PNP Flashcards
Prepare the Room and assign nursing roles
- Length based resuscitation tape
- Pediatric Equipment
- Pediatric protocols and dosing guidelines
- Scale
Don PPE
Consider potential safety threats to the team and the need for decontamination
Your patient has arrived. What would you like to do?
Assess the PAT:
Appearance
Work of breathing
Circulation to the skin
No alteration in the PAT means the child is :
Sick
One alteration in the PAT means the child is:
SickER
Two or more alterations in the PAT means the child is:
SickEST
After the PAT assessment. What do you need to assess next
Assess for obvious uncontrolled external hemorrhage or unresponsiveness/apnea and the need to reprioritize to C-ABC
If obvious uncontrolled external hemorrhage or unresponsiveness/apnea and the need to reprioritize to C-ABC is present. What are the identified interventions?
4
May include, but not limited to, the following:
1. Assessforapulse
2. Control external hemorrhage
3. Initiate chest compressions
- Then reassess.
What is first in the primary survey
Assess level of consciousness using AVPU
Open the airway:
May include, but not limited to, the following:
1.If cervical Spinal injury is suspected ,provide manual cervical spinal stabilization AND demonstrate manual opening of the airway using the jaw-thrust maneuver.
•when no trauma is suspected ,open the airway with a head tilt-chin lift or jaw thrust
When the patient is alert and can cooperate, it is acceptable to ask the patient to open their mouth to assess the airway.
Assess the airway for:
8
- Bony deformity
- Edema
- Fluid
- Foreign objects
- Loose or missing teeth
- Sounds
- Tongue obstruction
- Vocalization
When alterations are found when assessing the airway,what interventions are appropriate?
7
- anticipate the need for intubation.
- insert an oral or nasal pharyngeal airway.
- Place padding under the shoulders or torso.
- position the patient to optimize airway.
- Remove any loose teeth or for an objects.
- suction the airway.
7 Reassess
Assess for breathing effectiveness
8
- breath sounds
- Depth pattern, and rate of respirations.
- Increased work of breathing.
- Open wounds or deformities.
- Skin color.
- Spontaneous breathing.
- Subcutaneous emphysema
- Symmetrical chest rise and fall. 
When alterations are identified in breathing, which interventions are appropriate?
6
- Anticipate the need for a chest tube.
- Anticipate the need for drug assisted intubation.
- Anticipate the need for medication’s.
- Anticipate the need for decompensation of a pneumo-
- Anticipate the need for oxygen.
- Provide bag mask ventilation’s.
Reassess times four
If intubated, assess endotracheal tube placement by identifying which three things?
- Attach a CO2 detector after 5 to 6 breaths, assessed for evidence of an exhaled CO2.
- Simultaneously observe for rise and fall of the chest with the ventilations.
- Auscultation over the epigastrium for gurgling and lungs for bilateral breath sounds.
After identifying endotracheal tube placement, what else are you assessing?
The endotracheal tube position by noting the number at the teeth or gums and secure the tube.
After assessing the ET tube and noting the number at the teeth and gums, what do you need to do next?
Begin, mechanical, ventilation, or continued, assisted ventilation.
Apply pulse ox symmetry and capnography
Assess circulation by identifying three important things.
- Assess capillary refill.
- Inspect and palpate the skin for color, temperature and moisture.
- Palpate, pulses. 
When alterations are found, when assessing circulation, what interventions would be appropriate?
- Obtain IV or IO access
- Drawl labs.
- Facilitate fast exam.
- Apply a pelvic binder.
- Anticipate goal directed therapy for shock.
- Compare, central and peripheral pulses.
- Initiate chest compressions.
- Control hemorrhage.
- Apply cardiac monitor.
- Weigh the patient and administer 20 mL per kilogram for an infant or child 10 to 20 mL per per kilogram of blood 10 mL per kilogram for neonate’s.
Reassess
D- disability
Assess neurologic status using the GCS and assess pupils.
Best eye-opening
best verbal response.
Best motor response.
When alterations are identified while assessing the GCS, which interventions would be appropriate
1 Assess bedside glucose level
2 anticipate the need for drug assisted intubation
3. Anticipate the need for a head CT.
E. Exposure
Remove all clothing and inspect for obvious abnormalities or injuries
Is abnormalities or injuries are identified during exposure, what interventions would be appropriate?
If a transport device is in place, it may be removed
If there are no contraindications to patient may be turned to quickly access the posterior, or it can be deferred until they head to toe and imaging to evaluate, spinal and pelvic stability as indicated
After exposure and inspection, what is appropriate to do next?
Provide warmth using blankets, increased room, temperature, warmed fluids, and warming lights
