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pediatrics.json | knowledge | pediatrics | Challenges unique to pediatric prehospital researchers | Many challenges must be overcome when conducting pediatric prehospital research. Many of these are similar to those barriers encountered when conducting general prehospital research and have been covered in other chapters. In addition to these, however, the research population itself presents some challenges which are ... |
pediatrics.json | knowledge | pediatrics | Status of pediatric prehospital research | The Institute of Medicine’s (IOM) 2006 report Emergency Care for Children: Growing Pains focused on how pediatric emergency services are (and are not) integrated into the nation’s health care system. Among the issues discussed were emergency care planning, preparedness coordination, funding for pediatric emergency care... |
pediatrics.json | knowledge | pediatrics | Defining the “pediatric” patient population | In order to conduct any research, one must define both inclusion and exclusion criteria. For the inclusion criteria, basic definitions and biographical/demographic information are key. One can easily understand that a clear definition of the age groups under investigation is critical for anyone conducting quality pedia... |
pediatrics.json | knowledge | pediatrics | Sample size | When planning for any well-designed research study, and especially a randomized controlled trial or population-based study, the researcher must recognize that no single hospital or EMS agency is likely to have access to sample sizes large enough to answer important questions about critically ill or injured children. Th... |
pediatrics.json | knowledge | pediatrics | Epidemiology | While it is vital to define what is the pediatric population, it is also key to conducting research to know the epidemiology of the population studied. Information such as sex, age ranges, disease and injury prevalence, ethnic variation, and types of requests for prehospital assistance is essential. This information al... |
pediatrics.json | knowledge | pediatrics | Institutional review board approval | Other chapters cover the issue of obtaining institutional review board (IRB) approval and the unique obstacles faced by prehospital researchers. Ethical issues regarding pediatric patients can be even more controversial and challenging. For example, a child younger than 18 years of age cannot legally give consent as a ... |
pediatrics.json | knowledge | pediatrics | Informed consent – pediatric assent | Pediatric studies requiring consent are more complicated than adult studies because subject assent is necessary in addition to the consent of a participant's legal guardian. This means that, at a minimum, two groups of people must agree to participate in the study. Similar to consents, assent documents must be submitte... |
pediatrics.json | knowledge | pediatrics | Priority areas of research | One could ask many questions when conducting pediatric prehospital research. Several groups have tried to prioritize questions to direct researchers to first answer what are considered the most important ones for the field. Examples of these attempts include the Pediatric Emergency Medicine Research Agenda, EMSC priori... |
pediatrics.json | knowledge | pediatrics | Moving forward: challenges and opportunities | Clearly the researcher who addresses the prehospital care of children has opportunities to gain knowledge and improve care that far outweigh the challenges posed by the nature of this diverse, vulnerable, and complicated population. Several key gaps still remain, most of which have been identified in the IOM reports an... |
pediatrics.json | knowledge | pediatrics | Introduction | Approximately half of the EM responses to calls for pediatric patients are for medical complaints. Calls for medical complaints outnumber traumatic calls in patients under 5 years. Seizures and respiratory distress are common pediatric medical complaints. Other less common conditions, such as shock, cardiac arrest, and... |
pediatrics.json | knowledge | pediatrics | Respiratory and airway problems | Cardiopulmonary arrest in the majority of infants and children is respiratory in origin. Appropriate and timely treatment of a child in respiratory distress may prevent respiratory and subsequent cardiac arrest. Many respiratory diseases are unique to children; however, the underlying treatment is the same as for adult... |
pediatrics.json | knowledge | pediatrics | Controversies over airway management | The current literature highlights shortcomings associated with prehospital pediatric ETI. Few studies show improved outcomes, and several studies describe worsened outcomes. ETI and intubation medications may inadvertently interact with other physiological processes key to resuscitation. Adverse events and errors are f... |
