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Chapter Infants and Children Twenty-Five
Chapter ,[object Object],[object Object],[object Object],Twenty-Five CORE CONCEPTS
Newborns and Infants: Birth to 1 Year
[object Object],exposure to strangers. ,[object Object],parents. (Continued) Newborns and Infants
[object Object],on face. ,[object Object],[object Object],(Continued) Newborns and Infants
[object Object],a distance. ,[object Object],(before child becomes upset) . ,[object Object],build confidence. Newborns and Infants
Toddler: 1 to 3 Years
[object Object],[object Object],[object Object],[object Object],(remove, examine, replace) ,[object Object],(Continued) Toddlers
[object Object],[object Object],[object Object],Toddlers
Preschool: 3 to 6 Years
[object Object],[object Object],[object Object],[object Object],(remove, examine, replace) ,[object Object],(Continued) Preschoolers
[object Object],[object Object],permanent injury. ,[object Object],[object Object],Preschoolers
School Age: 6 to 12 Years
[object Object],[object Object],and disfigurement. ,[object Object],School-Age Child
Adolescent: 12 to 18 Years
[object Object],and disfigurement. ,[object Object],[object Object],[object Object],(away from adults) . Adolescent
Airway Differences between  Adults and Children
[object Object],[object Object],[object Object],[object Object],[object Object],(Continued) Airway Differences between Adults and Children
[object Object],not hyperextended. ,[object Object],faster/harder)   for a while, then  get worse rapidly. Airway Differences between Adults and Children
Opening the airway  Use head-tilt, chin-lift procedure  without  hyperextension.
[object Object],[object Object],[object Object],Suctioning
Treating Mild Airway  Obstruction ,[object Object],[object Object],[object Object]
Severe Airway  Obstruction ,[object Object],[object Object],[object Object],[object Object]
INFANTS Back blows and chest thrusts CHILDREN Abdominal thrusts Remove visible foreign body. Clearing Foreign Body Obstructions Attempt artificial ventilation with BVM.
[object Object],[object Object],[object Object],Oral Airways
[object Object],[object Object],as for adult. Nasal Airways
Nonrebreather Mask
[object Object],OR ,[object Object],Blow-By Technique
[object Object],[object Object],thrust (not head tilt). ,[object Object],with one hand, use two. (Continued) Artificial Ventilation
Mouth-to-Mask Ventilation
[object Object],[object Object],[object Object],[object Object],[object Object],Artificial Ventilation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],(Continued) Assessment: General Impression
[object Object],[object Object],and parents ,[object Object],[object Object],[object Object],[object Object],[object Object],Assessment: General Impression
[object Object],[object Object],[object Object],[object Object],(Continued) Approach to Evaluation
[object Object],[object Object],[object Object],[object Object],[object Object],(Continued) Approach to Evaluation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],(Continued) Approach to Evaluation
[object Object],[object Object],[object Object],[object Object],continue breathing assessment using stethoscope: (Continued) Approach to Evaluation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Approach to Evaluation
[object Object],evaluate head last. ,[object Object],[object Object],Detailed Physical Exam
P EDIATRIC RESPIRATORY EMERGENCIES
Patient  ASSESSMENT Partial Airway Obstruction Signs and Symptoms ,[object Object],respirations ,[object Object],[object Object],[object Object]
Patient  CARE Partial Airway Obstruction Emergency Care Steps ,[object Object],(parent’s lap okay) . ,[object Object],[object Object],[object Object],(Do not assess blood pressure.)
Patient  ASSESSMENT Complete Airway Obstruction Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object]
Patient  CARE Complete Airway Obstruction Emergency Care Steps ,[object Object],foreign body procedures. ,[object Object],BVM.  Assure good seal between  mask and face.
[object Object],[object Object],[object Object],[object Object],[object Object],Respiratory Emergencies
Tell new EMT-Bs that pediatric care experts emphasize that the priority of children in respiratory distress is “AAA,” not just “ABC.”  In other words, if you manage the patient’s airway and oxygenate, circulation improvement will follow! P RECEPTOR  P EARL
Patient  ASSESSMENT Early Respiratory Distress Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],(Continued)
Patient  ASSESSMENT Early Respiratory Distress Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],(Continued)
Patient  ASSESSMENT Early Respiratory Distress Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object]
Patient  ASSESSMENT Respiratory Distress Signs and Symptoms ,[object Object],[object Object],[object Object]
Patient  ASSESSMENT Respiratory Arrest Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object]
Signs of Respiratory Distress
Patient  CARE Respiratory Emergencies Emergency Care Steps ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
P EDIATRIC TRAUMA
Trauma In the United States, injuries kill  more children and infants than any other cause of death.
