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pediatrics.json | knowledge | pediatrics | Trauma Injuries | birth trauma injuries include those that can involve instruments used during delivery so abrasions or lacerations or bruising or subcutaneous fat necrosis excessive molding of the head and overriding parental bones also linear skull fractures avoid pressure to involved areas and displaced fractures need neurosurgical i... |
pediatrics.json | knowledge | pediatrics | Brachial Plexus Injuries | you could have brachial plexus injuries and they typically occur in deliveries complicated by shoulder injuries the facial nerve pla palsy and the findings include asymmetric faces when crying in dif phragmatic paralysis so that may occur from cervical root injury or brachial plexus injury the newborn may experience re... |
pediatrics.json | knowledge | pediatrics | Atrial Septal Defects | atrial septal defects this is an abnormal opening or hole that exists in the wall of the septum separating the atrial chambers of the heart it allows some of the oxygenated blood from the left atrium to flow into a hole to the right atrium and it's usually asymptomatic in infants and children it presents a characterist... |
pediatrics.json | knowledge | pediatrics | Ventricular Septal Septal Defects | septal septal defects and that's an abnormal opening that exists in the wall separating the right and left ventricles and it allows for oxygenated blood to flow from the left ventricle to the right its cardiac output is usually affected in in small openings patients are usually asymptomatic and growth and development a... |
pediatrics.json | knowledge | pediatrics | Ductus Arteriosus | patient ductus arteriosus it exists when the ducks ductus arteriosus fails to close after birth persistence of the ductus beyond 10 days of life is considered abnormal oxygen blood traveling through the aorta is shunted from the aorta across the duct to the pulmonary aorta where it maximizes or mixes with the deoxygena... |
pediatrics.json | knowledge | pediatrics | Physical Findings | findings so dypsnia poor feeding poor weight gain high blood pressure low blood pressure chest pain muscle weakness or heart failure in some infants and hypertension in older children there's a thing called a cyanotic disease and this is deoxygenated blood from the right side of the heart mixes with the left side it's ... |
pediatrics.json | knowledge | pediatrics | Trunctus Arteriosus | then there's trunctus arteriosus so pulmonary aorta arteries are combined as one vessel greatly increases blood flow to the lungs causing congestive heart failure patients will have slightly lower oxygen levels later in life eventually resulting in cyanosis and of course surgical invention is necessary and then tricusp... |
pediatrics.json | knowledge | pediatrics | Tetralogy | about is tetralogy and it's just what it sounds like it's four four of the heart defects and so it's ventricular septal the pulmonary stenosis right ventricular hypertrophy and an overriding aorta most of these infants are pink at birth because they usually have that patent ductus arteriosus that provides additional pu... |
pediatrics.json | knowledge | pediatrics | Transposition of the Great Arteries | talk about is transposition of the great arteries and that's known as tga and it's positions of the pulmonary artery and they order are reversed so blood gas uh blood goes to the lungs for oxygenation then returns to lungs while blood from the body um to the heart goes back to the body without becoming oxygenated so cy... |
pediatrics.json | knowledge | pediatrics | Cyanosis | is usually present soon after birth patients present with shortness of breath or finger and toe clubbing while and of course it's going to require surgical intervention total omulus pulmonary venous return so that's the four pulmonary veins connect to the right atrium instead of to the left atrium results in diminished... |
pediatrics.json | knowledge | pediatrics | Introduction to Pediatric Emergencies | chapter 36 pediatric emergencies pediatric emergencies represent a relatively small proportion of an EMS system's overall call volume however the assessment management of infants and children present distinct challenges that differ significantly from adult care it's not uncommon for healthc care providers to experience... |
pediatrics.json | knowledge | pediatrics | Infant Development and Assessment | to understand the unique characteristics of pediatric patients it's important to review the stages of growth and development as outlined in chapter nine on lifespan development during infancy which encompasses the first year of life the neonatal or newborn period specifically refers to the first month following birth i... |
