intergrate consideration of a pediatric patients size and anatomy into the assessment of mechanisms of injury
Demonstrate removal of a pediatric patient from a child car seat
Demonstrate proper spinal immobilization of a pediatric patient
Explain the importance of injury prevention programs to reduce pediatric injuries and death
Discuss the purpose of the federal emergency medical services for childeren program and the concept of family centered care
Discuss factors that can increase EMS providers stress on pediatric calls and ways of managing the stress that may be associated with a pediatric call