8 Flashcards
(12 cards)
Pediatric Assessment
8000
Pediatric assessment
• Identify parent, care giver or legal guardian
• Identify signs of abuse/neglect (observe patient’s surroundings)
• Ensure medications or accurate medication list is available for receiving facility
• Assessment of pediatric patient requires ___, ___ and ____
Abnormal findings:
• Appearance
- Decreased response to parents or environmental stimuli
- Rigid or poor muscle tone or not moving
• Breathing
- Abnormal or no cry or speech
- Increased/excessive ___ flaring
- ____ or abdominal muscle use
- Decreased or no respiratory effort
- Noisy breathing (wheezing, grunting, gasping, or gurgling)
- Respiratory rate outside normal range
• Circulation
- Abnormal skin color (cyanosis, mottling, or paleness)
- Obvious significant bleeding
- Capillary refill >__ seconds with other abnormal findings
OBSERVATION AUSCULTATION . PALPATION
NASAL
RETRACTIONS
2
Pediatric Bradycardia
8010
Symptomatic pediatric bradycardia: cool mottled skin, diminished pulses, altered mental status, increased capillary refill time (>__ seconds).
TREATMENT
• Airway/breathing management
- Monitor SpO2 and administer ___% O2 via ___
- Refer to Advanced Airway Guideline 9030 as indicated
• If signs of severe cardiopulmonary compromise are present
- Ventilate with BVM
- If patient 8 years old or less and has signs of poor perfusion (as described above) with a heart rate
2
100 NRB
60 . 2
REWARM
Pediatric Tachycardia
8020
Symptomatic pediatric tachycardia: cool mottled skin, diminished pulses, altered mental status, increased capillary refill time (>__ seconds).
Sinus Tachycardia = Infant <220 or Child <180 with narrow QRS Symptomatic Tachycardia = Infant >220 or Child >180 with signs of poor perfusion
TREATMENT
• If the patient is asymptomatic look for underlying causes (fever, dehydration, pain etc.)
• Airway/breathing management
- Monitor ___ and administer ___% O2 via ___
- Refer to Advanced Airway Guideline 9030 as indicated
• Determine Blood Glucose Level
2
SPO2 100 . NRB
Pediatric Shock
8030
Shock patients may deteriorate rapidly. Signs of shock include hypotension, cool mottled skin, diminished pulses, altered mental status, increased capillary refill time (>__ seconds) and _____.
TREATMENT
- Place patient in ___ position
- Maintain body ____
- Airway/breathing management
- Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
- Refer to Advanced Airway Guideline 9030 as indicated
- Assess temperature
- Determine Blood Glucose Level
2 . TACHYCARDIA
SUPINE
WARMTH
Pediatric Foreign Body
Airway Obstruction
8040
TREATMENT
• Airway/breathing management
- Foreign Body Airway Obstruction maneuvers as indicated below:
• Infant (Less than __ year old)
• Conscious
• Mild Obstruction with good air exchange
- Do not interfere with patient’s own attempts to expel the obstruction
- Monitor closely for signs of worsening
- Attempt to keep patient calm
• Severe Obstruction
- If possible, bare the infant’s chest
- Support the infant in ___ position, deliver up to 5 back blows in the ___ of the ____ back
- Continuing to support the infant, rotate to a ___ position with the head lower than the trunk
- Deliver up to 5 quick downward chest thrusts in the same location as chest compressions
- Repeat sequence until obstruction is cleared or the infant becomes unconscious
• Unconscious
- Reposition airway and remove object by direct laryngoscopy with Magill forceps
- Begin CPR as indicated
- Suction as indicated
- Refer to Advanced Airway Guideline 9030 as indicated
- If unable to clear airway and adequately oxygenate/ventilate, perform age appropriate cricothyrotomy (Appendix K)
Child (__ year or older) Conscious
• Mild Obstruction with good air exchange
- Encourage patient’s own spontaneous coughing and breathing efforts
- Attempt to keep patient calm
• Severe Obstruction:
- Abdominal thrusts (Heimlich maneuver)
• Unconscious
- Reposition airway and remove object by direct laryngoscopy with Magill forceps
