Transcript Chapter 61 - HVA Center for EMS Education

Chapter 16
Pediatric
Emergencies
National EMS Education
Standard Competencies (1 of 8)
Special Patient Populations
Recognizes and manages life threats based
on simple assessment findings for a patient
with special needs while awaiting additional
emergency response.
National EMS Education
Standard Competencies (2 of 8)
Pediatrics
Age-related assessment findings and agerelated assessment and treatment
modifications for pediatric-specific major
diseases and/or emergencies
• Upper airway obstruction
• Lower airway reactive disease
• Respiratory distress/failure/arrest
National EMS Education
Standard Competencies (3 of 8)
Pediatrics (cont’d)
• Shock
• Seizures
• Sudden infant death syndrome
Patients With Special Challenges
• Recognize and report abuse and neglect
National EMS Education
Standard Competencies (4 of 8)
Medicine
Recognizes and manages life threats based
on assessment findings of a patient with a
medical emergency while awaiting additional
emergency response.
National EMS Education
Standard Competencies (5 of 8)
Respiratory
Anatomy, signs, symptoms, and management
of respiratory emergencies including those
that affect the
• Upper airway
• Lower airway
National EMS Education
Standard Competencies (6 of 8)
Trauma
Uses simple knowledge to recognize and
manage life threats based on assessment
findings for an acutely injured patient while
awaiting additional emergency medical
response.
National EMS Education
Standard Competencies (7 of 8)
Special Considerations in Trauma
Recognition and management of trauma in
• Pregnant patient
• Pediatric patient
• Geriatric patient
National EMS Education
Standard Competencies (8 of 8)
Anatomy and Physiology
Uses simple knowledge of the anatomy and
function of the upper airway, heart, vessels,
blood, lungs, skin, muscles, and bones as the
foundation of emergency care.
Introduction
• Sudden illness and medical emergencies
are common in children and infants.
• Anatomical differences exist between adults
and children.
• Respiratory care for children is extremely
important.
General Considerations (1 of 3)
• Managing a pediatric emergency can be
one of the most stressful situations you face
as an EMR.
– You must remain calm and professional.
– Unless you are prepared, your anxiety and fear
may interfere with your ability to deliver proper
care.
General Considerations (2 of 3)
• The parents can be either allies or a
potential problem.
– Talk to both the parents and the child as much
as possible.
– Try to develop a rapport with the child.
– Squat, kneel, or sit down and establish eye
contact.
– Ask simple questions about the pain.
General Considerations (3 of 3)
• The parents
(cont’d)
– Be honest with the
child.
– Some agencies
provide the child
with a trauma
teddy bear to hold
while being
examined.
Pediatric Anatomy
and Function (1 of 3)
• Differences
between children
and adults
– A child’s airway is
smaller in relation
to the rest of the
body compared to
an adult’s airway.
– A child’s tongue is
relatively larger
than an adult’s.
Pediatric Anatomy
and Function (2 of 3)
• Differences between children and adults
(cont’d)
– A child’s upper airway is more flexible than that
of an adult.
– For at least the first 6 months of their lives,
infants can breathe only through their noses.
– When the demands on a child’s respiratory
system change, the child is able to quickly
compensate by increasing breathing efforts.
Pediatric Anatomy
and Function (3 of 3)
• Differences between children and adults
(cont’d)
– Infants and children have limited abilities to
compensate for changes in temperature as
compared to adults.
Examining a Child
• Use the same five steps as in the adult
patient assessment sequence:
– Perform a scene size-up.
– Complete a primary assessment.
– Complete a secondary assessment by
examining the child from head to toe.
– Obtain a medical history.
– Perform reassessments as needed.
The Pediatric Assessment
Triangle (1 of 5)
• The PAT helps you
quickly form a
general impression
of the child using
only your senses of
sight and hearing.
Used with permission of the American Academy of Pediatrics,
Pediatric Education for Prehospital Professionals,
© American Academy of Pediatrics, 2000.
