5. Pre-hospital care

Question 1

What acronym is used for the assessment of unwell child pre-hospital?

Answer 1

Catastrophic haemorrhage
Ac airway and C spine stabilisation
Breathing
Circulation
Disability
Exposure

Question 2

How should the drowning child be managed?

Answer 2

Safety
- Remove child from water without getting in water (use stick)
- Place in horizontal position to maintain BP
Airway
Breathing
Circulation

Question 3

What is the definition of hypothermia and what is important to remember in children?

Answer 3

Temp <35 (or higher thresholds in children)
If <6 months cannot shiver
Children have larger surface area to weight ratio to lose heat

Question 4

What is the management of mild hypothermia (>32oC)?

Answer 4

simple external rewarming measures:
- remove wet clothes
- dry the patient
- warm blankets
- space blanket
- hat
- place on external warm packs

Question 5

What is the management of moderate and severe hypothermia (<32oC)?

Answer 5

same as simple but also:
- give warmed humidified oxygen
- may need to start CPR if becomes pulseless but never diagnose death until patient was been rewarmed to at least 32 degrees
- warm IV fluids until 32 degrees then allow passive warming

Question 6

What is the ATMIST mnemonic and what is it used for?

Answer 6

Used for patient handover, often arriving in hospital
A - age
T - time of onset
M - medical complaint
I - investigations
S - vital signs
T - treatments given