pediatrics.json | knowledge | pediatrics | Apparent life-threatening events | Apparent life-threatening events (ALTE) may present as a call to 9-1-1 from a frantic parent stating that his or her child has stopped breathing or turned blue. The child may have already recovered to baseline status. An ALTE is defined as 'an episode that is frightening to the observer and that is characterized by som... |
pediatrics.json | knowledge | pediatrics | Seizures and seizure mimics | Seizures account for 10% of pediatric calls to 9-1-1. They often are associated with anxiety on the part of the family and bystanders. The EMS physician should be concerned about the cause of the seizure as well as field treatment; however, providers should not diagnose the cause of the seizure before initiating approp... |
pediatrics.json | knowledge | pediatrics | Shock | Many providers equate shock with hypotension, which may be useful for adults but presents problems when caring for children. Normal blood pressure varies with age and restoring adequate intravascular volume by the administration of 20 mL/kg of a crystalloid (normal saline or Ringer’s lactate) should be initiated quickl... |
pediatrics.json | knowledge | pediatrics | Cardiac arrest | Out-of-hospital cardiac arrest (OHCA) is a rare occurrence in childhood, with an incidence of 2.6–19.7 annual cases per 100,000 pediatric population. Survival rates for children who suffer OHCA are 6–12%, and overall intact neurological survival is reported to occur in 4%. In contrast to adults, cardiac arrest in infan... |
pediatrics.json | knowledge | pediatrics | Conclusion | Although pediatric calls account for only a small percent of EMS runs, they cause anxiety for providers. Some factors, such as training and appropriate equipment, can be addressed beforehand; other aspects cannot. The physician's level of comfort when providing direct medical oversight on pediatric calls will be discer... |
pediatrics.json | knowledge | pediatrics | Epidemiology of prehospital pediatric care | Despite the fact that pediatric calls account for only 13% of ambulance runs, they provoke a disproportionate degree of concern and anxiety for prehospital care providers and, in turn, medical oversight physicians. A recent study by the Pediatric Emergency Care Applied Research Network (PECARN) from 14 EMS ground agenc... |
pediatrics.json | knowledge | pediatrics | Evaluation of children | Evaluation is an area in which children are truly different. An accurate assessment of a pediatric patient is the key to proper field evaluation and treatment and, in turn, appropriate direct medical oversight. Evaluation should be tailored to each child in terms of age, size, and developmental level. |
pediatrics.json | knowledge | pediatrics | Pediatric Assessment Triangle | A useful learning tool that may be beneficial for providers is the Pediatric Assessment Triangle (PAT), which looks at Appearance, work of Breathing, and Circulation – a variation on the classic ABCs of primary assessment. This tool was developed by the Pediatric Education for Paramedics Task Force and has been incorpo... |
pediatrics.json | knowledge | pediatrics | Appearance | This is the most important component as it determines the severity of injury or illness. It consists of five characteristics, the TICLS mnemonic: Tone, Interactiveness, Consolability, Look/gaze, and Speech/cry. Assessment of tone includes: Is the child moving vigorously or is he limp? Interactiveness reflects how alert... |
pediatrics.json | knowledge | pediatrics | Work of Breathing | This portion of the tool can give the provider a quick indication of oxygenation and ventilation and can be done without a stethoscope. The characteristics to note include: abnormal airway sounds such as grunting, wheezing, or muffled phonation; abnormal positioning such as the tripod position, sniffing position, or re... |
pediatrics.json | knowledge | pediatrics | Circulation to the skin | This helps determine the adequacy of perfusion to vital organs, using three characteristics: pallor, which reflects inadequate blood flow; mottling, which is due to vasoconstriction; cyanosis, which is blue coloration of the skin and mucous membranes. If there is an abnormality in one or more aspects of the triangle, t... |
pediatrics.json | knowledge | pediatrics | Vital signs | One of the most challenging aspects for prehospital care providers in the assessment of infants and children is that their vital signs change with age, so it is difficult to remember what is within a normal range. Having a table with appropriate vital signs for age is an easy way to solve this problem. |
pediatrics.json | knowledge | pediatrics | Heart rate | A child’s heart rate decreases with age. Counting an infant’s very fast heart rate can be difficult by auscultation in a screaming child. It is often easier to feel the pulse as this is not as threatening. In an infant, the brachial pulse can be used while in a child or adolescent, the radial pulse is useful. While cou... |