– Can be used to
assess a child from
a distance
The Pediatric Assessment
Triangle (2 of 5)
• Appearance
– Indicator of how well the heart, lungs, and
central nervous system are working
– Compare the child’s appearance with what you
would expect from a healthy child.
– Assess eye contact, muscle tone, and skin
color.
– Reassess regularly because the appearance
can change quickly.
The Pediatric Assessment
Triangle (3 of 5)
The Pediatric Assessment
Triangle (4 of 5)
• Work of breathing
– More accurate
indicator of a
child’s condition
than merely
determining the
respiratory rate
– Determined by
measuring four
factors
The Pediatric Assessment
Triangle (5 of 5)
• Circulation to the
skin
– Three
characteristics are
used to assess the
circulation.
Respirations (1 of 2)
• Count respirations for 30 seconds and
multiply by 2.
• Look for signs of respiratory distress.
– Assess how much work the child is doing to
breathe.
– Look for abnormal breath sounds such as noisy
breathing, snoring, crowing, grunting, and
wheezing.
Respirations (2 of 2)
• Look for signs of respiratory distress.
(cont’d)
– Determine whether the child is holding himself
or herself in an abnormal position.
– Check for retractions of the neck and chest.
– Look for flaring of the nostrils.
Pulse Rate (1 of 2)
• The normal pulse
rate of a child is
faster than an
adult’s normal rate.
• For a child younger
than 1 year,
palpate a brachial
pulse.
Courtesy of Jennifer and Marc Lemaire.
Pulse Rate (2 of 2)
High Body Temperature
• High temperatures are accompanied by:
– Flushed, red skin
– Sweating
– Restlessness
• To feel a high temperature, touch the child’s
chest and head.
• A child’s heart rate increases with each
degree of temperature rise.
Respiratory Care (1 of 2)
• It is important to open and maintain the
airway and to ventilate adequately any child
with respiratory problems.
Respiratory Care (2 of 2)
• Causes of cardiopulmonary arrest in
children
– Suffocation caused by aspiration of a foreign
body
– Infections of the airway such as croup and
epiglottitis
– Sudden infant death syndrome (SIDS)
– Accidental poisonings
– Injuries around the head and neck
Treating Respiratory
Emergencies (1 of 7)
• Opening the airway
– Use the head tilt–
chin lift maneuver
on children who
have not sustained
any injury to the
neck or head.
– Do not hyperextend
the child’s neck
when you tilt the
head back.
Treating Respiratory
Emergencies (2 of 7)
• Opening the airway (cont’d)
– If there is a possibility of injury to the head or
neck, try the jaw-thrust maneuver.
• Basic life support
– CPR for children is different from adult CPR.
• If you are alone and EMS has not been
called, perform five cycles (2 minute) of CPR
before activating the EMS system.
Treating Respiratory
Emergencies (3 of 7)
• Basic life support
(cont’d)
– Use the heel of one
hand or two hands to
perform chest
compressions.
– Compress the
sternum at least one
third the depth of the
chest
Treating Respiratory
Emergencies (4 of 7)
• Basic life support (cont’d)
– CPR for infants is different from adult CPR.
• Check for responsiveness by tapping the
infant’s foot or gently shaking the shoulder.
• Check the brachial pulse.
• Use your middle and ring fingers to compress
the sternum just below the nipple line.
• Compress the sternum at least one third the
depth of the chest.
• Give gentle rescue breaths.
Treating Respiratory
Emergencies (5 of 7)
• Suctioning
– Clear the airway initially by turning the patient
on his or her side and use your gloved finger to
scoop out the substance.
– Use suctioning to remove the rest of the foreign
substance.
– Suctioning can be a lifesaving procedure.
Treating Respiratory
Emergencies (6 of 7)
• Suctioning (cont’d)
– The procedure for suctioning is the same as for
adults, with the following exceptions:
• Use a tonsil tip or rigid tip to suction the mouth.