- Begin CPR as indicated
- Suction as indicated
- Refer to Advanced Airway Guideline 9030 as indicated
- If unable to clear airway and adequately oxygenate/ventilate
• Airway/breathing management
- Once obstruction is removed, administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
- Refer to Advanced Airway Guideline 9030 as indicated
1
PRONE
MIDDLE . UPPER
SUPINE
Pediatric
Respiratory Distress
8050
The following signs and symptoms will be treated as Respiratory Distress: increased respiratory rate, increased work of breathing, retractions, nasal flaring, SpO2
95
NRB
100 . BVM . POSITIVE
Pediatric Asthma
8060
TREATMENT
• Airway/breathing management
- __ breath sounds
- Administer O2 via proper adjunct to maintain oxygen saturation of __% or greater
- Refer to Advanced Airway Guideline 9030 as indicated
- Mild distress - Wheezes only
- Moderate distress - Wheezes/decreased breath sounds/accessory muscle use
-Severe distress - Wheezes/stridor/decreased breath sounds with little or no air movement/accessory muscle use/tripoding
- Assess temperature
- Determine Blood Glucose Level
ASSESS
95
Pediatric Altered
Consciousness
8100
TREATMENT
• Maintain ____ ____ by placing the patient in the recovery position
- Determine blood glucose level. If BGL is abnormal, refer to Pediatric Diabetic Guideline ___
- Airway/breathing management
- Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
- If GCS
ASPIRATION PROPHYLAXIS
RECOVERY
8110
8
8120
NEUROLOGICAL
Pediatric Diabetic 8110 TREATMENT • Airway/breathing management - Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
- Determine Blood Glucose Level
- Assess temperature
- Look for underlying causes
• Treatments based on blood glucose level and level of consciousness:
Repeat BGL after ___ minutes
• Considerations
- Onset in 1 minute with a peak onset time of ___ minutes
- The hypoglycemic patient will usually awaken within 15 minutes
• Hyperglycemia
- If BGL is greater than ___ mg/dL
15
30
300
Pediatric
Overdose/Poisoning
8120
TREATMENT
• If substance is known, contact Poison Control at 1-800-222-1222. Provide all information requested by poison control representative
• Airway/breathing management
- Maintain ___ ___ by placing the patient in the ______ position
- Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
- Determine Blood Glucose Level
- Wear appropriate personal protective equipment
- Seizures may develop in many overdose/poison/ingestion situations
- Refer to Pediatric Seizure Guideline ___
• Consider specific treatment situations:
• Narcotic use/exposure - The goal is to increase _____, not LOC
• Organophosphate exposure
- For all suspected organophosphate exposures, notify HAZMAT Team
- Signs and symptoms include Diarrhea, Urination, ___, Bradycardia, Bronchorrhea, Bronchospasm, Emesis, Lacrimation and ___
• Acute Dystonic Reaction to anti-psychotics
- Signs and symptoms include painful muscle spasms of the face, neck and back
• Do not delay treatment or transport but if possible bring medication or substance ingested
ASPIRATION PROPHYLAXIS
RECOVERY
8130
RESPIRATIONS
MIOSIS . SALIVATION
Pediatric Seizures
8130
TREATMENT
• Maintain ____ precaution by placing the patient in the recovery position
• If trauma suspected, immobilize patient using proper technique
• If the patient is actively seizing, protect the patient from further injury
• Airway/breathing management
- Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
- Look for underlying causes
- Determine blood glucose level.
- If BGL is abnormal, refer to Pediatric Diabetic Guideline 8110
• Assess temperature - If patient is febrile (>____), apply cooling measures
• Active seizures - Treat status epilepticus aggressively.
ASPIRATION
RECOVERY
104.00
Pediatric Fever
8140
TREATMENT
• Airway/breathing management
- Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
• Assess temperature
- If temperature is >____, apply cooling measures (ice packs, wet towels to neck, axillae, groin, etc.)
• Determine Blood Glucose Level
104.00
