2. Pediatric Assessment

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

4. 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 Dont distract from care of child

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

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

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

8. Interaction with the environment or others silence listlessness unconscious

9. Emotional state withdrawn emotionally flat Response to you inattention to strangers Tone and body position limpness poor muscle tone position to indicate respiratory distress Mental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

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

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

12. Treat as you go care

13. 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

14. 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

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

16. DETAILED PE Toe-to-head exam with infants and small children Unless injury/illness wont permit, allow parent to hold child in lap Shelter from stares and onlookers Children loose heat quickly so recover quickly after exposing for exam

17. ON-GOING ASSESSMENT DONT TAKE YOUR EYES OFF YOUR PEDIATRIC PAITENT FOR A MINUTE

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