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Common pediatric emergencies and pediatric attention
1.
2.
3. Recognize the acuity and implement
appropriate emergency
management
Discuss the etiology and natural history
of common pediatric emergencies
Communicate effectively with
patients, families, nursing staff, EMS
personnel, ancillary service
personnel, referring physicians and
consultants.
5. Pathophysiology
Chronic recurrent lower airway disease with
episodic attacks of bronchial constriction
Precipitating factors include exercise, psychological
stress, respiratory infections, and changes in weather &
temperature
Occurs commonly during preschool years, but also
presents as young as 1 year of age
Decrease size of child’s airway due to edema &
mucus leads to further compromise
6. Assessment
History
When was last attack & how severe was it
Fever
Medications, treatments administered
Physical Exam
SOB, shallow, irregular respirations, increased or decreased
respiratory rate
Pale, mottled, cyanotic, cherry red lips
Restless & scared
Inspiratory & expiratory wheezing, rhonchi
Tripod position
7. Management
Assess & monitor ABC’s
Big O’s (Humidified if possible)
IV of LR or NS at a TKO rate
Assist with prescribed medications
Prepare for vomiting
Pulse oximeter
Intubate if airway management
becomes difficult or fails
8. Basics
Respiratory infection of the bronchioles
Occurs in early childhood (younger than 1 yr)
Caused by viral infection
Assessment/History
Length of illness or fever
has infant been seen by a doctor
Taking any medications
Any previous asthma attacks or other allergy
problems
How much fluid has the child been drinking
9. Signs & Symptoms
Acute respiratory distress
Tachypnea
May have intercostal and suprasternal
retractions
Cyanosis
Fever & dry cough
May have wheezes - inspiratory &
expiratory
Confused & anxious mental status
Possible dehydration
10. Management
Assess & maintain airway
When appropriate let child pick POC
Clear nasal passages if necessary
Prepare to assist with ventilations
IV LR or NS TKO rate
Intubate if airway management becomes
difficult or fails
11. Basics
Upper respiratory viral infection
Occurs mostly among ages 6 months to 3
years
More prevalent in fall and spring
Edema develops, narrowing the airway
lumen
Severe cases may result in complete
obstruction
12. Assessment/History
What treatment or meds have been
given?
How effective?
Any difficulty swallowing?
Drooling present?
Has the child been ill?
What symptoms are present & how have
they changed?
13. Physical Exam
Tachycardia, tachypnea
Skin color - pale, cyanotic, mottled
Decrease in activity or LOC
Fever
Breath sounds - wheezing, diminished
breath sounds
Stridor, barking cough, hoarse cry or
voice
14. Management
Assess & monitor ABC’s
High flow humidified O2; blow by if child
won’t tolerate mask
Limit exam/handling to avoid agitation
Be prepared for respiratory arrest, assist
ventilations and perform CPR as needed
Do not place instruments in mouth or
throat
Rapid transport
15. Basics
Common among the 1-3 age group who
like to put everything in their mouths
Running or falling with objects in mouth
Inadequate chewing capabilities
Common items - gum, hot dogs, grapes
and peanuts
16. Assessment
Complete obstruction will present as
apnea
Partial obstruction may present as labored
breathing, retractions, and cyanosis
Objects can lodge in the lower or upper
airways depending on size
Object may act as one-way valve
allowing air in, but not out
17. Management – Complete
Obstruction
Attempt to clear using BLS
techniques
Attempt removal with direct
laryngoscopy and Magill forceps
Cricothyrotomy may be indicated
18. Management - Partial Obstruction
Make child comfortable
Administer humidified oxygen
Encourage child to cough
Have intubation equipment
available
Transport to hospital for removal with
bronchoscope
19. Physical Assessment/Signs & symptoms
Onset very abrupt
Sudden jerking of entire body, tenseness, then
relaxation
LOC or confusion
Sudden jerking of one body part
Lip smacking, eye blinking, staring
Sleeping following seizure
20. Management
If mild or moderate
Give fluids orally if there is no abdominal pain,
vomiting or diarrhea and is alert
Severe
High flow O2
IV/IO with NS or LR
Fluid bolus of 20 ml/kg IV/IO push
Repeat fluid bolus if no improvement
21.
22. The care of the normal
newborn child, he
understands a special
evaluation in four moments.
23. IMMEDIATE ATTENTION
•Evaluation of the
breathing, cardiac frequency and
color,Test de Apgar.
•Anthropometry and the first
evaluation of age gestational.
CARE OF TRANSITION
•The first hours of life of the newborn
child need of a special supervision
of his temperature, vital signs and
clinical general condition.
24. ATTENTION OF THE NCH IN PUERPERIO
• Spent the immediate period of transition
the NCH remains together with his
mother in puerperal.
• This period has a great importance from
the educational and preventive point of
view.
PREVIOUS TO BE HIGH OF WITH HIS MOTHER
OF THE HOSPITAL
• It is necessary to give a last general
review
• The mother needs to interest and to
catch knowledge that will facilitate to
him the care of his son.
25.
26. PAEDIATRIC CONTROLS
• There will be realized pediatrics controls of healthy
children by major frequency when the child is
developing
CONTROL OF THE HEALTHY CHILD
• In this examination, the doctor checks the growth and
development of the baby or of the small child and tries
to find problems in time.
CONSULTATIONS OR CONTROLS
• They serve to receive information about the normal
development, nutrition, dream, safety, infectious
diseases " and other important topics.
27.
28. After the birth
of the
baby, the
following
consultation
must be
between 2 and
3 days after.
29. 1 MONTH. 2 YEAR
2 MONTH. 3 YEAR
4 MONTH. 4 YEAR
Of there in forward, the 6 MONTH. 5 YEAR
consultations must
happen to the following 9 MONTH. 6 YEAR
ages
1 YEAR. 8 YEAR
15 MONTH. 10 YEAR
18 MONTH. 10-21 EVERY
YEAR