• Use a flexible catheter to suction the nose of a
child.
• Use a bulb syringe to suction the nose of an
infant.
• Never suction for more than 5 seconds.
• Try to ventilate and reoxygenate the patient
before repeating the suctioning.
Treating Respiratory
Emergencies (7 of 7)
• Airway adjuncts
– Oral airways can maintain an open airway after
you have opened the patient’s airway manually.
– Use the steps in Skill Drill 16-1 to insert an oral
airway in a child or an infant.
– EMRs rarely use nasal airways for children.
Mild Airway Obstruction (1 of 2)
• Place the child on his or her back, tilt the
head, and lift the chin in the usual manner.
• Remove the object if it is clearly visible in
the mouth and can be removed easily.
– If not, do not attempt to remove the object as
long as the child can still breathe.
• Children should be transported to the
emergency department.
Mild Airway Obstruction (2 of 2)
• Administer oxygen if it is available and you
are trained to use it.
– Place the oxygen mask over the child’s mouth
and nose.
– Do not try to get an airtight seal.
– Hold the mask 1" to 2" away from the child’s
face.
Severe Airway Obstruction
in Children (1 of 3)
• Severe airway obstruction is a serious
emergency.
• Signs and symptoms
– Poor air exchange
– Increased breathing difficulty
– Silent cough
– Inability to speak
– No movement
Severe Airway Obstruction
in Children (2 of 3)
• Use the Heimlich
maneuver.
– It provides enough
energy to expel
most foreign
objects.
Severe Airway Obstruction
in Children (3 of 3)
• Relieving an airway obstruction in a child is
the same as for an adult, with a few
exceptions.
– When opening a child’s airway, tilt the head
back just past the neutral position.
– If you are by yourself, perform CPR for five
cycles before activating the EMS system.
Severe Airway Obstruction
in Infants (1 of 4)
• An infant is very fragile.
• If you suspect an airway obstruction, assess
the infant to determine whether any air
exchange is occurring.
– If the infant is crying, the airway is not
completely obstructed.
– If no air is moving in or out of the infant’s mouth
and nose, suspect an obstructed airway.
Severe Airway Obstruction
in Infants (2 of 4)
• Use a combination of
back slaps and the
chest-thrust
maneuver.
– Assess the infant’s
airway and breathing.
– Place the infant in a
face-down position
over your one arm
and deliver five back
slaps between the
shoulder blades.
Severe Airway Obstruction
in Infants (3 of 4)
• Use a combination of back
slaps and the chest-thrust
maneuver. (cont’d)
– Turn the infant face-up.
– Deliver five chest thrusts
in the middle of the
sternum with your two
fingers.
– Repeat these steps until
the object is expelled or
until the infant becomes
unresponsive.
Severe Airway Obstruction
in Infants (4 of 4)
• If the infant becomes unresponsive,
continue with the following steps:
– Ensure that EMS has been activated.
– Begin CPR, starting with chest compressions.
– Continue CPR until personnel with more
advanced EMS skills arrive.
Swallowed Objects
• If small, round objects do not become
airway obstructions, they usually pass
uneventfully through the child.
• Sharp or straight objects are dangerous if
swallowed.
– Arrange for prompt transport.
Respiratory Distress (1 of 3)
• Signs of respiratory distress
– A breathing rate of more than 60 breaths/min in
infants
– A breathing rate of more than 30 to 40
breaths/min in children
– Nasal flaring on each breath
– Retraction of the skin between the ribs and
around the neck muscles
– Stridor
Respiratory Distress (2 of 3)
• Signs of respiratory distress (cont’d)
– Cyanosis of the skin
– Altered mental status
– Combativeness or restlessness
• Treatment of respiratory distress
– Try to determine the cause.
– Support the child’s respirations by placing the
child in a comfortable position, usually sitting.
Respiratory Distress (3 of 3)
• Treatment of respiratory distress (cont’d)
– Keep the child as calm as possible by letting a
parent hold the child if practical.
