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Pediatrics for Prehospital Providers

Triage. Across the room assessmentAirwayRespiratoryCardiacDisabilityExposeVitals. Pediatric Respiratory Section. . Respiratory Distress vs. Failure. Increased rateNasal flaringUse of accessory musclesGrunting. Decreased L.O.C.Persistent cyanosis with supplemental oxygenDecreased

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Pediatrics for Prehospital Providers

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    1. Pediatrics for Prehospital Providers Paul B. Davenport BSN,RN,EMT-C

    2. Triage Across the room assessment Airway Respiratory Cardiac Disability Expose Vitals

    3. Pediatric Respiratory Section

    4. Respiratory Distress vs. Failure Increased rate Nasal flaring Use of accessory muscles Grunting Decreased L.O.C. Persistent cyanosis with supplemental oxygen Decreased breath sounds

    5. Croup vs. Epiglottis 3 months to 3 years Gradual onset Low grade fever Stridor Fall / Winter 3 years to 7 years Acute onset High fever Hoarse Drooling All year long

    6. Respiratory-Asthma Obstructive airway disease with hypereactivity of the bronchi and trachea.

    7. Respiratory-RSV 0-4 years of age December - April S/S of respiratory infection, thick secretions, and wheezing

    8. Respiratory Summary What does your patient look like? What do you hear? PMH

    9. Pediatric Cardiac Section

    10. Cardiac Dysrhythmia Treatment Vital signs, 100% Oxygen Stable vs. unstable Airway Vascular access Synchronized cardioversion 0.5 - 1.0 J/kg Defibrillation (2J/kg, 4J/kg, 4J/kg) Medications

    11. Disability

    12. Disability AVPU GCS Seizures Hypoglycemia Drug ingestion Dehydration

    13. Pediatric Assessment Expose

    14. Expose Evaluation of respiratory status Skin color(central and extremities) Rashes Trauma Burns

    15. Pediatric Assessment Vital Signs

    16. Pediatric Vital Signs L.O.C. Respiratory rate & quality Heart Rate Blood Pressure systolic BP= 70 + (2 X age in years) Temperature IV access

    17. Hypothermia Hyperthermia Core Temp.<95F Newborns Mild, Moderate, Severe Frostbite Management Core Temp. >101.5F Infection Poisoning Heat stroke Seizures Effects of hyperthermia

    18. IV Access

    19. IV Access in Pediatrics Attempts at peripheral IV access should not exceed 90 seconds--with decompensated shock/cardiac arrest. Children <6 years of age place IO cannula Location, location, location

    20. Case Scenarios

    21. Case Studies A woman runs into the station on a hot summer day, holding her 9 month old child in her arms. She states she left her child in the car while she went shopping. When she returned to the car the child was unresponsive.

    22. Case Study #2 Your unit is called to the scene of a 3 year old found outside. Patient was missing since early afternoon. It is now 9 p.m. Temperature outside is 32 degrees F. The patient is cold and unresponsive.

    23. Case Studies 3 You arrive on scene of a 2 month-old infant in cardiac arrest. CPR is in progress. The infant is intubated, however no IV access has been obtained. The monitor is showing VFIB.

    24. Case Studies #4 You are called to the scene of a house-fire. The firefighters pull a 5-year-old from the burning building. He has flame burns to the face, chest, abd., and both thighs. The patient is unresponsive with a weak pulse of 150bpm.

    25. Case Studies #5 You are called to the scene for a 1-year-old, unknown type problem. You arrive and find mother holding the 1-year-old female patient. Mother states that the patient has had a high fever for a week. The patient is lethargic and does not react when you pick her up. Vitals: HR 160 ST, BP 60/P, Resp. 40.

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