pediatrics.json | knowledge | pediatrics | Respiratory rate | A child's respiratory rate also decreases with age. When counting respirations, especially in infants, it is important to count for 30 seconds, then double the number, as very young infants may have periodic breathing (short periods of apnea of 5 seconds, followed by rapid breathing). Try to count respirations when the... |
pediatrics.json | knowledge | pediatrics | Blood pressure | Blood pressure determination is often difficult in a child due to lack of proper cuff size or agitation of the child caused by the cuff tightening. The proper size cuff has a width two-thirds the length of the upper arm (or thigh). In children under age 3 years, it may be difficult to obtain an accurate blood pressure,... |
pediatrics.json | knowledge | pediatrics | Pain | Pain is now considered the fourth vital sign but once again, assessing pain in children is not easy. A crying infant can be in pain, hungry, or just wet. A toddler may not understand the word “pain” but recognize “boo-boo” or “owie.” In older children, use of self-reporting scales such as the visual analog scale (VAS) ... |
pediatrics.json | knowledge | pediatrics | Weight measurement | While parents may know their child’s weight in pounds, medication dosing in children is by kilograms. While it is possible to mentally divide the weight in pounds by 2.2 to get kilograms, it may be easier and more reliable to use a calculator or phone application. If the parent does not know the child’s weight or no pa... |
pediatrics.json | knowledge | pediatrics | Specialized equipment needs | As mentioned above, children of different ages and sizes require different sized equipment. The length-based tape or computer or telephone applications can provide this information, but they are all useless unless you have the right equipment in your ambulance. Numerous organizations, including NAEMSP, recently revised... |
pediatrics.json | knowledge | pediatrics | Developmental approach | Another important consideration in taking care of pediatric patients is the various developmental levels. A 6-month-old crying infant cannot tell you where it hurts while an injured 15 year old can, but may not disclose important information in front of his or her parents or friends. Understanding some of the developme... |
pediatrics.json | knowledge | pediatrics | Infants | Infants under 2 months have a very limited repertoire. They cannot tell the difference between you and their caregivers by sight, but may turn to their mother's voice. When evaluating them, it is important to keep them warm, allow the parents to hold them if possible, and speak in a soothing voice. Those from 2 to 6 mo... |
pediatrics.json | knowledge | pediatrics | Toddlers | Toddlers are considered ages 1–3, and are gaining verbal and fine and gross motor skills rapidly. They can walk, run, play with toys, and feed themselves. Some say only a few words but others speak in phrases, and definitely say “no” They are very fearful of strangers, curious but not aware of danger, and very opiniona... |
pediatrics.json | knowledge | pediatrics | Preschoolers | Preschoolers include those 3–5 years of age. They are very mobile, speak in sentences and have a large vocabulary. They are creative thinkers but also illogical. They have many misconceptions about bodily functions and illness, and fear being left alone. Evaluation tips include distraction (use one of their toys to dem... |
pediatrics.json | knowledge | pediatrics | School-aged children | School-aged children are those who attend elementary and middle schools. They are independent, talkative, and have a fair understanding of illness and injury. They fear being different from friends and being separated from parents and friends, and do not like loss of control. When ill or injured, this independence is t... |
pediatrics.json | knowledge | pediatrics | Adolescents and teenagers | Adolescents can be rational and can express themselves well. They often like to take risks, even though they may understand the possible consequences. Friends take a front seat to parents and they like to appear independent of their parents. When evaluating adolescents, use their name and respect their modesty and priv... |
pediatrics.json | knowledge | pediatrics | Children with special health care needs | One of the most important aspects of evaluating a child with special health care needs is to ask a parent or caregiver their developmental level and baseline activities. The child may have physical disabilities but be developmentally normal for age, or have severe impairments in speech and mental abilities. This affect... |
pediatrics.json | knowledge | pediatrics | Consent issues | When taking care of pediatric patients, consent issues may arise. While parents commonly provide consent for treatment, if an injury occurs without them, several legal issues can arise. Obtaining informed consent is required by law but children cannot provide informed consent, because they are considered to be minors (... |