[object Object],[object Object],(Continued) Blunt Trauma (Most Common Type of Injury) ,[object Object]
[object Object],[object Object],(head, spine, abdominal injuries) ,[object Object],(abdominal, femur, head injuries) (Continued) Blunt Trauma
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Blunt Trauma
[object Object],[object Object],[object Object],[object Object],[object Object],(Continued) Blunt Trauma Specific Types of Injurie s
[object Object],adults’ ribs. ,[object Object],without external wounds. (Continued) Blunt Trauma Specific Types of Injuries ,[object Object]
[object Object],[object Object],than adults. ,[object Object],[object Object],(may cause gastric distention, impede breathing) . (Continued) Blunt Trauma Specific Types of Injuries
[object Object],[object Object],Blunt Trauma Specific Types of Injuries
[object Object],[object Object],[object Object],[object Object],[object Object],Trauma Other Considerations (Continued) ,[object Object]
[object Object],[object Object],(sterile sheet works well) . ,[object Object],transport to burn center. Trauma Other Considerations
Patient  CARE Trauma Emergency Care Steps ,[object Object],jaw thrust. ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Causes ,[object Object],[object Object],[object Object],Uncommon Causes Shock (Hypoperfusion)
Tell new EMT-Bs that one way  to remember how little blood children have is to envision that an infant’s total blood volume would fill only a soda can and a school age child’s a six-pack.  P RECEPTOR  P EARL
Patient  ASSESSMENT Shock (Hypoperfusion) Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],(Continued)
Patient  ASSESSMENT Shock (Hypoperfusion) Signs and Symptoms ,[object Object],Inspect diaper/ask parents when last changed. ,[object Object],[object Object]
Signs of Shock (Hypoperfusion)
Patient  CARE Shock (Hypoperfusion) Emergency Care Steps ,[object Object],high-concentration oxygen. ,[object Object],[object Object],[object Object],[object Object],[object Object]
Patient  CARE Near Drowning (submersion) Emergency Care Steps ,[object Object],[object Object],hypothermia, and drug ingestion (especially alcohol in teenagers) . ,[object Object],minutes/hours later.)
Abuse Improper or excessive action so as to injure or cause harm Neglect Giving insufficient attention or respect to someone who has a claim to that attention K EY TERMS
Physical abuse and neglect are forms of child abuse EMT-B  is most likely to suspect. EMT-B must be aware of  condition in order to recognize it.
Tell new EMT-Bs that the ED physician is required to report cases of child abuse.  Therefore, they should complete the PCR with factual information that they observed about the child’s home environment, the condition of the home, the reaction of the parents or other caretakers, the child’s hygiene, and general interaction of all family members involved,  and call it to the attention of the physician.  P RECEPTOR  P EARL
Patient  ASSESSMENT Abuse Signs and Symptoms ,[object Object],of healing ,[object Object],mechanism described ,[object Object],(Continued)
Patient  ASSESSMENT Abuse Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object]
Patient  ASSESSMENT Neglect Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object]
[object Object],(shaken baby syndrome) . ,[object Object],(Continued) Handling Abuse and Neglect
[object Object],[object Object],[object Object],Handling Abuse and Neglect
P EDIATRIC MEDICAL EMERGENCIES
Seizures ,[object Object],children, but EMT-B should  take seriously. ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Causes (unknown cause) Seizures
Patient  ASSESSMENT Child after Seizure Signs and Symptoms ,[object Object],[object Object],[object Object]
Patient  CARE Seizures Emergency Care Steps ,[object Object],[object Object],[object Object],[object Object],distress/arrest. ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Causes Altered Mental Status
Patient  CARE Altered Mental Status Emergency Care Steps ,[object Object],[object Object],[object Object]
Patient  CARE Poisoning: Responsive Patient Emergency Care Steps ,[object Object],[object Object],[object Object],[object Object]
Patient  CARE Poisoning: Unresponsive Patient Emergency Care Steps ,[object Object],[object Object],[object Object],[object Object],[object Object]
Fever ,[object Object],[object Object],appear as fever with rash. ,[object Object],[object Object]
Sudden Infant Death Syndrome (SIDS) ,[object Object],[object Object],[object Object]
Patient  CARE SIDS Emergency Care Steps ,[object Object],mortis is present. ,[object Object],[object Object]
I NFANTS AND CHILDREN WITH SPECIAL NEEDS
[object Object],[object Object],[object Object],[object Object],since birth Children with Special Needs
Technologically Dependent Children  (“High-Tech Kids”) ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Tracheostomy Tube Complications
Patient  CARE Tracheostomy Tube Emergency Care Steps ,[object Object],[object Object],[object Object],[object Object]
[object Object],familiar with equipment. Home Artificial Ventilation
Patient  CARE Home Artificial Ventilation Emergency Care Steps ,[object Object],[object Object],high-concentration oxygen. ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Central Intravenous Lines
Patient  CARE Central Intravenous Lines Emergency Care Steps ,[object Object],[object Object]
Shunt Tube running from brain to abdomen to drain excess cerebrospinal fluid Gastrostomy Tube Tube placed directly into the stomach for a child who cannot be fed by mouth K EY TERMS
Patient  CARE Shunt Emergency Care Steps ,[object Object],[object Object]
Patient  CARE Gastrostomy Tube Emergency Care Steps ,[object Object],[object Object],[object Object],[object Object],right side with head elevated.