pediatrics.json | knowledge | pediatrics | Toddler Development and Assessment | toddlers ranging from 1 to 3 years of age undergo significant developmental changes between 12 to 18 months they begin walking and exploring their surroundings becoming increasingly mobile and curious this newfound Independence allows them to open doors drawers boxes and Bottles which increases their risk of injury due... |
pediatrics.json | knowledge | pediatrics | Preschool and School-Age Children Development and Assessment | preschool children between 3 to 6 years old shows significant cognitive and communication development at this stage they are capable of understanding directions and can be much more specific in describing their Sensations they are also able to identify painful areas when asked which AIDS in their assessment however des... |
pediatrics.json | knowledge | pediatrics | Adolescent Development and Assessment | adolescents are typically aged between 12 and 18 years and are capable of abstract thinking and are able to actively participate in decision making regarding their care this period marks the onset of puberty which can be challenging times as they negotiate issues related to Independence body image sexuality and peer pr... |
pediatrics.json | knowledge | pediatrics | Anatomical and Physiological Differences in Children | during childhood the body undergo rapid growth and changes that significantly affect anatomy and physiology these changes along with the anatomical and physiological differences between children and adults can present challenges in assessment and treatment if not fully understood recognizing these developmental variati... |
pediatrics.json | knowledge | pediatrics | Respiratory Emergencies in Children | in the assessment and management of respiratory emergencies it's important to recognize that infants have limited capacity to compensate for Respiratory insults many infants and children experiencing respiratory conditions present with signs of respiratory distress if a child in respiratory arrest can be resuscitated p... |
pediatrics.json | knowledge | pediatrics | Upper Airway Emergencies | upper Airway emergencies can present with specific signs and symptoms including decreased or absent breath sounds and strider for body aspiration or obstruction is a common concern as children can obstruct their Airway with any object that fits into their mouth in cases of trauma dislodged teeth may also pose a risk of... |
pediatrics.json | knowledge | pediatrics | Lower Airway Emergencies | lower airway emergencies often present with signs and symptoms such as wheezing and or crackles the best approach to osculate breath sounds in a pediatric patient is to listen on both sides of the chest at the level of the armpit ensuring accurate assessment of Airway conditions and guiding further management asthma is... |
pediatrics.json | knowledge | pediatrics | Cardiopulmonary Arrest and Shock in Children | cardiopulmonary arrest in pediatric patients is most often associated with respiratory failure and arrest as children become hypoxic their heart rates may slow leading to brto cardia and eventually pea the overall survival rate from cardiac arrest in the prehospital setting for children is low and many survivors may ex... |
pediatrics.json | knowledge | pediatrics | Bleeding Disorders and Vascular Access | bleeding disorders such as hemophilia are congenital conditions characterized by a deficiency in one or more normal clotting factors in the blood this condition is hereditary and is predominantly found in males because all injuries in individuals with hemophilia are potentially serious these patients should be transpor... |
pediatrics.json | knowledge | pediatrics | Altered Mental Status and Seizures | altered mental status in pediatric patients can arise from several common causes including hypoglycemia hypoxia seizures and drug or alcohol ingestion each of these factors can significantly impact neurological function and overall well-being prompt identification and management of the underlying calls are essential to... |
pediatrics.json | knowledge | pediatrics | Meningitis and Gastrointestinal Emergencies | menitis is characterized by inflammation of the meninges the protective membranes covering the brain and spinal cord this condition can be caused by infections from bacteria viruses fungi or even parasites if left untreated menitis can lead to severe complications including permanent brain damage or death certain popul... |
pediatrics.json | knowledge | pediatrics | Poisoning and Dehydration | poisoning is a common concern among children and can occur through various routes including ingestion inhaling injecting or absorbing a toxic substance each mode of exposure can lead to different clinical presentations and requires prompt recognition and intervention understanding the potential sources and routes of po... |
pediatrics.json | knowledge | pediatrics | Fever and Hypoglycemia | fever is a common reason caregivers call 911 often arising from an increase in body temperature in response to an infection temperatures of 100.1 de fah or higher are generally considered abnormal while fever itself is rarely life-threatening it can indicate an underlying condition that requires further evaluation and ... |