– Prepare to administer oxygen if it is available
and you are trained to use it.
– Monitor the child’s vital signs.
– Arrange for prompt transport.
Respiratory Failure/Arrest (1 of 5)
• Often results as respiratory distress
proceeds
• Signs and symptoms
– A breathing rate of fewer than 20 breaths/min in
an infant
– A breathing rate of fewer than 10 breaths/min in
a child
– Limp muscle tone
Respiratory Failure/Arrest (2 of 5)
• Signs and symptoms (cont’d)
– Unresponsiveness
– Decreased or absent heart rate
– Weak or absent distal pulses
• A child in respiratory failure is on the verge
of experiencing respiratory and cardiac
arrest.
Respiratory Failure/Arrest (3 of 5)
• Treatment
– Support respirations by performing mouth-tomask ventilations.
– Administer oxygen if it is available.
– Begin chest compressions if the heart rate is
absent or less than 60 beats/min.
– Arrange for prompt transport.
Respiratory Failure/Arrest (4 of 5)
• Circulatory failure
– The most common cause of circulatory failure in
children is respiratory failure.
– Can lead to cardiac arrest
– Indicated by an increased heart rate, pale or
bluish skin, and changes in mental status
Respiratory Failure/Arrest (5 of 5)
• Circulatory failure (cont’d)
– If the heart rate is more than 60 beats/min:
• Complete the patient assessment sequence.
• Support ventilations.
• Administer oxygen.
• Observe vital signs.
– If the heart rate is less than 60 beats/min, begin
chest compressions and rescue breathing.
Altered Mental Status (1 of 2)
• Causes of altered mental status in children
– Low blood glucose level
– Poisoning
– Postseizure state
– Infection
– Head trauma
– Decreased oxygen levels
Altered Mental Status (2 of 2)
• Complete the patient assessment.
• Pay particular attention to the patient’s initial
vital signs.
• Calm the patient and the patient’s family.
• Be prepared to support the patient’s ABCs.
• Place unconscious patients in the recovery
position.
Respiratory Illnesses (1 of 7)
• Because infants breathe primarily through
their noses, even a minor cold can cause
breathing difficulties.
• Asthma
– Caused by a spasm or constriction and
inflammation of smaller airways in the lungs
– Usually produces a wheezing sound
– Calm and reassure the parents and the child.
Respiratory Illnesses (2 of 7)
• Asthma (cont’d)
– Place the child in a
sitting position.
– Pursed-lip breathing
relieves some of the
internal lung
pressures.
– Help administer the
child’s medication.
– Arrange for prompt
transport.
Respiratory Illnesses (3 of 7)
• Croup
– Infection of the upper airway that occurs
mainly in children between 6 months and
6 years of age
– Results in a hoarse, whooping noise during
inhalation and a seal-like, barking cough
– Often occurs in colder climates
Respiratory Illnesses (4 of 7)
• Croup (cont’d)
– A lack of fright and the willingness to lie down
are important signs that distinguish croup from
epiglottitis.
– If the EMS unit is delayed, turn on the hot water
in the shower and close the bathroom door.
– The moist, warm air relaxes the vocal cords.
Respiratory Illnesses (5 of 7)
• Epiglottitis
– Severe inflammation of the epiglottis
– The flap is so inflamed and swollen that air
movement into the trachea is completely
blocked.
– Usually occurs in children between ages 3 and
6 years
Respiratory Illnesses (6 of 7)
• Epiglottitis (cont’d)
– Signs and symptoms
• The child is usually sitting upright.
• The child cannot swallow.
•
•
•
•
The child is not coughing.
The child is drooling.
The child is anxious and frightened.
The child’s chin is thrust forward.
Respiratory Illnesses (7 of 7)
• Epiglottitis (cont’d)
– Make the child comfortable with as little
handling as possible.
– Keep everyone calm.
– Administer oxygen.
