Pediatric Emergencies Machela Worthington

Neonate (0 - 1 month) n Well developed senses of smell & hearing n Congenital illness- illness that child is born with, symptoms show up as child grows & develops

Young Infant (1 - 5 months) n Growing rapidly, curiosity & amazement are developing as they observe their environment n Common illnesses: n sudden infant death syndrome n vomiting & diarrhea n meningitis n child abuse n accidents n **Increased risk of having hypothermia**

Older Infant ( months) n Becoming more active, standing, & walking n Common problems: n febrile seizures n vomiting & diarrhea n dehydration n bronchiolitis n motor vehicle collision n croup n child abuse n poisonous ingestion falls

Toddler (1 - 3 yrs.) n Constantly moving, becoming independent n Do not like being away from parents n Common emergencies: n ingestions n falls n motor vehicle collisions n vomiting & diarrhea n febrile seizures n child abuse n croup n meningitis n ingestion of foreign bodies

Preschool (3 - 5 yrs.) n Motor development, plays sophisticated games n Common problems: n croup n asthma n ingestions n motor vehicle collisions n epiglittitis n meningitis n burns n child abuse n foreign body ingestions n drowning febrile seizures

School Age ( yrs.) n Brain is now 90% of adult weight n physically growing quick, very active n Common occurrences: n drowning n motor vehicle collisions n bike accidents n fractures n falls n sports injuries n child abuse n burns

Adolescent ( yrs.) n Undergoing various degrees of growth n Great deal of importance on body image & peers n Risk-taking behavior n Common emergencies: n mononucleosis (mono) n asthma n motor vehicle collisions n sports injuries n suicide gestures n sexual abuse n pregnancy n drug & alcohol related emergencies

Airway Problems - More common in kids than adults Foreign Body Obstruction-an object put in the mouth of a child and which object gets caught in airway. Incomplete Obstruction-when object is not completely blocking airway, to get the object out, encourage child to cough.

Pediatric Vital Signs

Trouble Breathing Croup-a viral illness, causes swelling of upper airways, larynx, trachea, & bronchi. n most common in fall & winter n begins with upper respiratory infection n lasts several days n contracted by children 6 months - 4 yrs. old n symptoms: n cough n runny nose n sore throat n trouble breathing

Trouble Breathing (cont.) Epiglittitls-bacterial infection of epiglottis n less common than croup, more likely to cause life-threating airway obstruction n covers tracheal opening, blocks airway n symptoms: n high fever brassy cough

Respiratory Infections Pediatric Asthma-common disease, involves reversible spasm of smaller airways in chest n common in children, outgrows disease n common triggers: n cold n exercise n animal dander n dust n smoke & airborne irritants n respiratory infections

Signs of Respiratory Difficulty/Failure

Hypoperfusion & Hypoydemia n common cause: n large fluid loss resulting in hypovolemia n common cause of pediatric loss: n dehydration n vomitting n blood loss from trauma n diarrhea

Cardiac Arrest n most common cause: n Respiratory arrest-child goes into respiratory failure, leads to profound hypoxia, leads to cardiac failure, & cardiac arrest. Provide good ventilation with 100% oxygen & cardiac compressions

SIDS (Sudden Infant Death Syndrome) n Occurs at a rate of 2 in 1,000 births n leading cause of death in children 1 week - 1 yr.. n Males are more commonly affected than females n winter months have more cases than other months n Common causes: n infants of mothers of low socioeconomic groups n infants of low birth weights

Altered Mental Status Seizures(febrile seizure)-most common n caused by a rapid increase of body temp. n associated with infection, fever causes short-circuit to brain causing seizure n does not last more than a few minutes n has a brief period of lethargy and confusion, then a return of a normal mental status n child is at higher risk of experiencing a high fever, not at risk for chronic seizures.

Altered Mental Status Diabetes-condition of altered glucose utilization n nothing should be placed in mouth

Altered Mental Status Behavioral-these disorders result in abnormal behavior Poisoning-high risk if children are able to get a hold of household cleaners, cosmetic products, and medications n Signs of poisoning: n discoloration of mouth or lips n smell on breath n vomit with chemical smell n CALL POSION CONTROL CENTER IMMEDIATELY!

Infections n many are NOT life-threatening n spread from child to child: n colds n flu n chicken pox n gastroenteritis(stomach bug) n strep throat n mononucleosis(viral)

Meningitis n Infectious disease caused by a virus or bacteria, transmitted by coughing or sneezing n infection of the lining surrounding brain & spinal cord n very serious! n Symptoms: n stiff neck n fever n headache n rash n altered mental status n seizures(maybe)

Pediatric Trauma n #1 killer of children over 1 yr.. Old n largely preventable majority occur in motor vehicle collisions

Pediatric Trauma by Age

Blunt Trauma Motor Vehicle Collisions n anyone has potential for being seriously injured n sport cars hit teenagers, direct trauma from bumper causes lower leg injuries n teen is thrown, chest & head injury n truck strikes school-age child, direct injury causes head injuries n results in internal bleeding, hypoperfusion and shock

Hypoperfusion n Child becomes very pale & diaphoretic n child’s capillary refill will become prolonged, beyond normal-2 sec. n Child may complain of nausea n heart continues to pump adequate amount of blood to vital organs n child’s peripheral pluses becomes weaker as body shifts

Chest Injury n Rib cage bends inward, then springs back to original state n takes a great deal of force to break a child’s rib n internal injury is also associated with pediatric rib fracture

Abdominal Injury n Child’s liver & spleen are only protected by rib cage n liver & spleen are very susceptible to injury

Head Injury n Signs & Symptoms: n loss of consciousness n headaches n blurred vision n nausea n vomit

Spinal Injury **Greater risk for children--heads are larger**

Bone Injury n Great deal of force to fracture a bone of a child

Burns n Result of child abuse n playing with matches n pulling hot pan off stove

Child Abuse n Child abuse-emotional, physical, or sexual injury inflicted by a parent or another person n Neglect-parent failure to act n 500, million children are abused each year in the U.S.

Procedures or Items used to treat emergencies n Tracheostomies-opening in front of neck that has been surgically created to allow placement of rigid tube(tracheostomy tube)-maintains adequate oxygenation & ventilation. n Mechanical Ventilators-very small & portable. Children that have trouble breathing independently. n Central Venous Catheters-children often have these that require frequent intravenous medications or blood sampling. Intravenous catheter is placed in upper are or chest.

Procedures or Items used to treat emergencies (cont.) n Feeding Tubes-soft, flexible tubes placed into stomach that provides liquid nutrition to children n Cerebrospinal Fluid Shunts (CSF)-special catheter that drains excess CSF off brain & into abdomen. Also called Ventriculoperitoneal Shunts (VP)-under skin, extends from ventricles of brain to peritoneal cavity.