pediatrics.json | knowledge | pediatrics | Drowning and Trauma | drowning is the leading cause of unintentional death among children aged 1 to 4 in the United States while many drowning incidents occur when children fall into swimming pools or lakes it is important to recognize that drownings also happen in bathtubs and even buckets of water especially in very young children among a... |
pediatrics.json | knowledge | pediatrics | Signs and Symptoms of Drowning | the signs and symptoms of drowning will vary depending on the type and duration of submersion common symptoms include coughing choking Airway obstruction and difficulty breathing patients may also present with altered mentation or exhibit seizure activity in more severe cases the patient may be un responsive with eithe... |
pediatrics.json | knowledge | pediatrics | Initial Management of Drowning Emergencies | when managing a drowning emergency the first priority is ensuring your own safety during the rescue once the patient is out of the water immediately assess and manage the airway breathing and circulation if Advanced interventions are necessary contact a paramedic crew for additional support administer 100% oxygen using... |
pediatrics.json | knowledge | pediatrics | Trauma Considerations in Drowning Patients | in managing a drowning patient always be prepared to apply suction to clear the airway of water or debris if trauma is suspected such as from a fall or diving incident apply a cervical collar and carefully place the patient on a backboard ensure that all Open Spaces under the patient are padded before securing them to ... |
pediatrics.json | knowledge | pediatrics | Leading Causes of Pediatric Trauma | trauma is a leading cause of death among children in the United States infants and toddlers are most frequently injured due to unintentional Suffocation drowning Falls or abuse for children age five and older motor vehicle crashes including incidents involving bicycles and pedestrians represent the most significant thr... |
pediatrics.json | knowledge | pediatrics | Psychological and Developmental Factors in Pediatric Trauma | psychologically children are less mature than adults which impacts their ability to assess risks and make safe decisions this underdeveloped judgment combined with a lack of experience often contributes to their involvement in accidents and injuries these psychological differences must be taken into account when assess... |
pediatrics.json | knowledge | pediatrics | Anatomical Differences in Pediatric Trauma | in pediatric trauma the location of injuries often differs from those seen in adults for the same type of accident due to physical differences children's bones and soft tissues are less developed meaning that the force of an injury affects their bodies differently a child's head is proportionately larger than an adults... |
pediatrics.json | knowledge | pediatrics | Introduction | professionals must remain cognizant that pediatric patients should not be regarded as miniature versions of adults the inherent dissimilarities extend beyond mere size encompassing distinctive physiological responses anatomical structures and psychosocial considerations regarding these differences is imperative for del... |
pediatrics.json | knowledge | pediatrics | Anatomy and Physiology | transport anatomy and physiology the basic anatomy of the circulatory system in pediatric patients mirrors that of adults yet differences in its function and response necessitate a tailored approach for critical care transport professionals understanding that the structural foundations are similar provides a foundation... |
pediatrics.json | knowledge | pediatrics | Growth and Development | imbalances growth and development monitoring physical growth and development is integral during Critical Care transport as deviations from normal developmental Milestones can signal underlying illnesses family crisis or neurologic injuries in pediatric patients knowledge of a child's developmental level is important in... |
pediatrics.json | knowledge | pediatrics | Pediatric Assessment | supportive environment during transport promoting a sense of agent and Trust in the healthcare process pediatric assessment the Pediatric assessment triangle or Pat serves as a tool for quickly and effectively assessing the overall condition of a pediatric patient comprising the child's appearance work of breathing and... |
pediatrics.json | knowledge | pediatrics | Transport Considerations | process transport considerations ensuring the availability of suitable equipment is fundamental in the context of pediatric Critical Care transport historically there has been notable Divergence among agencies and states in defining the prerequisites for Pediatric specific equipment during transport a standard of care ... |
