Pediatric emergencies

Pediatric emergencies

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Pediatric EmergenciesPediatric Emergencies

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FeverFever
–Common CausesCommon Causes
InfectionsInfections
Neoplasm (cancer)Neoplasm (cancer)
Drug ingestionDrug ingestion
Collagen vascular diseaseCollagen vascular disease
High environmental temperaturesHigh environmental temperatures

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Emergency Care for FeverEmergency Care for Fever
Ensure BSIEnsure BSI
Begin passive coolingBegin passive cooling
–Remove clothing/coveringsRemove clothing/coverings
–Damp towels Damp towels
No iceNo ice
No alcoholNo alcohol
No cold water bathsNo cold water baths

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Febrile SeizuresFebrile Seizures
common in children 6 months to 6 common in children 6 months to 6
yearsyears
caused by high fevercaused by high fever
history of infectionhistory of infection
generalized grand mal seizuregeneralized grand mal seizure
less than 15 minutesless than 15 minutes

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TreatmentTreatment
ABC’sABC’s
protect patientprotect patient
recovery positionrecovery position
high flow oxygenhigh flow oxygen
suction prnsuction prn
Passive cooling measurescooling measures
transporttransport

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DehydrationDehydration
Dry lips and gumsDry lips and gums
Fewer wet diapersFewer wet diapers
Sunken eyes Sunken eyes
Poor skin turgorPoor skin turgor
Sleepy or irritableSleepy or irritable
Sunken fontanelsSunken fontanels

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Care for DehydrationCare for Dehydration
Assess the ABCsAssess the ABCs
Obtain baseline vital signsObtain baseline vital signs
ALS backup may be needed for ALS backup may be needed for
IV administrationIV administration

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Airway ObstructionAirway Obstruction
CroupCroup
–An infection of the airway below the An infection of the airway below the
level of the vocal cords, caused by a level of the vocal cords, caused by a
virusvirus
EpiglottitisEpiglottitis
–Infection of the soft tissue in the area Infection of the soft tissue in the area
above the vocal cordsabove the vocal cords
Foreign body AspirationForeign body Aspiration

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CroupCroup
barking coughbarking cough
stridorstridor
wheezingwheezing
ralesrales
accessory muscle useaccessory muscle use
nasal flaringnasal flaring
grunting grunting

10. pediatricspediatrics
EpiglottitisEpiglottitis
severe dyspneasevere dyspnea
stridorstridor
inability to swallow - DROOLINGinability to swallow - DROOLING
feverfever
tripod positiontripod position

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Foreign body aspirationForeign body aspiration
Partial Partial
BlockageBlockage
–coughingcoughing
–accessory accessory
muscle usemuscle use
–nasal flaringnasal flaring
–wheezingwheezing
Complete Complete
BlockageBlockage
-no soundno sound
-no cryno cry
-stridorstridor
-cyanosiscyanosis
-loss of loss of
consciousnessconsciousness

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treatmenttreatment
ABC’sABC’s
high flow oxygen high flow oxygen
position of comfortposition of comfort
do not do not attempt to visualize the throat!attempt to visualize the throat!
do not do not put anything into patient’s mouth.put anything into patient’s mouth.

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AsthmaAsthma
dyspneadyspnea
wheezingwheezing
accessory muscle useaccessory muscle use
nasal flaringnasal flaring
respiratory rate - observerespiratory rate - observe

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TreatmentTreatment
ABC’sABC’s
high flow oxygenhigh flow oxygen
position of comfortposition of comfort
transporttransport

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What is the most frequent What is the most frequent
cause of cardiac arrest in cause of cardiac arrest in
pediatrics?pediatrics?

18. pediatricspediatrics
RespiratoryRespiratory arrestarrest!!

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MeningitisMeningitis
Inflammation of meningesInflammation of meninges
Bacterial or viralBacterial or viral
Permanent brain damage/deathPermanent brain damage/death

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Signs and Symptoms of Signs and Symptoms of
Meningitis Meningitis
FeverFever
ALOCALOC
HeadacheHeadache
SeizureSeizure
Nuchal Nuchal
rigidityrigidity
VomitingVomiting
PhotophobiaPhotophobia
IrritabilityIrritability
Bulging Bulging
fontanelfontanel

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TreatmentTreatment
BSI (Body substance Isolation)BSI (Body substance Isolation)
ABC’sABC’s
protect patientprotect patient
high flow oxygenhigh flow oxygen
passive cooling for feverpassive cooling for fever
monitor for shockmonitor for shock
TransportTransport
Call ALS for backup if unstableCall ALS for backup if unstable

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Submersion InjurySubmersion Injury
Drowning or near drowningDrowning or near drowning
Second most common cause of Second most common cause of
unintentional deathunintentional death
ABC’sABC’s
May be in respiratory or cardiac May be in respiratory or cardiac
arrestarrest
C-spine precautions?C-spine precautions?
Be ready to suctionBe ready to suction
Keep warmKeep warm

23. pediatricspediatrics
PoisoningPoisoning
Poisoning is common in childrenPoisoning is common in children
Ask specific questions of caregiversAsk specific questions of caregivers
Focus on the ABCsFocus on the ABCs
Give oxygenGive oxygen
Provide transportProvide transport
Child’s condition could change at any Child’s condition could change at any
timetime

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Sudden Infant Death Sudden Infant Death
SyndromeSyndrome
SIDS - “crib death”SIDS - “crib death”

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SIDSSIDS
Definition - unexplained death of Definition - unexplained death of
an apparently healthy infant.an apparently healthy infant.
7500+ cases per year in U.S.7500+ cases per year in U.S.
Leading cause of death in infants Leading cause of death in infants
<1 year old<1 year old
more cases in winter monthsmore cases in winter months

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Sudden Infant Death Sudden Infant Death
Syndrome (SIDS)Syndrome (SIDS)
Several known risk factors:Several known risk factors:
–Mother younger than 20 years oldMother younger than 20 years old
–Mother smoked during pregnancyMother smoked during pregnancy
–Low birth weightLow birth weight
–Putting babies to sleep on stomachPutting babies to sleep on stomach
–Siblings of SIDS babiesSiblings of SIDS babies

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Child AbuseChild Abuse
Any improper or excessive action that Any improper or excessive action that
injures or harms a child or infantinjures or harms a child or infant
physical, sexual, emotional abuse and physical, sexual, emotional abuse and
neglectneglect
More than 2 million cases reported More than 2 million cases reported
annuallyannually
Be aware of signs of child abuse and Be aware of signs of child abuse and
report it to authoritiesreport it to authorities

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Emergency Medical CareEmergency Medical Care
ABCsABCs
Transport if you Transport if you suspectsuspect child child
abuseabuse
Do not make accusationsDo not make accusations
EMT-Bs must report all EMT-Bs must report all
suspected cases of child abusesuspected cases of child abuse

35. pediatricspediatrics
Sexual AbuseSexual Abuse
Children of any age or either gender Children of any age or either gender
can be victimscan be victims
Limit examinationLimit examination
Do not allow child to wash, urinate, or Do not allow child to wash, urinate, or
defecatedefecate
Document carefullyDocument carefully
TransportTransport

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Thank youThank you