pediatrics.json | knowledge | pediatrics | Introduction | Child maltreatment is a serious public health problem. In 2011, an estimated 3.4 million referrals involving approximately 6.2 million children were made to Child Protective Service (CPS) agencies nationally. An estimated 676,569 children were determined to be victims of abuse or neglect. Of these, 78.5% experienced ne... |
pediatrics.json | knowledge | pediatrics | Role of the prehospital provider | Emergency medical services physicians and personnel play an important role in recognizing and reporting child maltreatment. They frequently have the opportunity to assess the scene and home environment as well as the interactions between the child and the caregiver(s). If there are any suspicions for maltreatment, it i... |
pediatrics.json | knowledge | pediatrics | Child maltreatment | Child maltreatment involves acts of commission and omission that result in harm or threat of potential harm to a child. Acts of commission involve physical, psychological, and sexual abuse. Acts of omission (neglect) may involve failure to provide adequate food, shelter, medical and dental care, and education. A caregi... |
pediatrics.json | knowledge | pediatrics | Assessment and general approach | Providing the appropriate level of medical care is the first priority when responding to any illness or injury. This priority does not change when responding to children who are victims of maltreatment. BLS and ALS measures should be implemented as indicated after provider safety is assured. Scene assessment and invest... |
pediatrics.json | knowledge | pediatrics | Secondary survey: signs and symptoms suggestive of abuse or neglect | The secondary survey should involve a careful examination of the child, especially the skin surfaces. The most common manifestations of child abuse are cutaneous injuries; therefore, a detailed physical examination is essential in identifying suspicious findings. Bruising, burns, and bite marks are often observed in ch... |
pediatrics.json | knowledge | pediatrics | Bruising | The age and developmental level of the child should be considered when understanding mechanisms and resulting injuries. Bruising is rare in infants before they begin to walk or crawl. When bruising is identified in this age group and a credible history is not obtained from the caregiver, abuse should be considered and ... |
pediatrics.json | knowledge | pediatrics | Burns | Burns are common injuries in children and may occur from both accidental and inflicted causes. Abusive burns represent about 10% of pediatric burns. Most common abusive burns will be scald burns such as immersion burns. Abusive burns may also occur from contact with hot thermal sources, chemicals, electricity, and even... |
pediatrics.json | knowledge | pediatrics | Fractures | It is estimated that 11–55% of pediatric fractures are the result of physical abuse. Younger children are particularly at risk for sustaining abusive fractures: 55–70% of all abusive fractures occur in infants less than 1 year of age. With respect to orthopedic injuries, a careful history and secondary survey are vital... |
pediatrics.json | knowledge | pediatrics | Transport decisions | Before determining that a child does not require EMS transport, careful consideration should be given to the age of the child, the ability to adequately determine if a fracture or other injury exists, and the history given by the caregivers. Any child with a suspicious or concerning history surrounding the injury shoul... |
pediatrics.json | knowledge | pediatrics | Scene survey | Emergency medical services providers are in an excellent position to provide valuable information about the scene and circumstances of the call. In many instances, they will be able to observe and confirm or refute the details provided by the caregiver and communicate these to the medical providers. This type of inform... |
pediatrics.json | knowledge | pediatrics | Obtaining the history | Obtaining a concise and detailed history will obviously depend on the acuity of the child’s condition. The ability of the child to respond to questions is contingent on age and developmental level as well as the degree of injury. A verbal child may be able to answer simple questions such as “what happened?” but he or s... |
pediatrics.json | knowledge | pediatrics | Communicating with the child and caregivers | Method and style of communication are very important when dealing with situations surrounding possible child maltreatment. Judgmental and accusatory questioning may only serve to threaten the caregiver and incite defensiveness or aggression. Maintaining objectivity is very important in managing interactions with the ch... |