pediatrics.json | knowledge | pediatrics | Respiratory Conditions | chosen respiratory conditions respiratory distress is evident in the increased work of breathing marked by elevated respiratory rate and potentially increased depth clinical signs include nasal flaring retractions and the use of acccessory muscles conversely respiratory failure is characterized by inadequate oxygen int... |
pediatrics.json | knowledge | pediatrics | Mechanical Ventilation | condition mechanical ventilation non-invasive mechanical ventilation specifically through the use of high flow nasal canulas offers a versatile respiratory support modality during transport high flow nasal canulas involve the administration of humidified oxygen at flow rates ranging from 2 to 60 L per minute this metho... |
pediatrics.json | knowledge | pediatrics | Cardiac Conditions | range cardiac conditions the spectrum of pediatric cardiac conditions requiring transport is Broad encompassing various scenar scarios from hypohemia stemming from traumatic events to congenital anomalies like structural heart defects Critical Care transport professionals frequently encounter children falling into four... |
pediatrics.json | knowledge | pediatrics | Renal Conditions | consequences renal conditions pre-renal disorders prevalent among renal conditions in children are predominantly driven by factors such as dehydration and diminished renal profusion dehydration often stemming from causes like vomiting diarrhea dka shock or Burns stands as a primary contributor to these disorders in the... |
pediatrics.json | knowledge | pediatrics | Meningitis | hypertension menitis with menitis the onset of symptoms is typically abrupt and the presentation can vary based on several factors including the child's age the specific infectious organism responsible and the overall health status of the patient fever chills and nucal rigidity are Hallmark indicators of menitis reflec... |
pediatrics.json | knowledge | pediatrics | Trauma | involvement trauma trauma stands as the predominant cause of mortality in pediatric patients aged one year and older with diverse etiologies such as motor vehicle crashes Suffocation submersion Falls Burns and incidents of violence contributing to this unfortunate statistic for critical care transport professionals eva... |
pediatrics.json | knowledge | pediatrics | Abuse and Neglect | management abuse and neglect a facet of any healthc care provider's role is to be aware of various signs of abuse and neglect this includes being vigilant for signs of psychological abuse physical abuse sexual abuse and neglect while certain indicators like bruises in atypical locations Burns or specific fractures may ... |
pediatrics.json | knowledge | pediatrics | Drowning | involved drowning drowning constituting a significant threat to children aged 1 to 14 stands as a prominent cause of fatal submergent injury the primary insult in such cases is hypoxemia a consequence of oxygen deprivation which may or may not be linked to aspiration this oxygen deficit initiates a Cascade of physiolog... |
pediatrics.json | knowledge | pediatrics | Flight Considerations | victims flight considerations certain considerations contribute to a more holistic and patient- centered approach during flights firstly unlike specific considerations that may be required for adult patients there are no distinct flight considerations outlined for Pediatric cases that being said the unique emotional ne... |
pediatrics.json | knowledge | pediatrics | Introduction to Neonatal Emergencies | chapter 23 neonatal emergencies introduction before we get started we need to cover a few definitions a newborn is an infant within the first few hours of birth a neonate is an infant within the first 28 days of birth a term newborn is one delivered in the 37th to 42nd week of gestation in the United States a substanti... |
pediatrics.json | knowledge | pediatrics | Anatomy and Physiology of a Neonate | Services anatomy and physiology of a neonate Thermo regulation in neonates is a critical consideration for critical care transport professionals due to the inherent challenges these vulnerable patients face in maintaining optimal body temperature neonates distinguished by a high body surface area to body weight ratio a... |
pediatrics.json | knowledge | pediatrics | Neonatal Assessment and Stabilization | efforts neonatal assessment and stabilization in the the domain of neonatal assessment and stabilization a critical responsibility for the critical care transport professional lies in a comprehensive review of pertinent medical history this includes an evaluation of prenatal issues neonatal symptoms Vital Signs physica... |
pediatrics.json | knowledge | pediatrics | Neonatal Resuscitation | ventilations neonatal resuscitation in the systematic approach to neonatal assessment Healthcare Providers adhere to a structured methodology to comprehensively evaluate the newborn's Health the process initiates with a rapid visual assessment encompassing the child's overall appearance work of breathing and identifica... |