– Arrange for prompt transport.
Drowning (1 of 3)
• Caused by submersion in water and initially
causes respiratory arrest
• Second most common cause of accidental
death among children 5 years of age or
younger in the United States
• Do not put yourself in danger as you
attempt a rescue.
Drowning (2 of 3)
• Signs and symptoms include lack of
breathing and no pulse.
• Treatment
– Assess the ABCs.
– Turn the child onto one side and allow the water
to drain out of the child’s mouth.
– Use suction if it is available.
– Start rescue breathing if necessary.
Drowning (3 of 3)
• Treatment (cont’d)
– Administer supplemental oxygen.
– If no pulse is present, start chest compressions.
– Stabilize the neck.
– To reduce the risk of hypothermia, dry the child
and cover him or her with dry blankets.
– Arrange for prompt transport.
Heat-Related Illnesses
• Heatstroke is a serious and potentially fatal
condition that requires rapid treatment.
– Remove the child’s clothing, sponge water over
the child, and fan him or her.
– You may wrap the child in wet sheets to speed
up the evaporation and cooling process.
– Arrange for rapid transport.
High Fever (1 of 2)
• Fevers are common in children.
• Because the temperature-regulating
mechanism in young children has not fully
developed, a very high temperature can
occur quickly.
• Most children can tolerate temperatures as
high as 104°F (40°C).
High Fever (2 of 2)
• Treatment
– Uncover the child so that body heat can escape.
– Attempt to reduce the high temperature by
undressing the child.
– Fan the child to cool him or her down.
– Protect the child during any seizure, and make
certain that normal breathing resumes after
each seizure.
Seizures (1 of 3)
• Can result from a high fever or from
disorders such as epilepsy
• Vary in intensity
• During a seizure:
– The child loses consciousness.
– The eyes roll back.
– The teeth become clenched.
– The body shakes with jerking movements.
Seizures (2 of 3)
• During a seizure: (cont’d)
– The child’s skin becomes pale or turns blue.
– Sometimes the child loses bladder and bowel
control.
• Treatment
– Place the patient on the floor or a bed to
prevent injury.
– Maintain an adequate airway after the seizure
ends.
Seizures (3 of 3)
• Treatment (cont’d)
– Provide supplemental oxygen.
– Arrange for prompt transport.
– Monitor the patient’s vital signs and support the
ABCs.
– After the seizure is over, cool the patient if he or
she has a high fever.
Vomiting and Diarrhea
• Usually caused by gastrointestinal
infections
• May produce severe dehydration
– The dehydrated child is lethargic and has very
dry skin.
– Hospitalization may be required to replace
fluids.
– If you suspect dehydration, arrange for
transport.
Abdominal Pain
• One of the most serious causes of
abdominal pain in children is appendicitis.
– Seen in people between 10 and 25 years
– Usually the child is nauseated, has no appetite,
and occasionally will vomit.
• Treat every child with a sore or tender
abdomen as an emergency.
• Arrange for prompt transport.
Poisoning (1 of 6)
• Ingestion
– An ingested poison is taken by mouth.
– Signs and symptoms
• Chemical burns, odors, or stains around the
mouth
• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
Poisoning (2 of 6)
• Ingestion (cont’d)
– Later symptoms
• Abnormal or decreased respirations
• Unconsciousness
• Seizures
– Try to identify the poison, and send the
container to the emergency department.
– Gather any spilled tablets and replace them in
the bottle so they can be counted.
Poisoning (3 of 6)
• Ingestion (cont’d)
– Contact the local poison control center if
transportation is delayed.
– You may need to give the child large amounts
of water or administer activated charcoal.
– Monitor the child’s breathing and pulse.
– Arrange for prompt transport.
Poisoning (4 of 6)
• Absorption
– Occurs when a poisonous substance enters the
body through the skin
– Localized symptoms include skin irritation or
burning.
– Systemic signs and symptoms include nausea,
vomiting, dizziness, and shock.