pediatrics.json | knowledge | pediatrics | Documentation | Accurate, detailed, and concise documentation of the scene, a complete physical examination of the child, and history from the caregiver and child are vitally important. Responses and statements made by the child and the caregiver should be placed in quotes. Conflicting histories should be noted. The objective findings... |
pediatrics.json | knowledge | pediatrics | Medical conditions that may be confused with child abuse | Numerous medical conditions may present with signs and symptoms that may be confused with child maltreatment. Some of these conditions may have already been identified in the child's history. For example, a child with a blood clotting disorder such as hemophilia is more prone to bruising; however, this should not be in... |
pediatrics.json | knowledge | pediatrics | Sexual abuse | Sexual abuse represents the third most common form of child maltreatment. Research and statistics describing EMS response to child sexual abuse calls are minimal; therefore, it is unknown how frequently these types of calls are encountered in the pre-hospital environment and under what conditions. Because it is rare fo... |
pediatrics.json | knowledge | pediatrics | Responding to intimate partner violence calls | It is not unusual for EMS to respond to calls involving intimate partner violence (IPV). Concerns for child maltreatment should always be considered when responding to calls where IPV is occurring and children are part of the family unit. Children who reside in homes in which IPV is present are at increased risk of bei... |
pediatrics.json | knowledge | pediatrics | Medicolegal duties | All states and territories in the United States require reporting suspicions of child abuse. Prehospital providers should have a good understanding of how legal requirements guide reporting in their respective states or jurisdictions. Accurate and detailed written documentation is vital in conveying important informati... |
pediatrics.json | knowledge | pediatrics | Conclusion | Emergency medical services providers are in an excellent position to provide valuable information in the recognition, documentation, and ultimate intervention in cases of child maltreatment, but it is likely that prehospital personnel need more training in recognizing and managing child maltreatment than is typically p... |
pediatrics.json | knowledge | pediatrics | Key Terms | Adult: For the purpose of providing emergency medical care, anyone who appears to be approximately 12 years old or older., Apparent life-threatening event (ALTE): A sudden event in infants under the age of 1 year, during which the infant experiences a combination of symptoms including apnea, change in color, change in ... |
pediatrics.json | knowledge | pediatrics | INTRODUCTION | In an emergency, you should be aware of the special healthcare or functional needs and considerations of children and infants. Knowing these needs and considerations will help you better understand the nature of the emergency and provide appropriate care. A young child may be scared or nervous due to the circumstances ... |
pediatrics.json | knowledge | pediatrics | ANATOMICAL DIFFERENCES | It is important to be aware of the anatomical differences among adults, children and infants. The most significant of these differences involve the airway and breathing. Children and infants have proportionately larger tongues than do adults, so it is easier for the tongue to block the airway. Placing pressure under th... |
pediatrics.json | knowledge | pediatrics | Determining the Age Group of the Patient for the Purpose of Providing Emergency Medical Care | At times, care must be provided according to the age of the patient and it is not always easy to determine exact age. The American Red Cross follows established age categories for emergency care that are based on epidemiological patterns of injury including care needed, while at the same time being easy to recognize ba... |
pediatrics.json | knowledge | pediatrics | CRITICAL FACTS | It is important to be aware of the anatomical differences among adults, children and infants. The most significant of these differences involve the airway. In general, children and infants predominantly suffer respiratory emergencies, which, if untreated, can lead to cardiac emergencies. Anyone who appears younger than... |
pediatrics.json | knowledge | pediatrics | CHILD DEVELOPMENT - Infants (Birth to 1 Year) | Infants’ inability to do anything for themselves and their inability to communicate where there may be pain or discomfort makes them among the most vulnerable of children and patients. After the first few weeks of birth, an infant can usually recognize a parent’s or caregiver’s voice. After a few months, facial recogni... |