pediatrics.json | knowledge | pediatrics | Respiratory Conditions | transport respiratory conditions apnea characterized by appalls and respirations lasting more than 20 seconds seconds is a critical consideration in neonatal care it often manifests with clinical signs such as cyanosis poar hypertonia or bardia which necessitates prompt intervention two distinct forms of apnea exist pr... |
pediatrics.json | knowledge | pediatrics | Cardiovascular Conditions | identified cardiovascular conditions cyanosis results from an elevation in arterial deoxygenation leading to increased levels of deoxygenated hemoglobin acrocyanosis a benign condition manifests as cyanosis specifically in the extremities while the central skin color remains within the Baseline range this phenomenon is... |
pediatrics.json | knowledge | pediatrics | Gastrointestinal Conditions | rapidly gastrointestinal conditions neonatal gastrointestinal conditions Encompass a spectrum of congenital anomalies affecting various segments of the GI tract these anomalies can manifest as a treesia which represent the complete absence of luminal continuity stenosis characterized by the narrowing of the tract dupli... |
pediatrics.json | knowledge | pediatrics | Infectious Diseases/Sepsis | episode infectious diseases and sepsis the susceptibility of neonates to infectious diseases stems from the immaturity of their immune systems neonatal immune defenses are not fully developed rendering these vulnerable infants less capable of mounting robust responses against pathogens consequently when confronted with... |
pediatrics.json | knowledge | pediatrics | Hyperthermia/Hypothermia | patients hyperthermia and hypothermia hyperthermia in neonates typically results from factors such as over bundling or exposure to elevated ambient temperatures but it can also manifest in the context of a herpes syflex infection or dehydration on the other hand hypothermia is observed across all climates with a higher... |
pediatrics.json | knowledge | pediatrics | Toxic Exposure | complications toxic exposure toxic exposures of neonates primarily stem from transplacental exposure or intentional Administration by another individual often observed in cases involving children when confronted with such situations a systematic approach is needed for Effective management initiating the assessment with... |
pediatrics.json | knowledge | pediatrics | Trauma/Birth Injuries | patient trauma and birth injuries trauma and birth injuries particularly those involving the head and neck NE are common occurrences during the birthing process While most birth injuries tend to be self-resolving and nonfatal specific conditions may arise vacuum Kut characterized by the accumulation of fluid at the sit... |
pediatrics.json | knowledge | pediatrics | Neurologic Conditions | Center neurologic conditions differentiating seizures from other motor phenomena such as jitteriness is important in neonatal care seizures characterized by abnormal electrical activity in the brain constitute a medical emergency frequently signaling an underlying medical condition these events can disrupt essential ph... |
pediatrics.json | knowledge | pediatrics | Metabolic Conditions | encylopaedia metabolic acidosis is a physiological disturbance characterized by an abnormal accumulation of cat ions in the bloodstream often involving lactic acid from compromised tissue profusion or toxic byproducts associated with inborn errors of metabolism this condition results from an imbalance between the produ... |
pediatrics.json | knowledge | pediatrics | The Transfer Process for a Neonate | the transfer process for a neonate the process of neonatal transport involves a systematic and well-coordinated approach initiated by The Physician at the referring Hospital the transport request sets in motion a series of essential steps the mode of transportation is carefully selected based on the patient's condition... |
pediatrics.json | knowledge | pediatrics | Flight Considerations | transport flight considerations in the context of aeromedical neonatal transport several critical considerations must be addressed to ensure the safety and well-being of the infant with a primary focus on Airway management the establishment of a secure Airway is Paramount before takeoff in instances where inflight intu... |
pediatrics.json | knowledge | pediatrics | The Scoop on Pediatrics | In This Chapter Understanding the differences between children and adults Assessing pediatric patients in medical and trauma situations Kids are not simply pint-sized versions of adults. Any parent can tell you how different it is to interact with their children as they transition from infant and toddler stages to scho... |
