Emergency Care Children Flashcards
neonates
infants
toddlers
school-aged children
adolescents
neonates (birth to 1 month),
infants (1 month to 1 year),
toddlers (1 to 3 years),
school-aged children (3 to 12 years), and adolescents (12 to 18 years)
unique c siderations in airway management
relatively large occiput, small jaw, high and anterior larynx, narrow cricoid cartilage, and large tongue
increased rate of breathing
Tachypnea
increased depth of respiration
hyperpnea
Systolic blood pressure (5th percentile)
70 + [2 × (age in years)]
12 mo: weight (kg)
4 + (age in months/2)
1–12 y: weight (kg)
10 + [2 × (age in years)]
imaging modality of choice for a number of disease conditions in children, such as pyloric stenosis, appendicitis, and intussusception
Ultrasound
Neonatal resuscitation focuses
respiratory assistance with effective positive-pressure ventilation
cardiac arrest is most commonly secondary to
respiratory failure in children
cardiac arrest is most commonly secondary to
respiratory failure in children
Common medications can have adverse effects in children
dental staining from tetracycline antibiotics and
life-threatening complications from antimotility drugs commonly used for adult diarrheal disease
Caring for critically ill children is best accomplished with at least two patient care providers on each team in addition to the driver or pilot.
One of the patient care members should be a registered nurse with a minimum of 5 years of experience at least 3 years of neonatal or pediatric critical care or ED training
Additional member(s) may include a respiratory therapist, physician, or paramedic.
guidelines to minimize the impact of the limitations inherent in a transport environment are
Prepare the transport vehicle
Stabilize the patient before transport
Monitor as many physiologic parameters as possible electronically
Anticipate deterioration
Pediatric Conditions at Risk for Deterioration During Transport
- Pneumonia
- Recurrent brief resolved unexplained event
- Foreign body aspirations
- Airway obstructions
- Epilepsy
- Poisoning or overdose
- Multisystem or severe intracranial trauma
- Tracheitis
- Severe asthma
- Metabolic derangements
- Severe sepsis
Preestablished transfer protocols should provide information about each regional center to which a patient might be referred
(1) special services available;
(2) criteria for referral;
( 3) telephone numbers for consultation, referral, and transport;
(4) distance and usual response time;
(5) type of transport personnel and their capabilities;
(6) type of transport vehicles; and
(7) protocols for preparation of patients
most important factor determining the type of transport
team availability and skill level
Pediatric Conditions Commonly Requiring Interfacility Transports
- Intracranial trauma
- Severe trauma
- Airway (upper or lower) airway disorders
- Sepsis/septic shock
- Seizures
- Developmental or neurologic condition
- Poisoning or overdose
- Intracranial trauma
- Multisystem trauma
may do better without IV placement, because IV placement
particularly true for children with a partial airway obstruction from croup, a foreign body, or epiglottitis
Standardized techniques can help mitigate c munication errors,
ISBARQ (introduction, situation, background, assessment, recommendation, questions) model
referring physician and patient are identified
introduction
working diagnosis and current medical condition
situation
what is known about the patient, such as past medical history and past tests or treatments
background
what is happening at the time of transport (current findings, patient needs, treatments, new test results)
assessment
made by receiving physicians r ing further stabilization of the patient, sometimes at the request of the referring doctor
recommendations