Poisoning (5 of 6)
• Absorption (cont’d)
– Ensure that the child is no longer in contact with
the poisonous substance.
– Protect yourself from exposure.
– Remove the child’s clothing if it is contaminated.
– Brush off any dry chemical and then wash the
child with water for at least 20 minutes.
– Try to identify the poison.
Poisoning (6 of 6)
• Absorption (cont’d)
– Monitor the child for any changes in respiration
and pulse.
– If the child has vomited, save a sample and
send it to the hospital.
– Arrange transport.
Sudden Infant Death Syndrome
(1 of 2)
• Also called crib death
• Sudden and unexpected death of an
apparently healthy infant
• Usually occurs in infants between the ages
of 3 weeks and 7 months
• No adequate scientific explanation exists for
SIDS.
• Be compassionate with the parents.
Sudden Infant Death Syndrome
(2 of 2)
• If the infant is still warm, begin CPR and
continue until help arrives.
• If the infant is dead, do not mistake the
large, bruise-like blotches on the body for
signs of child abuse.
– The blotches are caused by the pooling of the
infant’s blood after death.
– Follow the local protocol for the management of
deceased patients.
Pediatric Trauma (1 of 2)
• Trauma is the number one killer of children.
• Treat an injured child as you would treat an
injured adult, but remember these
differences:
– A child cannot communicate symptoms as well
as an adult.
– A child may be shy and overwhelmed by adult
rescuers.
Pediatric Trauma (2 of 2)
• Treat an injured child as you would treat an
injured adult, but remember these
differences: (cont’d)
– You may need to adapt materials and
equipment to the child’s size.
– A child does not show signs of shock as early
as an adult but can progress into severe shock
quickly.
Patterns of Injury (1 of 4)
• The patterns of injury sustained by children
will be related to three factors:
– Type of trauma they experience
– Type of activity causing the injury
– Child’s anatomy
• Motor vehicle crashes
– Unrestrained patients have more head and neck
injuries.
Patterns of Injury (2 of 4)
• Motor vehicle crashes (cont’d)
– Restrained patients often suffer head, spinal,
and abdominal injuries.
• Bicycle accidents
– Children often suffer head, spinal, abdominal,
and extremity injuries.
– The use of bicycle helmets can greatly reduce
the number and severity of head injuries.
Patterns of Injury (3 of 4)
• Children hit by cars
often sustain chest,
abdominal, thigh, and
extremity injuries.
• Falls from a height or
diving accidents cause
head, spinal, and
extremity injuries.
• Burns are a major
cause of injuries to
children.
Patterns of Injury (4 of 4)
• Treatment regardless of the cause of injury
– Check the patient’s ABCs.
– Stop severe bleeding.
– Treat the patient for shock.
– Conduct a full-body assessment.
– Stabilize all injuries you find.
– If the patient has head lacerations, treat the
wounds with direct pressure and bandaging.
Traumatic Shock in Children
(1 of 2)
• Children show shock symptoms much more
slowly than adults do, but they progress
through the stages of shock quickly.
• If these signs of shock are present, the child
is already in severe shock:
– Cool, clammy skin
– Rapid, weak pulse
– Rapid or shallow respirations
Traumatic Shock in Children
(2 of 2)
• Seizures are relatively common in children
who have sustained a serious head injury.
• The greatest dangers are airway obstruction
and hemorrhage.
• Treatment
– Open and maintain the airway.
– Control bleeding.
– Arrange for prompt transport.
Car Seats and Children
• If you find a child
properly restrained in
a car seat after a
motor vehicle crash,
leave the child in the
car seat until the
ambulance arrives.
• In many cases, a child
can be transported to
the hospital secured in
the car seat.
Child Abuse (1 of 4)
• Be concerned if the child is withdrawn,
fearful, or hostile and is unwilling to discuss
how the injuries occurred.
• Treat the child’s injuries and, if you suspect
abuse, ensure the child’s safety.