pediatrics.json | knowledge | pediatrics | CHILD DEVELOPMENT - Toddlers (1 to 3 Years) | Toddlers can readily recognize familiar faces and may be fearful of strangers. They may not be cooperative when dealing with an unknown person, even if the parent or caregiver is in the room. Toddlers may also fear being separated from the people they know. Crying makes it difficult for them to communicate. Some toddle... |
pediatrics.json | knowledge | pediatrics | Preschoolers (3 to 5 Years) | Preschoolers communicate their ideas more effectively than toddlers, but they may have difficulty with certain concepts. They may have difficulty understanding complex sentences that contain more than one idea, so speak in simple terms. Children at this stage often feel that bad things are caused by their thoughts and ... |
pediatrics.json | knowledge | pediatrics | School-Age Children (6 to 12 Years) | Children of school age have been exposed to more unfamiliar faces and are more likely to cooperate with strangers. With reassurance from familiar faces (parents, caregivers, guardians, teachers), they are likely to understand the situation once it has been explained, and are able to cooperate with emergency responders.... |
pediatrics.json | knowledge | pediatrics | Adolescents/Teens (13 to 18 Years) | The characteristics of adolescents and teens vary quite a bit from the beginning of the age group (age 13) to the end (age 18). Thirteen year olds are just leaving the school-age group, and 18 year olds are on the cusp of adulthood and already may have had to take on adult responsibilities. Generally, adolescents are m... |
pediatrics.json | knowledge | pediatrics | ASSESSING PEDIATRICS - General Considerations | Assessing an injured or sick child is similar to assessing an adult, with a few differences. Primary assessments on a conscious child should be done unobtrusively, so the child has time to get used to you and feel less threatened. Try to carry out as many of the components of the initial evaluation by careful observati... |
pediatrics.json | knowledge | pediatrics | ASSESSING PEDIATRICS - Scene Size-Up | Begin observing the scene from the moment you arrive. The big picture will allow you to assess the situation and may give clues to other issues, such as child abuse. As usual, also assess the scene for personal safety. Be alert for any signs that may indicate poisoning (empty bottles, for example) and look for signs of... |
pediatrics.json | knowledge | pediatrics | Pediatric Assessment Triangle | The Pediatric Assessment Triangle is a quick initial assessment of a child that takes between 15 and 30 seconds and provides a picture of the severity of the child’s or infant’s injury or illness. This is done during the scene size-up as part of forming your general impression and before beginning the primary assessmen... |
pediatrics.json | knowledge | pediatrics | CRITICAL FACTS 1 | Assessing an injured or sick child is similar to assessing an adult, with a few differences. Primary assessments on a conscious child should be done unobtrusively, so the child has time to get used to you and feel less threatened. Try to carry out as many of the components of the initial evaluation by careful observati... |
pediatrics.json | knowledge | pediatrics | Equipment for Assessing and Caring for Children and Infants | As children come in all different sizes, so does the equipment used to assess them. A wide range of sizes should be available for assessing children, to provide optimal care. Essential equipment and supplies include: Bag-valve-mask (BVM) resuscitators with oxygen reservoirs. Oxygen masks. Non-rebreather masks. ... |
pediatrics.json | knowledge | pediatrics | Airway | An airway that is open, even if only partially open, will allow the child to cough, cry or breathe. Even with an open airway, the child should be observed closely for any change in status. A child whose airway becomes compromised or shows signs or symptoms of inadequate breathing or a lack of oxygen will need immediate... |
pediatrics.json | knowledge | pediatrics | Ventilation/Oxygenation | A child who is in respiratory distress may be agitated or drowsy. Agitation results from trying to get air; drowsiness is the result of insufficient oxygenation. The breathing effort increases in many cases, but as respiratory failure sets in, the breathing effort may decline considerably as the child weakens. Addition... |
pediatrics.json | knowledge | pediatrics | Circulation | Circulation in a child is similar to that of an adult, though the average child’s pulse is more rapid than an adult’s. Observe the child for signs and symptoms of shock, which include restlessness; cold, clammy, pale or ashen skin; rapid or irregular breathing; falling blood pressure; altered mental status; rapid, weak... |
pediatrics.json | knowledge | pediatrics | Determining the Level of Consciousness | Using the AVPU scale, you can start to determine the child’s level of consciousness (LOC). The AVPU scale is a mnemonic that describes stages of awareness: Alert (the patient can respond to questions and is aware of the surroundings), Voice (the patient responds to verbal stimuli), Pain (the patient only responds to pa... |
