Transcript 19 - Philadelphia University

Chapter 22
First Aid for Colleges
and Universities
10th Edition
Pediatric and
Geriatric
Emergencies
Slide Presentation prepared by
Randall Benner, M.Ed., NREMT-P
© 2012 Pearson Education, Inc.
Learning Objectives
• Explain special assessment techniques to use
with children.
• Explain how children’s vital signs differ from
those of adults.
• List special emergency situations involving
children.
• Describe the signs and symptoms of the
following respiratory conditions: croup,
epiglottitis, and asthma.
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Learning Objectives
• Discuss other common emergencies among
children.
• Describe how to manage a case of SIDS.
• Explain how to identify child abuse and neglect.
• Explain how body systems change with age.
• Explain special issues to consider when assessing
the elderly.
• Discuss special issues to consider when caring for
trauma in the elderly.
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Introduction
• First Aiders care for victims of all ages.
• The very young and very old have unique needs
that are particular to their age group.
• This chapter will review the assessment and
treatment considerations for these victims.
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Assessing the Child
• Not simply “small adults”
• Unique psychological and physical differences
• You must care for the young victim, as well as
consider the needs of their parents, family, or
regular caregivers.
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Physiology Unique to Children
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Assessing the Child
• Special Assessment Techniques
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Does the child notice me?
Does the child know the parents?
Does the child look sick?
Is the child in extreme pain?
How is the child breathing?
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Assessing the Child
• Special Assessment Techniques
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Display confidence, competence, and friendliness.
Stay close to the child’s eye level.
Explain your actions in terms the child understands.
Save most painful parts of assessment for last.
Incorporate the parent’s help into assessment.
Be honest, gentle, and patient.
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Assessing the Child
• Obtaining a history
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Don’t become unnerved by child or parents.
Get information from a reliable source.
Ask standard questions about signs/symptoms.
Ascertain the mechanism of injury and any treatment
already rendered.
• Always treat disturbances to ABC’s first.
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Assessing the Child
• Taking vital signs.
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Respirations
Pulse
Temperature
Neurological assessment
• Overall impressions of how a child looks and acts
are more important regarding the child’s status than
any one vital sign.
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Emergencies Involving Children
• Treatment between adults and children is often the
same, it’s how you provide treatment that differs
– Heads are proportionally larger – always assume cervical
injury.
– Bones tend to bend rather than break with trauma,
causing more internal injuries.
– Skin surface is proportionally larger in a child, as is the
tongue.
– Gastric distention is common with dyspnea.
– Always stop bleeding quickly (minor bleeding can indicate
major problems).
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Emergencies Involving Children
• Common emergencies often involve dyspnea or
obstructed airway
– Asthma
– Croup
– Epiglottitis
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Croup and Epiglottitis
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Emergencies Involving Children
• Asthma care guidelines
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Allow child to assume position of comfort.
Be calm and reassuring.
Activate EMS or take the child to a medical facility.
If allowed and capable, help the child with their inhaler, if
prescribed.
– Utilize high-flow oxygen if equipped and needed, and
child is capable.
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Emergencies Involving Children
• Cardiac arrest
– Most common cause of airway/breathing failure
– Be able to identify signs and symptoms of arrest.
• Cardiac arrest management
– Refer to Chapter 5 for CPR guidelines for infants and
children
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Emergencies Involving Children
• Seizures
– Causes are same as for adults, however children also
seize due to high body temperature
• Seizure management
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Take precautions, activate EMS.
Turn the victim onto their side.
Do not restrain the victim (protect/cradle head).
Loosen tight clothing.
Sponge feverish child with lukewarm water.
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Emergencies Involving Children
• Shock
– Commonly due to blood loss, airway/breathing failure,
acute infection, heart failure, and, in newborns,heat loss
– Symptoms similar to adult victims
• Shock management
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Take precautions, activate EMS.
Have the victim lie flat.
Support ABCs.
Keep the child warm.
Monitor vital signs.
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Sudden Infant Death Syndrome
• Sudden Infant Death Syndrome (SIDS)
– Commonly known as “crib death”
– Occurs when an apparently healthy infant suddenly dies
in their crib
– Many theories abound as to cause, nothing confirmed
• SIDS management
– Even if infant is obviously dead, always activate EMS and
begin CPR.
– Help parents cope.
– Facilitate the transference of the patient to EMS, ensure
any other children at home are cared for.
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Identifying Child Abuse
• Abuse clues
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Child Abuse
• First aid care for abuse/neglect
– Inform parents or other adults present that you are there
for the child’s care.
– Focus attention on child, use age appropriate
assessment.
– Assess and treat any injuries found.
– Do not confront anyone with suspicions.
– Report your suspicions promptly to appropriate
authorities.
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Child Death or Abuse
• Caring for yourself
– Most children who die from accidents are pronounced
dead at the scene.
– Always control your emotions so you can best manage
young victims.
– When the episode is over, seek assistance from a mental
health professional if you have trouble coping.
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Geriatric Emergencies
• People over the age of 65
• Large percentage of the population
• Largest consumer group of health care and
medicine
• Most have 3 or more illnesses/conditions
• Also affected by the physiology of aging
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Physical Changes in the Elderly
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Geriatric Emergencies
• Special assessment considerations
– Older bodies compensate less well; small problems can
quickly become large ones.
– Multiple medications may impede treatment or complicate
conditions.
– Psychiatric disorders may complicate assessment.
– Effects of aging can be hard to distinguish from disease
effects.
– The elderly may underreport or fail to report symptoms.
– Communication challenges are common.
– Victim complaints are often vague (fatigue, headache,
loss of appetite, constipation, etc.).
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Geriatric Emergencies
• Special exam considerations
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Victims fatigue easily
Several layers of clothing may be present
Explain all actions clearly to geriatric victim.
The geriatric victim may not want transport or treatment
due to fear of losing independence.
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Geriatric Emergencies
• Special trauma considerations
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Increased risk and incidence of falls
Higher risk for trauma from criminal assault
Prone to head injuries
Prone to spinal cord injuries with or without a traumatic
mechanism
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Summary
• With children or the elderly, speak clearly and
slowly, using terms they can understand.
• Sometimes the victim is not the best source of
information for history.
• Both age extremes at higher risk for brain trauma,
spinal trauma, and trauma through neglect.
• Always provide support to the airway, breathing,
and circulatory mechanisms (ABCs) first—then
worry about minor injuries or other findings.
© 2012 Pearson Education, Inc.