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EMS > Chapter 8 - Pediatric Emergencies > Flashcards

Chapter 8 - Pediatric Emergencies Flashcards

1
Q

Symptomatic pediatric bradycardia: cool mottled skin, diminished pulses, altered mental status, increased capillary refill time greater than or equal to 3 seconds.

True or false?

A

True

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2
Q

Pediatric Bradycardia - 8010

TREATMENT: (6)

A

• Airway/breathing management
▪Monitor SpO2
▪ Administer 100% O2 via NRB
• If signs of severe cardiopulmonary compromise are present:
▪ Administer 100% O2 and ventilate the patient with BVM
▪ Provide advanced airway adjuncts if the patient deteriorates
▪ If patient eight years old or less and has signs of poor perfusion, the heart rate remains
< 60 despite 100% O2 and ventilation, initiate chest compressions
• Look for signs of Airway obstruction
▪Absent breath sounds
▪Tachypnea
▪Intercostal and suprasternal retractions
▪Stridor
▪Choking
▪Cyanosis
• Initiate cardiac monitoring
• Determine blood glucose level
• Assess temperature
▪ Hypothermia - Rewarm patient, ensure patient compartment is warm and administer warm IV fluids

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3
Q

Symptomatic pediatric tachycardia: cool mottled skin, diminished pulses, altered mental status, increased capillary refill time greater than or equal to 3 seconds.

True or false?

A

True

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4
Q

Pediatric Tachycardia - 8020

Sinus Tachycardia =

infant < ______ or Child < _____ with narrow QRS

A

220, 180

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5
Q

Pediatric Tachycardia - 8020

Symptomatic Tachycardia =

infant > ______ or Child > _____ with signs of poor perfusion

A

220, 180

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6
Q

Pediatric Tachycardia - 8020

TREATMENT: (6)

A

• If the patient is a symptomatic look for underlying causes (fever, dehydration, pain, etc)
• Airway/breathing management
▪Monitor SpO2
▪ Administer 100% O2 via NRB
• if signs of severe cardiopulmonary compromise are present:
▪ administer O2 and ventilate the patient with a BVM

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7
Q

Pediatric Tachycardia - 8020

TREATMENT: (6)

A

• If the patient is a symptomatic look for underlying causes (fever, dehydration, pain, etc)
• Airway/breathing management
▪Monitor SpO2
▪ Administer 100% O2 via NRB
• if signs of severe cardiopulmonary compromise are present:
▪ Administer 100% O2 and ventilate the patient with a BVM
▪ Provide advanced airway adjuncts if the patient deteriorate
• Initiate cardiac monitoring
• Assess temperature
• Consider specific treatment based on evaluation of patient and QRS

pg. 1
* No - Determine blood glucose level *

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8
Q

Shock pts may deteriorate rapidly. Sx of poor perfusion incl: cool mottled skin, dimin. pulses, AMS, increased cap refill time (> 3 secs) and tachycardia AND BP < 70 systolic. True or false?

A

True

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9
Q

Pediatric Shock - 8030

TREATMENT: (7)

A 
•   Place patient in SUPINE position
•   Maintain body warmth
•   Airway/breathing management
   ▪Monitor SpO2
   ▪Administer O2 via NRB
•   Assess temperature
•   Determine blood glucose level
•   Initiate cardiac monitoring
•   If unable to intubate after 2 attempts
   ▪Insert supra- glottic airway if child is equal to or greater than 4' tall. Otherwise, ventilate via BVM and airway adjunct(s)
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10
Q

Ped. Foreign Body Airway Obstruction - 8040
TREATMENT:
Foreign body Airway obstruction Maneuvers as indicated below: Conscious infant
▪Mild Obstruction with good air exchange (3)

A
  • Do not interfere with patient’s owns attempts to expel the obstruction.
  • Monitorr closely for signs of worsening
  • Attempt to keep patient com

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11
Q

Ped. Foreign Body Airway Obstruction - 8040
TREATMENT:
Foreign body Airway obstruction Maneuvers as indicated below: Conscious infant
▪Severe Obstruction (5)

A
  • If possible, bare the infant’s chest
  • support the infant in prone position, deliver up to five back blows in the middle of the upper back
  • Continuing to support the infant, rotate to a Supine 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 into obstruction is cleared or the infant becomes unresponsive

