EMT Chapter 32 Pediatric Emergencies

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Pediatrics

-a specialized medical practice devoted to the care of the young

Infancy

-the first year of life

Toddler

-the period following infancy until 3 yeas of age

Preschool-Age

-children between 3 to 6 years of age

School-Age

-children between 6 to 12 years of age

Adolescents

-children between 12 to 18 years of age

Shaken Baby Syndrome

-a syndrome seen in abused infants and children
-the patient has been subjected to violent, whiplash-type shaking injuries inflicted by the abusing individual that may cause coma, seizures, and increased intracranial pressure due to tearing of the cerebral veins with consequent bleeding into the brain

Pediatric Respiratory Rates

-Newborn= 30-60 breaths/min
-Infant= 25-50
-Toddler= 20-30
-Preschool-age= 20-25
-School-age= 15-20
-Adolescent= 12-20
-Older than 18 years= 12-20

Pediatric Pulse Rates

-Infant= 100 to 160 beats/min
-Toddler= 90 to 150
-Preschool-age= 80 to 140
-School-age= 70 to 120
-Adolescent= 60 to 100

Pediatric Assessment Triangle (PAT)

-a structured assessment tool that allows you to rapidly form a general impression

Work of Breathing

-an indicator of oxygenation and ventilation
-work of breathing reflects the child's attempt to compensate for hypoxia

Tachypnea

-increased respiratory rate

Grunting

-an "uh" sound heard during exhalation
-reflects the child's attempt to keep the alveoli open
-a sign of increased work of breathing

Sniffing Position

-optimum neutral head position for the uninjured child who requires airway management

Nares

-the external openings of the nostrils
-a single opening is called a naris

Bradypnea

-slow respiratory rate
-ominous sign in a child that indicates impending respiratory arrest

Stridor

-high-pitched inspiratory sound
-indicates a partial upper airway obstruction (such as in croup of from a foreign body)

Wheezing

-high- or low-pitched sound heard usually during expiration
-indicates a partial lower airway obstruction (such as in asthma or bronchiolitis)

Grunting

-an "uh" sound heard during exhalation
-reflects the pediatric patient's attempt to keep the alveoli open by increasing pressure in the chest cavity
-indicates inadequate oxygenation

-Absent Breath Sounds (despite increased work of breathing)

-indicates a complete upper or lower airway obstruction (such as a foreign body, severe asthma, or pneumothorax)
-this is also known as a silent chest, which is an ominous sign of impending respiratory distress
-leading to respiratory arrest if not quickly addressed

Central Pulses

-pulses that are closest to the core (central) part of the body where the vital organs are located
-include the carotid, femoral, and apical pulses

Tool to determine blood pressure in children 1 to 10 years of age

-70 + (2 x child's age in years) = systolic blood pressure

Pertussis

-an acute infections disease characterized by a catarrhal stage, followed by a paroxysmal cough that ends in a whooping inspiration
-also called whooping cough

Pediatric Resuscitation Tape Measure

-a tape used to estimate an infant or child's weight on the base of length
-appropriate drug doses and equipment sizes are listed on the tape

Blanching

-turning white

Generalized Tonic-Clonic Seizure

-a seizure that features rhythmic back-and-forth motion of an extremity and body stiffness

Neisseria Meningitidis

-a form of bacterial meningitis characterized by rapid onset of symptoms, often leading to shock and death

Child Abuse

-a general term applying to all forms of child abuse and neglect

Neglect

-refusal or failure on the part of the caregiver to provide life necessities

Sudden Infant Death Syndrome (SIDS)

-death of an infant or young child that remains unexplained after a complete autopsy

Apparent Life-Threatening Event (ALTE)

-an event that causes unresponsiveness, cyanosis, and apnea in an infant, who then resumes breathing with stimulation

When ventilating a pediatric patient with a bag-mask device, the EMT should:

-block the pop-off valve if needed to achieve adequate chest rise

An 8-year-old female with a history of asthma continues to experience severe respiratory distress despite being given multiple doses of her prescribed albuterol by her mother. She is conscious, but clearly restless. Her heart rate is 130 beats/min and her respiratory rate is 30 breaths/min. She is receiving high-flow oxygen via a nonrebreathing mask. You should:

-be prepared to assist her ventilations, transport at once, and request an ALS intercept en route to the hospital

Submersion injuries in the adolescent age group are MOST commonly associated with:

-alcohol

The suture of the anterior fontanelle is typically closed by _____ months of age, and the suture of the posterior fontanelle is typically closed by _____ months of age.

-18,6

A child may begin to show signs of separation anxiety as early as:

-6 months

Which of the following statements regarding spinal injuries in pediatric patients is correct?

-if the cervical spine is injured, it is most likely to be an injury to the ligaments because of rapid movement of the head

Early signs of respiratory distress in the pediatric patient include all of the following, EXCEPT:

-cyanosis

Febrile seizures in a child:

-may indicate a serious underlying illness

Immediate transport is indicated for a child when he or she:

-has a history suggestive of a serious illness

Which of the following statements regarding preschool-age children is correct?

-they can usually identify painful areas when questioned

If the situation allows, a child should be transported in a car seat if he or she weighs less than _____ lb.

-40 lb

When assessing the heart rate of a 6-month-old infant, you should palpate the brachial pulse or ________ pulse.

-femoral

Use of a nonrebreathing mask or nasal cannula in a child is appropriate ONLY if:

-his or her tidal volume is adequate

A 6-month-old male presents with 2 days of vomiting and diarrhea. He is conscious, but his level of activity is decreased. The infant's mother tells you that he has not had a soiled diaper in over 12 hours. The infant's heart rate is 140 beats/min and his anterior fontanelle appears to be slightly sunken. You should suspect:

-moderate dehydration

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