Chapter 42 - Chapter 42 Pediatrics Top Causes of Pediatric...

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Chapter 42: Pediatrics Top Causes of Pediatric Deaths MVC/MVA’s Burns Drownings Suicides Homicides Emergency Medical Services of Children (EMSC)- federally funded program aimed at improving the health of pediatric patients who suffer form life-threatening illnesses and injuries. Newborns- first hours – after birth Neonates- birth – 1month Infants- 1-12months Toddlers- 1-3years Preschoolers- 3-5years School-aged children- 6-12years Adolescents- 13-18years In infants pay special attention to the fontanelles, for dehydration Since the infant & child’s head is so large, laying them in the supine position may tip the head forward obstructing the airway. Growth plate - the area just below the head of a long bone in which growth in bone length occurs; the epiphyseal plate. Infants and children increase their cardiac output by increasing their heart rate. Bleeding that would not be dangerous in an adult may be life-threatening in an infant or child. Pediatric Assessment Triangle Appearance Breathing- airway & respiratory problems are the most common cause of cardiac arrest in infants and young children. Circulation Conditions that place a pediatric patient at risk of cardiopulmonary arrest include: Respiratory rate >60 Heart rate >180 or <80 (under 5years) Heart rate >180 or <60 (over 5years) Respiratory distress Trauma Burns Cyanosis LOC Seizures Fever w/petechiae (small, purplish, hemorrhagic spots on the skin)
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Transport Priority Urgent- proceed w/rapid trauma assessment, then transport immediately Non-urgent- complete the focused HX and physical exam @ the scene. General Management of Pediatric Patients Basic Airway Management o Foreign Body Airway Obstruction (FBAO) Children- > 1year, perform a series of abdominal thrusts. Infants- <1year, perform 5back blows & 5chest thrusts Suctioning o Suction <10sec, but no more than 15sec o Avoid stimulation of the Vagus nerve Nasogastric Tube- after intubation 2 Problems that lead to cardiopulmonary arrest in children: 1. shock 2. respiratory failure IV access o External jugular vein should only be used for life-threatening situations Intraosseous Infusion o Drugs administered IO Epinephrine 1/1,000 - 0.1mg/kg ET 1/10,000 – 0.01mg/kg IV/IO Atropine- 0.02mg/kg Dopamine- 2-10mcg/kg/min Lidocaine- 1mg/kg Sodium bicarbonate- 1mEq/kg Dobutamine Fluid challenge- 20ml/kg of an isotonic solution Electrical therapy o AED - 2j/kg then, 4j/kg Infections- infectious diseases account for the majority of pediatric illnesses. Stages of Respiratory Compromise
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Chapter 42 - Chapter 42 Pediatrics Top Causes of Pediatric...

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