pediatrics.json | knowledge | pediatrics | Exposure | Despite the need to keep the child covered if you are concerned about shock, you must be able to assess the child properly and thoroughly, barring any life-threatening situation. Check the child for any other injuries or signs of trauma. You do not need to uncover the child completely. You may remove the top part of th... |
pediatrics.json | knowledge | pediatrics | SAMPLE History | When taking a child’s SAMPLE (signs and symptoms, allergies, medications, pertinent medical history, last oral intake and events leading up to the incident) history, you will need the parent’s or caregiver’s cooperation. Encourage this cooperation by remaining respectful and polite during the conversation, even if the ... |
pediatrics.json | knowledge | pediatrics | Symptoms and Duration | Ask the parent, caregiver, or child, if appropriate, about the symptoms, any changes (worsening or easing) and how long they have been present. While obtaining a patient history, inquire about: Fever. Unusual activity level. History of eating, drinking and urine output. History of vomiting, diarrhea and abdomin... |
pediatrics.json | knowledge | pediatrics | Allergies | Ask the parent, caregiver or child, if appropriate, if they have any allergies. While obtaining a patient history, inquire about allergies to: Medications. Food. Environmental elements, such as dust, pollen or bees. |
pediatrics.json | knowledge | pediatrics | Medications | Ask the parent or caregiver about medications the child might take. Does the child take any prescription medications or has the parent or caregiver given any over-the-counter medications recently? Does the child have any allergies to medications? Could the child have gotten into someone else’s medications? |
pediatrics.json | knowledge | pediatrics | CRITICAL FACTS 3 | You will need the parent’s or caregiver’s cooperation while taking a child’s SAMPLE history. Be respectful and polite, even if you suspect child abuse or neglect. Avoid asking yes-or-no questions. Allow a child to participate; older children may want to talk privately, especially if you must ask sensitive questions con... |
pediatrics.json | knowledge | pediatrics | Pertinent Past Medical Problems or Chronic Illnesses | Ask the parent or caregiver if something like this has ever occurred before. If so, what caused it before and what happened in the long run? Does the child have any chronic illnesses, such as asthma or diabetes? Has the child been ill lately with any other type of illness? |
pediatrics.json | knowledge | pediatrics | Last Oral Intake | Ask the parent or caregiver when the child last had something to eat or drink and what it was. |
pediatrics.json | knowledge | pediatrics | Events Leading Up to the Injury or Illness | Ask the parent or caregiver what specifically was going on when the injury or illness was first noticed. What was the environment like (where did it happen)? What was the child doing? What was the child’s reaction? |
pediatrics.json | knowledge | pediatrics | Physical Exam | Conducting a physical exam of a child or an infant requires some special handling. Try to have only one individual deal with the child, to reduce the anxiety of being handled by multiple strangers. If you can, crouch down to the child’s eye level. Speak calmly and softly and maintain eye contact. Be gentle and never lo... |
pediatrics.json | knowledge | pediatrics | COMMON PROBLEMS IN PEDIATRIC PATIENTS - Airway Obstructions | Some of the most common airway problems you may encounter with small children and infants are airway obstructions. Airway obstructions may be categorized as either partial or complete. Signs of a partial airway obstruction in a child or an infant who is alert and sitting up include: Abnormal high-pitched musical soun... |
pediatrics.json | knowledge | pediatrics | COMMON PROBLEMS IN PEDIATRIC PATIENTS - Breathing Emergencies | Respiratory distress is apparent when the child or infant begins to experience difficulty breathing. If uncorrected, respiratory distress can lead to respiratory failure. |
pediatrics.json | knowledge | pediatrics | Anatomic and Physiological Differences in Children | Anatomical differences among adults, children and infants can change their susceptibility to respiratory difficulties and affect how to provide emergency care: In children and infants, the tongue is larger in relation to the space in the mouth than it is in adults. This can increase the risk of the tongue blocking th... |
pediatrics.json | knowledge | pediatrics | Pathophysiology | The process of respiratory emergencies usually follows the pattern of respiratory distress, followed by respiratory failure, which is then followed by respiratory arrest if emergency interventions are not attempted or are not successful.