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12
Q

Ped. Foreign Body Airway Obstruction - 8040
TREATMENT:
Foreign body Airway obstruction Maneuvers as indicated below: Unconscious infant (3)

A
  • Reposition Airway and remove object by direct laryngoscopy with Magill forceps
  • Begin CPR as indicated
  • Suction as indicated

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13
Q

Ped. Foreign Body Airway Obstruction - 8040
TREATMENT:
Foreign body Airway obstruction Maneuvers as indicated below: Conscious child
▪Mild Obstruction with good air exchange (2)

A
  • Encourage patients own spontaneous coughing and breathing efforts
  • Attempt to keep patient calm

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14
Q

Ped. Foreign Body Airway Obstruction - 8040
TREATMENT:
Foreign body Airway obstruction Maneuvers as indicated below: Conscious child
▪Severe Obstruction: (1)

A

• Abdominal thrusts (Heimlich maneuver)

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15
Q

Ped. Foreign Body Airway Obstruction - 8040
TREATMENT:
Foreign body Airway obstruction Maneuvers as indicated below: Unconscious child (3)

A
  • Reposition Airway and remove object by direct laryngoscopy with Magill forceps
  • Begin CPR is indicated
  • Suction as indicated

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16
Q

Ped. Foreign Body Airway Obstruction - 8040

GENERAL TREATMENT: (2)

A

• Airway/breathing management
▪Monitor SpO2
▪ Once obstruction is removed, maintain oxygen saturation of 95% or greater
▪ Assist ventilations with BVM if necessary
▪ Premature Neonate in Neonate: 40 to 60 per minute
▪ Infants and children: 12 to 20 per minute (once every 3 to 5 seconds)
• Initiate cardiac monitoring

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17
Q

The following signs/symptoms will be treated as respiratory distress: increased RR, increased work of breathing, retractions, nasal flaring, SpO2 < 95%. True or false?

A

True

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18
Q

Pediatric Respiratory Distress - 8050

Normal Respiratory Rates

Infant (<1yr) =

A

30 - 60

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19
Q

Pediatric Respiratory Distress - 8050

Normal Respiratory Rates

Toddler (1-3yr) =

A

24 - 40

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20
Q

Pediatric Respiratory Distress - 8050

Normal Respiratory Rates

Preschooler (4-5yr) =

A

22 - 34

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21
Q

Pediatric Respiratory Distress - 8050

Normal Respiratory Rates

School-age (6-12yr) =

A

18 - 30

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22
Q

Pediatric Respiratory Distress - 8050

Normal Respiratory Rates

Adolescent (13-18yr) =

A

12 - 20

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23
Q

Pediatric Respiratory Distress - 8050

TREATMENT (5)

A

• Airway/breathing management
▪Monitor Spo2
▪Administer O2 via NRB
▪ If unable to maintain oxygen saturation with NRB, provide 100% O2 via BVM and positive pressure ventilations
▪Assess breath sounds
• Initiate cardiac monitoring
• Assess temperature
▪If patient is febrile apply cooling measures
• Determine Blood Glucose Level
• MILD croup (barking cough)
• MODERATE to SEVERE croup (Inspiaratory or expiratory stridor at rest)
• If unable to intubate after 2 attempts
▪Insert supra-glottic airway (Appendix D) of child is equal or greater than 4’ tall. Otherwise, ventilate via BVM and airway adjunct(s)

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24
Q

Pediatric Asthma - 8060

TREATMENT: (6)

A

• Airway/breathing management
▪Monitor SpO2
▪Administer O2 via NRB
▪Assess breath sounds
• Initiate cardiac monitoring
• Assess temperature
▪If patient is febrile apply cooling measures
• Treatment should be based on lung sounds and level of distress
▪MILD distress - Wheezes only
▪MODERATE distress - Wheezes/decreased breath sounds/accessory muscle use
▪SEVERE distress - Wheezes/stridor/decreased breath sounds with little to no air movement/accessory muscle use/tripoding
• If unable to intubate after 2 attempts
▪Insert supra-glottic airway (Appendix D) if child is equal or greater than 4’ tall. Otherwise, ventilate via BVM and airway adjunct(s)
• Determine Blood Glucose Level

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25
Q

Pediatric Non-Fatal Drowning - 8090

TREATMENT (9)

