Pediatric Assessment

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Survival Following Respiratory Arrest versus Cardiopulmonary Arrest in Children. . . . . . 100%. half. 0%. Respiratory capture. Cardiopulmonary capture. . Survival rate. General Impression. Wiped out versus Not Sick. . AppearanceT.I.C.L.S.. BreathingW.O.B.. Course to Skin .

Presentation Transcript

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Pediatric Assessment BY: Fidel O. Garcia EMT-P Co-Owner ProEMSeducators.com fidel@proemseducators.com

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Survival Following Respiratory Arrest versus Cardiopulmonary Arrest in Children 100% Survival rate half 0% Respiratory capture Cardiopulmonary capture

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General Impression Sick versus Not Sick

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Pediatric Assessment Triangle (PAT) Breathing W. O. B. Appearance T. I. C. L. S. Course to Skin

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Respiratory Distress Appearance: Normal Breathing: Increased Circulation to Skin: Normal

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Respiratory Failure Appearance: Abnormal Breathing: Increased or diminished Circulation to Skin: Normal to unusual

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Shock Appearance: Abnormal Breathing: Normal Circulation to Skin: Abnormal

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CNS brokenness or Metabolic irregularity Appearance: Abnormal Breathing: Normal Circulation to Skin: Normal

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The ABC's give support of ordinary key capacity Airway Ventilation Breathing Oxygenation Circulation Perfusion

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Respiratory issue or Shock ?

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Physical Examination - Airway Rapid Assessment Clear Maintainable Unmaintainable Pediatric versus grown-up aviation routes BVM contemplations Intubation contemplations Check D.O.P.E

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Physical Examination - Breathing Effort Mental Status Skin Color Rate: Neonate 40 – 60 Infant 40 – 50 Toddler 30 – 40 Child 20 – 30 Adolescent 12 - 20 Air Entry

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Common Upper Airway Emergencies Croup: Epiglotitis FBAO 6 months - 3 yrs 3yrs – 6 yrs all ages Slow onset rapid onset "Seal bark" quiet high pitched screech Usually brisk fix long term fix usually fast settle Fall or winter anytime anytime Usually not life life threatening Usually not life threatening threatening Viral bacterial neither Mild secretions drooling may dribble Hx URI no hx URI No hx URI Moderate fever High fever no fever

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Common Lower Airway Emergencies Asthma: Hyper - receptive aviation routes RSV : Virus bringing on bronchiolitis

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Common Lowewr Airway Emergencies Asthma RSV Air catching disease Virus creating bronchiolitis Rapid Onset Slow onset Afebrile Febrile Under 2 years of age 3 years and more seasoned Previous history No history Wheezes Wheezes/rhonchi No drainage Rhinorrhea May be life threatening Less life debilitating

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Shock Or Respiratory?

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Assessment of Shock Mental Status: Altered or diminished Extremity temp: Warm or frosty Determine Pulses: Infant: 100 – 160 Toddler: 90 – 150 Preschooler: 80 – 140 Child: 70 – 120 Adolescent: 60 – 100 Internal Pulse Quality: Color/Cap refill: Central versus fringe Renal output: 1 – 2 ml/kg/hr

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Blood weight Low end of ordinary systolic pressure Age >60 0 to 1 month >70 1 month to 1 yr >70 + (2 x age in yrs) Older than 1 What data bloods weight give ?

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Hemodynamic Response to Shock Vascular resistance Blood weight Cardiac yield Compensated stun Decompensated stun

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Review of the Physical Finding in Shock Early signs (adjusted) expanded rate poor systemic perfusion modified mental status Late signs (decompensated) frail focal heartbeats decreased mental status decreased pee yield hypotension

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Phases of Pediatric Shock Early Late (hypotension) Delayed passing Survival Immediate capture in place Multiple organ dysfuntion

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Physical Finding in Shock Early signs (adjusted) expanded rate poor systemic perfusion changed mental status Late signs (decompensated) powerless focal heartbeats decreased mental status decreased pee yield hypotension

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Etiologies of Pediatric Shock Hypovolemic Distributive Septic Anaphylactic Neurogenic Cardiogenic Obstructive

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Child biting the dust with Multiple Organ Dysfunction Syndrome (MODS) , notwithstanding revival endeavors

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Etiologies of Cardiopulmonary Failure Many Etiologies Respiratory Failure Shock Cardiopulmonary Failure

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Definition of Cardiopulmonary Failure Global Deficitis in : Ventilation Oxygenation Perfusion Resulting in : Agonal Respirations Bradycardia Cardiopulmonary capture

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Priorities of Initial Management Cardiopulmonary disappointment oxygenate, ventilate, screen reassess for: respiratory disappointment shock acquire vascular get to

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Many Etiologies Respiratory Failure Shock Cardiopulmonary Failure Cardiopulmonary capture Death Cardiopulmonary recuperation Unimpaired neurologic recuperation Impaired neurologic recuperation

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