Pediatric Emergencies for EMT-P (6) Special Populations

Interactions and developmental milestones.

birth - 2 months

controls gaze
turns head

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Interactions and developmental milestones.

2-6 months

eye contact
uses both hands
rolls over
sleep through night

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Interactions and developmental milestones.

6-12 months

sits without support
crawls
puts things in mouth
teething begins

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Interactions and developmental milestones.

toddler

crawls/walks
sensory developments
runs, climbs
balance
fine motor Skills
toilet training

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Interactions and developmental milestones.

preschool

can understand directions
normal running/walking
20/20 vision

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Interactions and developmental milestones.

school

Can communicate efficiently.

6 - 12 years old.

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Interactions and developmental milestones.

adolescence

Issues of independence and sexuality.

13 - 17 years old.

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What are some airway considerations for pediatrics?

Short necks
Smaller airway
The epiglottis is long and floppy.
Keep nares clear <6 months old.
The neck is very soft and collapsible; don’t hyper-extend the neck.

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Fill in the blank:

The narrowest portion of child’s airways is ____.

cricoid cartilage

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What is the approximate blood volume in a pediatric?

70 ml/kg

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What causes delayed capillary refill in shock?

Shunting of the vessels causes peripheral vasoconstriction.

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What considerations are present for the nervous system of a pediatric with trauma?

The brain and spine are not as protected.
Less subarachnoid space = less cushion for the brain.
It is easier to damage the head and spine.

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What considerations are present for the musculoskeletal system in pediatrics?

Fractures are easier due to the lack of ossification centers.

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What considerations are present for the chest and lungs of a pediatric?

Very thin chest wall.
Ribs are more pliable.
It is easier to hear heart and lung sounds.

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What considerations are present for the skin in a pediatric patient?

Skin is thin and more elastic.
More BSA ratio.
Temperature isn’t regulated as well.
Increased risk of hypothermia and severe burns.

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What considerations are present for the metabolic demands of a pediatric?

Less glycogen stores in the liver.
Cover the head to manage heat loss.

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What is the Pediatric Assessment Triangle?

PAT

Work of breathing
Circulation of skin
Appearance

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What is the mnemonic TICLS used for when assessing the appearance of a pediatric patient?

Tone: Muscle tone – are they rigid or limp?
Interactiveness: Are they alert and how easily are they distracted? Do they grasp or reach?
Consolability: Can they be calmed by a caregiver?
Look/gaze: Do they have a fixed gaze or a glassy stare?
Speech/cry: Is their cry strong, and is their speech age-appropriate?

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What do you assess with work of breathing in the PAT?

Abnormal airway sounds: snoring, hoarse speech, stridor, wheezing or grunting
Abnormal positioning: sniffing positions, tripod, refusing to lie down
Retractions: supraclavicular, intercostal, substernal retractions, head bobbing
Flaring: flaring of nares on inspiration

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What is grunting indicative of?

Partially closed epiglottis.

Typically common in patients with pneumonia.

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What is mottling indicative of?

Study These Flashcards

vasoconstriction and vasodilation

Define:

Acrocyanosis

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It is characterized by blue hands or feet.

Define:

Pallor

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It is characterized by white or pale skin.

What is the minimal blood pressure formula in an infant and child?

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Infant: Minimum systolic = 70 mmHg
Child: 70 + (age × 2) mmHg

What is the most **common** cause of **s****eizure** in pediatrics?

fever

# Treatment: febrile seizure

* Tylenol 10-15mg/kg * Midazolam .1mg/kg * Ativan .1mg/kg * Fluids 20ml/kg * Check BGL

What are the **signs/symptoms** of **meningitis**?

* Nuchal rigidity * Petechiae and purpura * Altered mental status (AMS)

# Define: biliary atresia

Congenital condition where bile ducts are absent or blocked, leading to **excess bilirubin and jaundice**.

# Define: intussusception

Telescoping of small intestine into itself. ## Footnote Typically common to children from 6 months - 6 years.

# Define: meckel diverticulum

**Malformation of small intestine** causing pockets.

# Define: pyloric stenosis

The **pyloric sphincter becomes hypertrophied** and presents with projectile vomiting.

# Treatment: **Hyperglycemia** in pediatrics

* fluids * insulin

# Define: Congenital Adrenal Hyperplasia | CAH

Decrease in **cortisol** production.

What is the **poison control's** phone number?

1-800-222-1222

_List the medications for:_ 1. Carbon Monoxide 2. Organophosphate 3. TCA 4. Opiates 5. Beta Blockers 6. Ca Channel Blockers 7. Benzoiazepines

1. Oxygen (CO) 2. Atropine (Organophosphates) 3. Sodium bicarbonate (TCA) 4. Naloxone (Opiates) 5. Glucagon (Beta blockers) 6. Calcium (Calcium channel blockers) 7. Flumazenil/Romazicon (Benzodiazepines)

What do you look for when assessing circulation of **skin** in PAT?

* pallor * mottling * cyanosis

List the steps to remove a **foreign body airway obstruction**.

1. Hold the infant face down on your forearm. 2. Support the head and face with your hand. 3. Deliver five back blows. 4. Turn the infant upright. 5. Perform five chest thrusts using two fingers. 6. Check the airway.

# Treatment: Unresponsive upper airway obstruction

Immediately begin **CPR**. ## Footnote Try to visualize with DL after compressions for removal with Magill forceps.

# Define: croup

**Viral infection** of the **upper airway**.

List **assessment findings** for **croup**.

* Age: Typically <5 years old. * Auscultation: Stridor * Symptoms: Barking cough, difficulty breathing.

# Treatment: croup

* **Allow child to be comfortable** and do not irritate. * Administer **racemic epinephrine** (2.25%) 0.5ml mixed in 3ml *normal saline*.

List **assessment findings** for **anaphylaxis**.

* Mild: urticaria, wheezing * Severe: wheezing, hypotension, diffuse edema, shortness of breath, tachycardia

# Treatment: anaphylaxis

* **Epinephrine**: 0.01 mg/kg IM (1:1,000), max 0.3 mg, Q 5 minutes * **Diphenhydramine**: 1-2 mg/kg IV, max 50 mg * **Albuterol**: 1.25 mg via nebulizer with 6 lpm O₂

# Define: epiglottitis

**Bacterial infection** of supraglottic structures.

List **assessment findings** for **epiglottitis**.

* sitting upright in sniffing position * drooling * stridor * muffled voice

# Treatment: epiglottitis

* rapid transport _Do not_: * agitate the pt * start an IV * visualize the oropharynx ## Footnote Consider: Nebulized normal saline.

# Treatment: asthma

* **Albuterol/Atrovent:** 1.25mg / 250 mcg * **Epinephrine:** .01 mg/kg IM, Max .3mg (1:1,000) Q 5min

If a pediatric will not tolerate a **NRB**, how can you deliver oxygen if needed?

Blow-by technique

How often do you **ventilate** a pediatric patient?

1 breath every 3-5 seconds

What is the formula for **minimum systolic BP** in children \> 1 yr?

(Age x 2) + 80

What is the **minimum systolic** for an **infant?**

\>70mmHg

Pediatric Emergencies Flashcards

Explore the Pediatric patient and the prehospital emergencies that exist (51 cards)