A

• ALL near drowning patients should be transported
• Maintain body warmth
• If trauma suspected, immobilize using proper techniques
• Airway/breathing management
▪Monitor SpO2
▪ Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
▪Apply CPAP (Appendix H) to patients with pulmonary edema
• If unable to intubate after 2 attempts
▪Insert supra-glottic airway (Appendix D) if child is equal or greater than 4’ tall. Otherwise, ventilate via BVM and airway adjunct(s)
• Assess temperature
• Determine Blood Glucose Level
• ANTICIPATE RAPID DETERIORATION AND THE NEED TO INTUBATE

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26
Q

Pediatric Allergic Reaction/Anaphylaxis - 8100

TREATMENT: (10)

A

• Airway/breathing management
▪Monitor SpO2
▪Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
▪ANTICIPATE RAPID DETERIORATION AND THE NEED TO INTUBATE
• Initiate cardiac monitoring
• ASSIST WITH THE ADMINISTRATION OF PATIENT’S AUTO-INJECTOR EPINEPHRINE IF PRESENT
• Determine blood glucose level
• ANTICIPATE RAPID TRANSPORT IN THE SETTING OF ANAPHYLAXIS
• Assess temperature
• MILD reaction - Without respiratory compromise
• MODERATE reaction - Involves respiratory compromise
• SEVERE reaction/ANAPHYLAXIS - severe respiratory distress
• If unable to intubate after 2 attempts
▪Insert supra-glottic airway (Appendix D) if child is equal or greater than 4’ tall. Otherwise, ventilate via BVM and airway adjunct(s)

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27
Q

Pediatric Altered Consciousness - 8110

Treatment: (11)

A

• Maintain aspiration prophylaxis by placing the patient in the RECOVERY POSITION
• If trauma suspected, immobilize using proper techniques
• Airway/breathing management
▪Monitor SpO2
▪ Administer O2 via proper adjunct maintain oxygen saturation 95% or greater
• Determine blood glucose level
• Initiate cardiac monitoring
• Assess temperature
• Look for underlying causes
▪ look for signs of abuse, toxins etc.
• Hypoglycemia - BGL < 50 mg/dl
• Hyperglycemia - BGL > 300 mg/dl
• Narcotic use
• unknown etiology
▪ Consider other treatable neurological or metabolic disorders and if identified follow the appropriate protocol

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28
Q

Pediatric Diabetic - 8120

TREATMENT: (5)

A 
•   Airway/breathing management
   ▪Monitor SpO2
   ▪Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
•   Determine blood glucose level
•   Initiate cardiac monitoring
•   Look for underlying causes

pg. 1

29
Q

Pediatric Overdose/Poisoning - 8130

TREATMENT: (8)

A

• If substance is known, contact Poison Control at 1-800-222-1222. Provide all information requested by poison control representative
• do not delay treatment or transport but if possible bring medication or substance ingested
• Maintain aspiration prophylaxis by placing the patient in the RECOVERY POSITION
• Airway/breathing management
▪Monitor SpO2
▪Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
• Determine blood glucose level
• Initiate cardiac monitoring
• Assess temperature
▪If patient is febrile apply cooling measures
• Consider specific treatment situations
▪Seizures may develop in many overdoses/poison/ingestion situations

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30
Q

Pediatric Seizures - 8140

TREATMENT: (6)

A

• Maintain aspiration precautions by placing a patient in the RECOVERY POSITION
• If trauma suspected, mobilize patient using proper technique
• If the patient is actively seizing, protect the patient from further injury
• Airway/breathing management
▪Monitor SpO2
▪ Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
• DETERMINE BLOOD GLUCOSE LEVEL IN EVERY PEDIATRIC SEIZURE PATIENT
• Assess temperature

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31
Q

Pediatric Fever - 8150

TREATMENT: (5)

A

• Airway/breathing management
▪Monitor SpO2
▪ Administer O2 via proper adjunct to maintain oxygen saturation of 95% or greater
• Assess temperature
▪ If patient is febrile (rectal >105.0° or tympanic > 104.0°) apply cooling measures
• Determine blood glucose level
• Initiate cardiac monitoring
• If the pediatric patient has a temperature > 102.0° and the patient has Ibuprofen or Acetaminophen:
▪ administer Ibuprofen 10 mg/kg (not for children under 6 months) PO or Acetaminophen 15 mg/kg PO

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32
Q

Pediatric Fever - 8150

Apply cooling measures if patient’s temperature is:

A

rectal > 105.0° or tympanic 104.0°

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EMS (36 decks)

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