pediatrics.json | knowledge | pediatrics | Sorting Out What Makes Children Different from Adults | Besides the obvious differences in size and maturity, there are several key differences between children and adults that affect your assessment approach, scene management, and treatment. These differences are developmental, anatomical, and physiological. Developmental differences From the time they are born until they ... |
pediatrics.json | knowledge | pediatrics | Developmental differences | From the time they are born until they transition to adulthood, children experience rapid physical growth. How they engage with their environment and other humans also changes dramatically. Children can be broadly divided into the following subgroups: Infants: Birth to 1 year Toddlers: 1 to 3 years Preschool: 3 to 5 ye... |
pediatrics.json | knowledge | pediatrics | Anatomical differences | There are several major anatomical differences between children and adults that can affect your assessment and treatment. These differences are more pronounced in younger children (infant through preschool age); they begin to disappear as the children age into school age and adolescence. By the time they are 18, most o... |
pediatrics.json | knowledge | pediatrics | Physiological differences | Children have incredible demands for oxygen and nutrients as they grow and develop, due to metabolic needs. As a result, children breathe more quickly and their hearts beat faster as compared to adults; blood pressures tend to be lower. Table 13-3 shows the normal ranges in vital signs, based on age. In general, the pe... |
pediatrics.json | knowledge | pediatrics | Managing the Pediatric Patient | The way that you approach pediatric patients is similar to that of any adult patient — you evaluate the scene for any safety issues, perform the primary assessment and treat any life-threatening conditions, decide whether the situation is critical enough to require immediate transport, and then perform a secondary asse... |
pediatrics.json | knowledge | pediatrics | Assessment tips | For children ranging from infant to toddlers, performing the pediatric assessment triangle (PAT) can help you to quickly determine how critical the situation is without rushing right up to the child. As you enter the scene, take a moment to look at the following signs (see Figure 13-1): Appearance: Is the child awake? ... |
pediatrics.json | knowledge | pediatrics | Medical situations | Several pediatric medical conditions are commonly seen by EMTs. In the majority of cases, your care is supportive — ensure that problems with airway, breathing, and circulation are identified and managed, and help maintain body temperature and oxygenation during transport. In some situations, you may need to intervene ... |
pediatrics.json | knowledge | pediatrics | Trauma situations | Trauma is the number-one killer of children in the United States. In general, infants and toddlers are most commonly hurt through falls or abuse. In suspected abuse, there may be multiple bruises in various stages of healing. The caregiver may provide a history of the patient being “accident prone.” Injury patterns may... |
pediatrics.json | knowledge | pediatrics | Head, brain, and spinal injuries | Head and brain injuries are common in children due to the relative larger size and weight of the head. Look for signs of injury to the head and scalp, and control any external bleeding. Signs of increasing cerebral pressure (ICP) include altered mental status, headache, and vomiting. Severe ICP may cause the brain to c... |
pediatrics.json | knowledge | pediatrics | Chest and abdominal injuries | The chest wall is more pliable in children than in adults. This pliability provides less protection to the heart, lungs, and upper abdominal organs such as the liver and spleen. If there is a mechanism of injury (MOI) to the chest, evaluate carefully for signs of internal injury, such as respiratory distress and shock.... |
pediatrics.json | knowledge | pediatrics | Falls and burns | As toddlers master the act of walking, falls are common and can sometimes result in bone fractures. Suspect a fracture if the child guards the injury site, can’t put weight on a leg, or is unable to move an extremity without discomfort. Fractures may be incomplete (greenstick fractures) because the child’s bones are mo... |
pediatrics.json | knowledge | pediatrics | Disaster management for multiple patients | In disaster management, you can use the JumpSTART method to triage children under the age of 8 years and weighing less than 100 pounds (see Figure 13-2). Patients who can walk are first categorized as “green” and sent over to the treatment area, where they can be re-triaged. Patients with a spontaneous breathing rate b... |
pediatrics.json | knowledge | pediatrics | Introduction | As technology advances, medicine has become better equipped to extend the life expectancy of individuals who have complex medical conditions. Children with conditions such as hearing impairment, seizures, and extreme prematurity are living with technology that can be both life-sustaining and life-enriching. EMS physici... |
