Pediatric Emergencies & Childbirth EMT 100

Guidelines in Dealing with Children Get parental consent (implied in emergency) Involve the parent(s)? Talk TO child Try to be close to eye level Don’t lie or surprise!

Croup – inflammation of the larynx, trachea, and bronchi Usually between 3 months and 3 years – Usually while asleep Complication of viral infection, eg cold Difficulty breathing Crowing sound on inspiration (inspiratory stridor) Seal-like barking cough Breath cool moist air for 5 minutes – If no improvement after 5 minutes, EMS!

Epiglottitis Usually between 3 –10 years Caused by bacterial infection High fever Difficulty breathing Inspiratory stridor Drooling Try moist air breathing Will need antibiotics and possibly EMS

Seizures (Tonic-Clonic) Most common are febrile Toxin ingestion Treat as any seizure and get follow up medical care

Child Abuse: Treat and Notify Police or County Protective Services Wounds in different stages of healing Wounds that suggest defensive posturing –H–Hands and forearms –B–Back, back of head,back of legs “Fishy” explanation

Emergency Childbirth

Signs that birth is imminent: Contractions 2-3 minutes apart or less – How is the interval timed? Mother feels urge to push with each contraction Crowning

Preparation Get mother comfortable (prop with pillows) Drape abdomen, each leg, as well as under her Wash hands! Get ready for the big “catch”

Delivery: Head

Delivery: Shoulders Head and shoulders rotate naturally If possible, clear airway

Delivery: Chest and Rest of Body

Delivery: Catch!

Lay baby NEXT to Mother and: Clear Airway Towel dry and wrap in dry blanket If not breathing (crying) yet, clear airway again, and flick soles of feet If still not breathing, give 2 breaths, check pulse and CPR if needed EMS

Two most important concerns: Airway & Breathing Preventing heat loss

Cutting the cord After drying and breathing has started Make two ties: 4 inches from baby and 6 inches from baby Cut between

Placenta Delivery With infant wrapped up and breathing, and cord cut, place on mother’s abdomen Let placenta deliver passively!

Three things have to go to hospital: Mother Baby Placenta

Surprises! (Complications) Twins Prematurity – More prone to airway/breathing problems & heat loss Breech – Tush and feet appear first – Footling breech- arm or leg appears first True obstetrical emergency Nuchal cord – cord around infant’s neck – Slip over baby’s head Prolapsed cord – cord comes out first – True obstetrical emergency

Ectopic Pregnancy Female of child rearing age Sudden onset of belly pain with no obvious cause Development of shock Treat shock and activate EMS

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