Respiratory distress occurs when the child is having trouble breathing but is visi... |
pediatrics.json | knowledge | pediatrics | Assessing Breathing Emergencies | The child’s ability to breathe adequately must be assessed by checking the mental status, muscle tone, breathing movement, breathing effort and skin color. Once you have made your assessment, be sure to frequently perform follow-up assessments to note if there are any changes in the child’s respiratory status. |
pediatrics.json | knowledge | pediatrics | CRITICAL FACTS 2 | Certain problems are unique to children, such as specific kinds of injury and illness. Some of the most common airway problems the emergency responder may encounter with small children and infants are airway obstructions.
Anatomical differences among adults, children and infants can change their susceptibility to respi... |
pediatrics.json | knowledge | pediatrics | Common Respiratory Problems in Children | Although many types of breathing problems can affect children, some will be seen by emergency responders more often than others, such as croup, epiglottitis, asthma and choking on an obstruction.
Croup is a common upper airway virus that affects children younger than 5. The airway constricts, limiting the passage of ai... |
pediatrics.json | knowledge | pediatrics | Providing Care for Breathing Emergencies | Treatment of all respiratory emergencies is generally the same. Use equipment that is properly sized for the child, particularly if using an oxygen mask. The mask should fit the child and should deliver the appropriate amount of oxygen. Monitor the airway and breathing continuously, and arrange for transport as quickly... |
pediatrics.json | knowledge | pediatrics | Circulatory Failure | As with adults, undetected and uncorrected circulatory failure in children and infants can cause cardiac arrest. Signs and symptoms of circulatory failure include: Increased heart rate (but can also be decreased). Unequal pulses (femoral compared with radial). Delayed capillary refill. Changes in mental status. Unlike ... |
pediatrics.json | knowledge | pediatrics | Seizures | A seizure is a disorder in the brain’s electrical activity, sometimes marked by loss of consciousness and often by uncontrollable muscle movement; also called a convulsion. A chronic condition, such as epilepsy, or an acute event may cause seizures. In children, febrile seizures are the most common type of seizure. The... |
pediatrics.json | knowledge | pediatrics | Assessing Seizures | When obtaining a history from the parent or caregiver, you need to know several things to assess what type of seizure the child may be having and what may have caused it. Ask questions such as: Has the child ever had seizures before? If so, does the child have medications for them? If not, is there a family history o... |
pediatrics.json | knowledge | pediatrics | Managing Seizures | The general principles of managing a seizure are to prevent injury, protect the child’s airway and ensure that the airway is open after the seizure has ended. Call for more advanced medical personnel for a child or an infant who has had a seizure and for a young child or an infant who experienced a febrile seizure brou... |
pediatrics.json | knowledge | pediatrics | Fever | Fever is defined as an elevated body temperature. It signifies a problem and, in a child or an infant, can indicate specific problems. Often these problems are not life threatening, but some can be. A high fever in a child often indicates some form of infection. In a young child, even a minor infection can result in a ... |
pediatrics.json | knowledge | pediatrics | Poisoning | Poisoning can cause many types of emergencies, from seizures to cardiac arrest. Unintentional poisoning is a leading cause of unintentional death in the United States for adolescents, children and infants. Just under half of exposure cases managed by Poison Control Centers involve children younger than 6. Children in t... |
pediatrics.json | knowledge | pediatrics | Shock | Shock is the body’s reaction to a physical or emotional trauma in both adults and children. Physical trauma could include loss of blood. In small children, the loss of blood may be much more significant than in adolescents or adults. This adds to the increased risk of shock and the speed with which it may develop. Chil... |
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