3. Pediatric Assessment

4. SCENE SIZE-UP & SAFETY
Enter Slowly
Observe for safety and mechanism of injury

5. If parents interfere:
Try to persuade to assist in care
If necessary, have friend or relative remove from scene
Child may not live in traditional 2-parent home
use tact
Gain confidence and calm all involved
Don’t distract from care of child

6. Assessing
The condition of a sick/injured child can change rapidly
Signs or symptoms can be subtle

7. INITIAL ASSESSMENT
General Impression
Well or sick
Mental status
drowsy
sleepy
inattentive
Effort of breathing

8. Skin color
pale
cyanotic
flushed
Quality of speech
strong cry
speak only in short sentences
grunts

9. Interaction with the environment or others
silence
listlessness
unconscious

10. Emotional state
withdrawn
emotionally flat
Response to you
inattention to strangers
Tone and body position
limpness
poor muscle tone
position to indicate respiratory distress
Mental status
AVPU
never shake

11. Airway
depressed mental status
secretions
blood
vomitus
trauma
infections
Do not hyperextend neck

12. Breathing
Chest expansion
Effort of breathing
Sounds of breathing
Breathing rate
Color

13. “Treat as you go care”

14. FOCUSED HISTORY AND PHYSICAL
EXAM
Ask simple questions
Always explain what you are doing to a child
Base-line vital signs
low b/p may indicate imminent cardiac arrest

15. PRIORITY PATIENTS
Poor General Impression
Unresponsive or listless
Does recognize parents or primary care givers
Not comforted when held by parent but becomes calm and quiet when set down

16. Compromised airway
Respiratory arrest or inadequate breathing
Possibility of shock
Uncontrollable bleeding

17. DETAILED PE
Toe-to-head exam with infants and small children
Unless injury/illness won’t permit, allow
parent to hold child in lap
Shelter from stares and onlookers
Children loose heat quickly so recover quickly after exposing for exam

18. ON-GOING ASSESSMENT
DON’T TAKE YOUR EYES OFF YOUR PEDIATRIC PAITENT FOR A MINUTE

19. RESPIRATORY COMPRIMISE IS THE
PRIMARY CAUSE of CARDIAC ARREST
IN CHILDREN