ENPC Assessment Flashcards
Preparation and triage
-activate trauma/resuscitation team
-prepare room: 1. pediatric equipment 2. length-based resuscitation tape 3. pediatric protocols and dosing guidelines
Across the room observation
-Assess for uncontrolled hemorrhage
-Pediatric assessment triangle (appearance, work of breathing, circulation to skin)
-Sick/Sicker/Sickest
Primary Survey
Airway and alertness
Breathing and ventilation
Circulation and control of hemorrhage
Disability
Exposure and environmental control
Full set of vital signs
Get adjuncts and give comfort
Airway and alertness assessment
-AVPU
-Head tilt/chin lift or jaw thrust with assistance of second person
-Tongue obstructing
-loose or missing teeth
-foreign objects
-blood, vomit, secretions
-edema
-snoring, gurgling, or stridor
-bony deformity
Airway and alertness interventions
-suction airway
-place folded towel under shoulders/torso
-allow to remain in preferred position
insert an oro-or nasopharyngeal airway
-indicate need for intubation
Breathing and ventilation assessment
-is there spontaneous breathing?
-Is there symmetrical chest rise?
-what is the depth, pattern, & general rate of respirations?
-is there increased work of breathing?
-what is the skin color?
-are there open wounds or deformities?
-Are breath sounds present and equal bilaterally?
-Is there subcutaneous emphysema?
-Is there any tracheal deviation or jugular vein distention?
Signs of increased work of breathing
abnormal positioning
-grunting
-retractions/accessory muscle use
-head bobbing
-nasal flaring
Breathing and ventilation interventions
-apply oxygen
-provide ventilations with BVM
-indicate need for intubation
-indicate need for thoracentesis
-indicate need for chest tube
Circulation and control of hemorrhage assessment
-inspect for uncontrolled hemorrhage
-palpate central and peripheral pulses
-inspect and palpate skin for color, temperature, & moisture
-assess capillary refill
Circulation and control of hemorrhage interventions
-control uncontrolled hemorrhage
-initiate chest compressions & advanced life support
-assess patency of prehospital line
-obtain IV/IO access
-Cardiac monitor if dysrhythmia is suspected
-Fluid bolus using push-pull method (20 mL/kg infant/child and 10 mL.kg neonate or cardiogenic shock)
Disability assessment
-GCS (eve, verbal, motor)
-FOUR score (eye response, motor response, brainstem reflexes, respiration status)
-Assess pupils
-Assess blood glucose
Disability interventions
-Dextrose
-Head CT
-Need for intubation
Exposure and environmental control assessment
-Remove all clothing
-Inspect for uncontrolled hemorrhage or obvious signs of illness or injuries
Exposure and environmental control interventions
-Blankets
-Warming lights
-increased room temp
-warmed fluids
-warmed oxygen
F
Full set of vital signs