pediatrics.json | knowledge | pediatrics | The caregiver as a resource and the emergency information sheet | A family member and/or home nurse care for the vast majority of children with special health care needs at home. As such, supplies for their routine care are usually present in the home, and caregivers have a great deal of knowledge with regard to both the child’s medical issues as well as the maintenance and routine f... |
pediatrics.json | knowledge | pediatrics | DOPE mnemonic | DOPE mnemonic When evaluating any device that requires troubleshooting, it is essential to use a systematic approach, such as the DOPE mnemonic. Though this is routinely used with a failing endotracheal intubation, similar concepts can be applied to almost all the devices discussed below. The original DOPE mnemonic rem... |
pediatrics.json | knowledge | pediatrics | Tracheostomy tubes | A tracheostomy may become dislodged or obstructed, leading to complications in management of airway and breathing. When tracheostomy tubes are connected to ventilators, pneumothorax and/or equipment malfunction can also lead to respiratory distress or failure. Tracheostomies serve to maintain the airway in a tracheosto... |
pediatrics.json | knowledge | pediatrics | Home oxygen | Many technology-dependent children require home oxygen. The patient's home oxygen settings can be assessed by observing the flow and FiO2 on an oxygen concentrator and/or oxygen tank in the home. The patient should be transferred over to the ambulance oxygen supply for the transport, but any personal tanks should be br... |
pediatrics.json | knowledge | pediatrics | Ventilators | Children with tracheostomies may require ventilator support for part of the day, if not 24 hours a day. These ventilators generally have battery packs; however, the ventilator should be placed on the ambulance's power supply for transport. The settings should remain standard per the caregiver's instructions, unless con... |
pediatrics.json | knowledge | pediatrics | Gastrostomy/gastrojejunostomy tubes | Many technology-dependent children require a method of obtaining nutrition other than by mouth. Most of these children have surgically created stomas into the stomach (a gastrostomy tube) or both the stomach and jejunum (a gastrojejunostomy tube). These tubes can present with a number of complications, but most commonl... |
pediatrics.json | knowledge | pediatrics | Vagus nerve stimulators | A vagus nerve stimulator (VNS) is a small device that is surgically implanted under the skin. Typically, it is placed near the patient’s clavicle and can be felt with palpation. The device has a wire that leads from the device to the vagus nerve. It is then programmed to deliver a weak electrical current, similar to a ... |
pediatrics.json | knowledge | pediatrics | Cochlear implants | A cochlear implant is generally located behind and above the external ear and aids individuals with significant auditory impairment. In general, these should be left in place and not adjusted or removed during prehospital care. However, the presence of this hardware means that patients with these implants are at higher... |
pediatrics.json | knowledge | pediatrics | Ventriculoperitoneal shunts | A ventriculoperitoneal (VP) shunt is placed in children with obstructive hydrocephalus. Obstructive hydrocephalus is common in patients with neural tube defects, such as spina bifida, meningocele, and myelomeningocele. Since the cerebrospinal fluid (CSF) in the ventricles of the brain does not adequately drain, a VP sh... |
pediatrics.json | knowledge | pediatrics | Central venous catheters | Central venous catheters can exist in a variety of places with varying levels of permanence. If the child has one of these present and it is currently in use, it can be used emergently to deliver intravenous medications and fluids, if a peripheral IV or intraosseous access cannot be obtained first. Patients with centra... |
pediatrics.json | knowledge | pediatrics | Conclusion | While technology-dependent children are not the most common patients encountered in the prehospital setting, becoming familiar with commonly used devices can increase one's confidence significantly. In addition, EMS agencies should identify patients who are technology dependent in their local area in order to know thei... |
pediatrics.json | knowledge | pediatrics | Introduction | Injury is the leading cause of death and disability in children, and adolescents, young adults, and pediatric patients constitute 25% of all injured patients in the United States. While overall mortality is one-third the rate of trauma deaths in adults, case fatality rates for children are higher. In other words, for e... |
