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EMT Book > PEPP 1: Pediatric Assessment > Flashcards

PEPP 1: Pediatric Assessment Flashcards

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1
Q

Sick or not sick

A

Most important question

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2
Q

PAT

A

Pediatric Assessment Triangle. Use first for every single pediatric case.
Rapid VISUAL assessment
Formalizes the general impression

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3
Q

PAT elements

A

Appearance
Work of breathing
Circulation to skin

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4
Q

PAT questions

A

How severe is the injury?
What is the most likely physiologic abnormality?
How quickly do I need to act?

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5
Q

Appearance

A

Single most important factor
Responding to stimulus
Looking around the room
Tells about circulation: look to skin color
Use TICLS
Complete visually from across the room while still in caregivers arms

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6
Q

TICLS

A

Used to quantify Appearance of PAT
Tone: Child moving vigorously, sit or walk, or limp?
Interactiveness: try testing attention with a pen light
Consolability: Yes or No
Look: Looks at your face or track a toy, not vacant start
Speech/cry: strong cry or wimper? Slurring?

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7
Q

Tone

A

Is the child moving vigorously?
Resisting exam? Or lie limp?
Verbalize as normal, decreased or increased

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8
Q

Interativeness

A

Can you draw attention? Turn to a sound?
Listless and disinterested?
Verbalize as Normally active and alert, Listless, Lethargic, or Unresponsive

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9
Q

Consolability

A

Can caretaker console child?

Verbalize as Consolable or Inconsoloable

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10
Q

Look or gaze

A

Fix gaze on face; track movement?

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11
Q

Speech or cry

A

Slurring words? Speak in whole sentences?

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12
Q

Respiratory distress

A

Appearance; normal
Work of breathing: increased
CTC: normal
Not urgent. Since other two elements are ok, pt is successfully compensating with incr work of breating

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13
Q

Work of breathing

A

Assess from across the room
Listen for abnormal sounds
Look for abnormal positioning, retractions or nasal flaring

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14
Q

Abnormal airway sounds

A

Upper airway: snoring or stridor

Lower airway: grunting or wheezing

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15
Q

Snoring

A

Low pitched sound
Caused by loss of tone in upper airway
Partial airway obstruction

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16
Q

Stridor

A

High pitched whistling sound
Upper airway, partial obstruction of trachea or vocal chords
On inspiration or both

17
Q

Upper airway obstruction causes

A 
Loss of consciousness
Loss of muscle tone
Viral or bacterial infection
Foreign body aspiration
Blunt neck trauma
18
Q

Grunting

A

Lower airway
Caused by pushing air against closed vocal chords
Pneumonia, pulmonary contusion or pulmonary edema

19
Q

Wheezing

A

Lower airway
High pitched musical sound
Caused by air pushed through small openings in the lungs, usually on expiration
Asthma and bronchiolitis

20
Q

Sniffing position

A

Severe upper airway obstruction

21
Q

Tripod position

A

Trying to maximize accessory muscle use

22
Q

Retractions

A

Seen beneath, between or above ribs, above clavicle or beneath sternum

23
Q

Nasal flaring

A

Moderate to high hypoxia

24
Q

Urgency

A

Increased work of breathing with normal appearance: respiratory distress, not urgent transport
Increased WOB with poor appearance, respiratory failure, transport quickly
Poor appearance with low WOB means pt may be fatigued and respiratory arrest is imminent. Be ready to bag.

25
Q

Respiratory failure

A

Appearance: abnormal
Work of breathing: increased or decreased (fatigue)
Circulation to skin: normal or abnormal

26
Q

Shock

A

Appearance: abnormal
Work of breathing: normal
Circulation to skin: abnormal

27
Q

Skin circulation indicators

A

Pallor: early sign
Mottling: patchy
Cyanosis: late finding, always critical unless with normal appearance, may just be cold.

28
Q

CNS disfuntion

A

Appearance: abnormal
Work of breathing: normal
Circulation to skin: normal

29
Q

Steps in pediatric assessmetn

A

1-Scene size up
2-Primary assessment (PAT, hands on ABCDE, transport decision)
3-History taking
4-Secondary assessment: physical exam, monitoring devices
5-Reassessment

30
Q

Immediate transport if

A 
Cardiac arrest
Complete airway obstruction
Impending delivery
Decompensated shock
Status epilepticus
Wheezing
Stridor
Severe pain with  normal blood pressure
31
Q

Immediate transport and treatment enroute if

A

Incomplete airway obstruction
Closed head injury with normal breathing
Multisystem trauma
Inability to treat on scene (equipment failure, safety)

32
Q

Causes of unresponsiveness

A

Sepsis
Seizure
Abuse

33
Q

Respiratory Rates

A 
Infant 30-60
Toddler 24-40
Preschooler 22-34
School age 18-30
Adolescent 12-16
35
Q

Heart Rates

A 
Infant 100-160
Toddler 95-150
Preschooler 80-140
School age 70-120
Adolescent 60-100
35
Q

Blood Pressures

A 
Infant >60
Toddler >70
Preschooler >80
School age >90
Adolescent 12-16

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