Child Abuse (2 of 4)
• Signs and symptoms
– Multiple fractures
– Bruises in various stages of healing
– Human bites
– Burns
– Reports of bizarre accidents
Child Abuse (3 of 4)
Courtesy of Ronald Deickmann, M.D.
Child Abuse (4 of 4)
• Transport the child.
– If the parents object, summon law enforcement
personnel.
• Signs and symptoms of neglect
– Lack of adult supervision
– Malnourished-appearing child
– Unsafe living environment
– Untreated chronic illness
Sexual Assault of Children
• In addition to experiencing sexual assault,
the child may have been beaten and may
have other serious injuries.
• Obtain as much information from the child
and any witnesses.
• Provide a caring approach.
• All victims of sexual assault should receive
transport to an appropriate medical facility.
Emergency Medical Responder
Debriefing
• Calls involving children tend to produce
strong emotional reactions.
• You may need to talk about feelings of
anger or frustration with a counselor.
• By attending debriefing sessions, you can:
– Express your feelings
– Learn some coping strategies
– Maintain a healthy approach to future calls
Summary (1 of 7)
• Because the anatomy of children and
infants differs from that of adults, special
knowledge and skills are needed to assess
and treat pediatric patients.
• Because both the child and the parents may
be frightened and anxious, you must
behave in a calm, controlled, and
professional manner.
Summary (2 of 7)
• The child who is unresponsive, is lackluster,
and appears ill should be evaluated
carefully because the lack of activity and
interest signal serious illness or injury.
• The three components of the pediatric
assessment triangle are overall
appearance, work of breathing, and
circulation to the skin.
Summary (3 of 7)
• It is important to open and maintain the
patient’s airway and to ventilate adequately
any child with respiratory problems.
• Young children often obstruct their upper
and lower airway with foreign objects, such
as small toys or candy.
Summary (4 of 7)
• In complete or severe airway obstruction in
a conscious child, you should perform the
Heimlich maneuver. If the child becomes
unresponsive, begin cardiopulmonary
resuscitation.
• To relieve an airway obstruction in an infant,
use a combination of back slaps and chest
thrusts.
Summary (5 of 7)
• Three serious respiratory problems in
pediatric patients are asthma, croup, and
epiglottitis.
• Other pediatric medical emergencies
include drowning, heat-related illnesses
such as heatstroke, high fevers, seizures,
vomiting and diarrhea, and abdominal pain.
Summary (6 of 7)
• The two most common types of poisonings
in children are caused by ingestion (taken
by mouth) and absorption (entering through
the skin).
• Sudden infant death syndrome, also called
crib death, is the unexpected death of an
apparently healthy infant.
Summary (7 of 7)
• Major trauma in children usually results in
multiple system injuries.
• If you suspect child abuse or sexual assault,
you must transport the child to an
appropriate medical facility.
Review
1. The purpose of the pediatric assessment
triangle (PAT) is to:
A. guide the hands-on physical assessment.
B. help you determine if the child’s vital signs are
appropriate.
C. allow you to quickly form a general impression
of the child.
D. help you remember the systematic
assessment process.
Review
Answer:
C. allow you to quickly form a general
impression of the child.
Review
2. Which of the following statements about
SIDS is FALSE?
A. It usually occurs in children between the ages
of 3 and 7 years.
B. No adequate scientific explanation exists.
C. It occurs in apparently healthy children.
D. You should start CPR if the child is still warm
when you arrive.
Review
Answer:
A. It usually occurs in children between
the ages of 3 and 7 years.
Review
3. Which of the following is NOT a common
respiratory condition in children?
A. asthma
B. epiglottitis
C. pneumonia
D. croup
Review
Answer:
C. pneumonia
Credits
• Opener: © Mark C. Ide
• Background slide image (ambulance): ©
Comstock Images/Alamy Images
• Background slide images (non-ambulance):
© Jones & Bartlett Learning. Courtesy of
MIEMSS.