pediatrics.json | knowledge | pediatrics | Anatomical and physiological considerations | There are several key anatomical and physiological characteristics unique to the pediatric patient of which the prehospital professional needs to be aware when evaluating an injured child. These characteristics can affect the presentation of traumatic injuries, especially in young children, and require a heightened ind... |
pediatrics.json | knowledge | pediatrics | General | Because of a child's smaller body size, traumatic forces can be distributed over a larger area, thus making multisystem trauma the rule rather than the exception with childhood injuries. Children often sustain internal injuries with little or no external evidence of trauma. Thus, as a general rule, internal injury cann... |
pediatrics.json | knowledge | pediatrics | Head | Head injury is the most common cause of serious trauma in children. The disproportionately large head in young children functions like a 'lawn dart,' causing them to lead head-first during falls or rapid deceleration mechanisms, such as car crashes. More than 80% of multisystem pediatric trauma cases involve the head a... |
pediatrics.json | knowledge | pediatrics | Airway | The pediatric airway has several unique anatomical features with which the prehospital professional must be familiar to ensure successful airway management. These features are usually present until about 8 or 9 years of age when the airway assumes more of an adult configuration. Because of the relatively short neck, pa... |
pediatrics.json | knowledge | pediatrics | Spinal column | Although vertebral injuries in children are uncommon, the cervical spine has a high injury risk potential due to the large head being supported by relatively weak neck muscles and elastic supporting ligaments. Through the age of 8, anatomically, the pediatric c-spine has a higher fulcrum (C1-C2) compared to adults upon... |
pediatrics.json | knowledge | pediatrics | Cardiovascular | The cardiovascular response to hemodynamic instability from bleeding in young children is one of rapid and accentuated vasoconstriction with limited stroke volume boosting capacity. The ability to increase cardiac output is almost entirely dependent on the capacity to increase heart rate because of the diminished compl... |
pediatrics.json | knowledge | pediatrics | Musculoskeletal, chest, and abdomen | The pediatric musculoskeletal system is generally more pliable and elastic than an adult's and, therefore, less likely to yield fractures in response to equivalent mechanical force. For example, significant blunt force trauma can be distributed to the intrathoracic cavity without evidence of rib fractures. Therefore, i... |
pediatrics.json | knowledge | pediatrics | Injury patterns | Children in the United States are far more likely to sustain blunt trauma than are adults; blunt force mechanisms represent nearly 90% of the pediatric injury burden. Motor vehicle occupant injuries remain the leading cause of death in the pediatric age group. Although penetrating injury mechanisms are far more typical... |
pediatrics.json | knowledge | pediatrics | Pain management | Due to the wide range of developmental and communication variability in assessing pain in children and unfounded concern about masking injury, pediatric trauma patients are frequently undertreated with analgesics. Recent national efforts to define an evidence-based approach to pain management in all injured patients st... |
pediatrics.json | knowledge | pediatrics | Resuscitation and management priorities | The approach to the trauma survey is basically the same as in adults. The sequencing of the steps in assessment of the injured child must be primarily attendant to the integrity of the airway and adequacy of ventilation, along with protection and immobilization of the cervical spine as necessary. Controlling bleeding, ... |
pediatrics.json | knowledge | pediatrics | Field triage | The Centers for Disease Control and Prevention's 2011 Guidelines for the Field Triage of Injured Patients introduced a modification to the Step 1 criteria that recognizes that patients requiring ventilatory support, independent of respiratory rate, require immediate transport to a trauma center. This revision is partic... |
pediatrics.json | knowledge | pediatrics | Introduction | For the past several decades, most prehospital research has been conducted with adult participants, largely because it is difficult to access and study the pediatric patient population. In addition, the original models for EMS were focused on trauma (primarily from military experience) and cardiac emergencies, both pop... |
pediatrics.json | knowledge | pediatrics | The need for pediatric prehospital care research | Children represent one-fourth of the US population, which translates to more than 73 million infants, toddlers, school-aged children, and adolescents. Furthermore, each age group has very different emergency care needs. For example, the Ontario Prehospital Advanced Life Support (OPALS) study group found that pediatric ... |
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