Pediatric Assessment NSC

Pediatric Assessment NSC - Pediatric Assessment Pediatric...

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Pediatric Assessment Pediatric Assessment
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High Stress Situation High Stress Situation Child In pain Frightened Guilty
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High Stress Situation High Stress Situation Parent Frightened Guilty Exhausted
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High Stress Situation High Stress Situation Paramedic Frightened May over-empathize
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High Stress Situation High Stress Situation Who has to control situation?
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Basic Points Basic Points Oxygenation, ventilation adequate to preserve life, CNS function? Cardiac output sufficient to sustain life, CNS function? Oxygenation, ventilation, cardiac output likely to deteriorate before reaching hospital? C-spine protected? Major fractures immobilized?
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Basic Points Basic Points If invasive procedure considered, do benefits outweigh risks? If parent is not accompanying child, is history adequate? Transport expeditiously Reassess, Reassess, Reassess
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Patient Assessment Patient Assessment Priorities are similar to adult Greater emphasis on airway, breathing
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Patient Assessment Patient Assessment Limit to essentials Look before you touch
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Pediatric Assessment Triangle: Pediatric Assessment Triangle: First Impression First Impression Appearance - mental status, body position, tone Breathing - visible movement, effort Circulation - color Appearance Breathing Circulation
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Pediatric Assessment Triangle Pediatric Assessment Triangle Initial Assessment Initial Assessment Appearance - AVPU Breathing - airway open, effort, sounds, rate, central color Circulation - pulse rate/strength, skin color/temp, cap refill, BP ( use at early ages) Appearance Breathing Circulation
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Initial Assessment Initial Assessment Categorize as: Stable Potential Respiratory Failure or Shock Definite Respiratory Failure or Shock Cardiopulmonary Failure
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Initial Assessment Initial Assessment Identify, correct life threats If not correctable, Support oxygenation, ventilation, perfusion Transport
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Vital Signs Vital Signs Essential elements Proper equipment Knowledge of norms Carry chart of norms for reference
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Weight Weight Why is weight a pedi vital sign? (Age[yrs] x 2) + 8
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Heart Rate Heart Rate Apical auscultation Peripheral palpation Tachycardia may result from: Fear Pain Fever
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Heart Rate Heart Rate Tachycardia + Quiet, non-febrile patient = Decrease in cardiac output Heart rate rises long before BP falls!
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  • Spring '10
  • Johnson
  • volume depletion, common problems, high stress situation, Pediatric Assessment Triangle Pediatric Initial Assessment

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