1. Describe two characteristics of a  typical child in each of the five age groups. 2. Describe the management of pediatric respiratory distress. 3. How do children compensate for blood  loss compared to an adult? 4. What are some indications of child abuse?  R EVIEW QUESTIONS

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Infants and Children

  • 1. Chapter Infants and Children Twenty-Five
  • 2.
  • 3. Newborns and Infants: Birth to 1 Year
  • 4.
  • 5.
  • 6.
  • 7. Toddler: 1 to 3 Years
  • 8.
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  • 10. Preschool: 3 to 6 Years
  • 11.
  • 12.
  • 13. School Age: 6 to 12 Years
  • 14.
  • 15. Adolescent: 12 to 18 Years
  • 16.
  • 17. Airway Differences between Adults and Children
  • 18.
  • 19.
  • 20. Opening the airway Use head-tilt, chin-lift procedure without hyperextension.
  • 21.
  • 22.
  • 23.
  • 24. INFANTS Back blows and chest thrusts CHILDREN Abdominal thrusts Remove visible foreign body. Clearing Foreign Body Obstructions Attempt artificial ventilation with BVM.
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  • 38.
  • 39.
  • 40. P EDIATRIC RESPIRATORY EMERGENCIES
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46. Tell new EMT-Bs that pediatric care experts emphasize that the priority of children in respiratory distress is “AAA,” not just “ABC.” In other words, if you manage the patient’s airway and oxygenate, circulation improvement will follow! P RECEPTOR P EARL
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 53.
  • 55. Trauma In the United States, injuries kill more children and infants than any other cause of death.
  • 56.
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  • 58.
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  • 60.
  • 61.
  • 62.
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  • 65.
  • 66.
  • 67. Tell new EMT-Bs that one way to remember how little blood children have is to envision that an infant’s total blood volume would fill only a soda can and a school age child’s a six-pack. P RECEPTOR P EARL
  • 68.
  • 69.
  • 70. Signs of Shock (Hypoperfusion)
  • 71.
  • 72.
  • 73. Abuse Improper or excessive action so as to injure or cause harm Neglect Giving insufficient attention or respect to someone who has a claim to that attention K EY TERMS
  • 74. Physical abuse and neglect are forms of child abuse EMT-B is most likely to suspect. EMT-B must be aware of condition in order to recognize it.
  • 75. Tell new EMT-Bs that the ED physician is required to report cases of child abuse. Therefore, they should complete the PCR with factual information that they observed about the child’s home environment, the condition of the home, the reaction of the parents or other caretakers, the child’s hygiene, and general interaction of all family members involved, and call it to the attention of the physician. P RECEPTOR P EARL
  • 76.
  • 77.
  • 78.
  • 79.
  • 80.
  • 81. P EDIATRIC MEDICAL EMERGENCIES
  • 82.
  • 83.
  • 84.
  • 85.
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  • 89.
  • 90.
  • 91.
  • 92.
  • 93. I NFANTS AND CHILDREN WITH SPECIAL NEEDS
  • 94.
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  • 96.
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  • 100.
  • 101.
  • 102. Shunt Tube running from brain to abdomen to drain excess cerebrospinal fluid Gastrostomy Tube Tube placed directly into the stomach for a child who cannot be fed by mouth K EY TERMS
  • 103.
  • 104.
  • 105. 1. Describe two characteristics of a typical child in each of the five age groups. 2. Describe the management of pediatric respiratory distress. 3. How do children compensate for blood loss compared to an adult? 4. What are some indications of child abuse? R EVIEW QUESTIONS