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Module 62

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Stridor, retractions on inspiration. Emergency Medical Care ... Stridor. Grunting. Cyanosis. Altered Mental Status. Nasal flaring. Muscle retractions. ... – PowerPoint PPT presentation

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Title: Module 62


1
Module 6-2
Infants and Children
2
Infants and Children
Anatomical and Physiological
Common Problems
Airway
Trauma
Assessment
Child Abuse and Neglect
3
Infants and Children
Anatomical and Physiological Concerns
4
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5
Infants and Children
Airway Management
6
Airway Opening
Position to open the airway is different - do
not hyperextend.
7
Head-tilt/Chin-lift
8
Jaw-thrust Maneuver
9
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10
Airway Adjuncts
Oral Airway
Not for initial ventilation.
Patient should not have a gag reflex.
Sizing - Corner of mouth to the tip of the ear.
Insert oral airway following the anatomic curve
without rotation.
11
Airway Adjuncts
Nasal Airway
Nasal airways are usually not used in children
by First Responders.
12
Infants and Children
Assessment
13
Child on Parents Lap
14
General Impression
Assess mental Status.
Effort of breathing, color.
Quality of cry / speech.
Interaction with environment and parents.
Emotional State.
Response to First Responder.
Tone / body position.
15
Approach to evaluation
Begin assessment from across room.
Observe for mechanism of injury.
Assess the surroundings.
16
Respiratory Distress
17
Hands-on Approach
Palpate brachial or femoral pulse.
Compare central and distal pulses.
Assess skin color, temperature, and condition.
18
Assess capillary refill.
19
Infants and Children
Common Problems in Infants and Children
20
Airway Obstruction
The American Heart Association reports that more
than 90 of pediatric deaths from foreign body
airway obstruction occur in children under five
years of age.
21
Partial Airway Obstruction
Infant or child alert and sitting.
Stridor, retractions on inspiration.
Pink. Good peripheral perfusion.
22
Emergency Medical Care
Partial Airway Obstruction
Allow position of comfort assist younger child
to sit up do not lay down. May sit on parents
lap.
Do not agitate child.
23
Complete Airway Obstruction
No crying, speaking, and cyanosis.
Increased respiratory difficulty.
Patient loses responsiveness.
24
Emergency Medical Care
Complete Airway Obstruction
Clear the airway using infant / child foreign
body procedures.
Attempt artificial ventilations with
mouth-to-mask technique.
25
Respiratory Emergencies
There is nothing more important that controlling
the airway and ensuring adequate breathing in a
pediatric patient.
26
Respiratory Distress
Respiratory rate gt 60 in infants.
Respiratory rate gt 30/40 in children.
Nasal flaring. Muscle retractions.
Stridor. Grunting. Cyanosis.
Altered Mental Status.
27
Respiratory Failure/Arrest
Respiratory rate lt 20 in infants.
Respiratory rate lt 10 in children.
Limp muscle tone. Unresponsive.
Cyanosis and a slow heart rate.
Weak or absent distal pulses.
28
Role of the First Responder
Scene Size-Up
Initial Assessment
Physical Exam
On-going Assessment
Provide mouth-to-mask or barrier device
ventilations.
Observe heart rate.
29
Circulatory Failure
Circulatory failure that is uncorrected is also
a common cause of cardiac arrest in infants and
children.
30
Signs of Shock in an Infant
31
Signs of Shock in a Child
32
Role of the First Responder
Scene Size-Up
Initial Assessment
Physical Exam
On-going Assessment
Complete an initial assessment on all patients.
Support oxygenation and ventilation.
33
Seizures
Seizures, including seizures caused by fever
(febrile), should be considered potentially
life-threatening.
34
Causes of Seizures
Fever
Infection
Poisoning
Low Blood Sugar
Hypoxia
Trauma
35
History of Seizures
Has the child had prior seizure(s)?
If yes, is this the childs normal seizure
pattern?
Is the child on seizure medications?
Could the child have ingested any other
medications?
36
Role of the First Responder
Scene Size-Up
Initial Assessment
Physical Exam
On-going Assessment
Protect the patient from the environment.
Assure patency of airway and place patient in
recovery position if no possibility of spinal
trauma.
37
Sudden Infant Death Syndrome (SIDS)
The sudden, unexplained death of an otherwise
normal and healthy infant.
38
SIDS
Most common in first year of life.
Many causes are not clearly understood.
Baby is most commonly discovered in the early
morning.
39
Role of the First Responder
Scene Size-Up
Initial Assessment
Physical Exam
On-going Assessment
Try to resuscitate unless the baby is stiff.
Comfort, calm, and reassure the parents while
awaiting EMS resources.
40
Infants and Children
Trauma
41
Trauma
Injuries are the leading cause of death in
infants and children.
42
Injury Pattern
Motor Vehicle Crashes
Falls
Burns
Sports Injuries
Child Abuse / Neglect
43
Head
Proportionally larger and more easily injured.
The single most important maneuver is to ensure
an open airway by means of the jaw-thrust.
44
Chest
Children have very soft pliable ribs.
There may be significant injuries without
external signs.
45
Abdomen
More common site of injury in children than
adults.
Often a source of hidden injury.
46
Role of the First Responder
Scene Size-Up
Initial Assessment
Physical Exam
On-going Assessment
Assure airway position and patency.
Provide spinal stabilization.
Manually stabilize extremity injuries.
47
Infants and Children
Child Abuse and Neglect
48
Abuse
Improper or excessive action so as to injure or
cause harm.
49
Neglect
Giving insufficient attention or respect to
someone who has a claim to that attention.
50
Child Physical Abuse
51
Child Physical Abuse
52
Child Physical Abuse
53
Child Abuse Death
54
Physical Abuse
55
Signs and Symptoms of Abuse
Multiple bruises in various stages.
Injury inconsistent with mechanism described.
Patterns of injury.
Parents seem inappropriately unconcerned.
CNS injuries - Shaken baby syndrome.
56
Signs and Symptoms of Neglect
Lack of adult supervision.
Malnourished appearing child.
Unsafe living environment.
Untreated chronic illness.
Untreated soft tissue injuries.
57
Role of the First Responder
Scene Size-Up
Initial Assessment
Physical Exam
On-going Assessment
Do not accuse in the field.
Report objective information to the transporting
unit. Report what you see and hear.
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