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Common Pediatric Medical Emergencies PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Common Pediatric Medical Emergencies" by Ken Sanner, NRP.

This medical PowerPoint presentation talks about some common pediatric medical emergencies.

ome common pediatric medical emergencies include Seizures, Asthma attacks, Allergic reactions, Dehydration, Poisoning, Burns, Head injuries, Choking, Sepsis, etc.

Tags : Pediatric Medical Emergencies, Seizures, Asthma attacks, Allergic reactions, Dehydration, Poisoning, Burns, Head injuries, Choking, Sepsis, Emergency Medicine, Emergency Medicine PowerPOint presentation

Published on : Apr 12, 2023 | Views : 1259 | Downloads : 6

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Slide 1-

Common Pediatric Medical Emergencies Ken Sanner, NRP
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Disclaimer This presentation covers only a snapshot of the subjects presented- each topic could be lecture of its own! You are encouraged to do further research and dive deeper into each topic. Not all pediatric emergencies are covered in this presentation- only some common conditions.
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Objectives Discuss how to assess pediatric patients of varying age groups. Identify common pediatric medical emergencies that present in the prehospital environment. Review BLS & ALS treatment for common pediatric medical emergencies. Explore potential transport dispositions for pediatric patients.
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Overview Pediatric Patient Assessment Asthma Allergic Reaction & Anaphylaxis Croup Hyperglycemia Hypoglycemia Hypovolemia
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Overview Apparent Life-Threatening Event (ALTE) Seizures Overdose & Poisoning Foreign Bodies Infections Cardiac arrest Transport Decisions
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Pediatric Patient Assessment Age Ranges Newborn: birth to 1 hour. Neonate: 1 hour to 28 days. Infant: 28 days to 1 year. Toddler: 1 year to 2 years. Preschooler: 3 years to 4 years. School Age: 5 years to 12 years. Adolescent: 13 years to 18 years.
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Pediatric Patient Assessment First things first- the across the room assessment. The pediatric assessment triangle (PAT). Common tool found in pediatric assessment courses. Is the patient “sick” or “not sick”? Work of Breathing Appearance Circulation to Skin
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Pediatric Patient Assessment Younger Children Do a toe-to-head assessment. Include the caregiver as intimately as possible. Be aware of separation anxiety. Save painful assessments and procedures for last. Build trust with the patient. Provide distractions. Older Children Explain what you are doing and why. Keep the caregiver in close proximity. Get as much information from the patient prior to asking the caregiver. Adolescents will want to be treated as adults. In some instances patients may want privacy from their caregivers.
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Pediatric Patient Assessment Assessment Components Complete the primary survey. Obtain vital signs. Comprehensive history taking. The secondary assessment is key. Remember to use your diagnostics & tools. Ominous Findings in Kids Head bobbing Grunting Hypotension Bradycardia Hypoxia Altered mental status If the child shows signs of decompensation, time is quickly running out!
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Pediatric Patient Assessment Age Appropriate Vital Signs The Maryland Medical Protocols for Emergency Medical Services Providers
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Asthma What is it? A completely reversible obstructive airway disease. Three components: Bronchospasm Edema Excessive mucus production What causes it? Environmental & genetic factors Exacerbations are caused by a trigger. Pollen, dust, smoke, animal dander Temperature changes Physical activity Signs & Symptoms Dyspnea Wheezing Coughing Pertinent negatives
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Asthma Treatment: BLS ABCs Provide oxygen & ventilations as needed Assist with metered-dose inhaler Epi-Pen or IM epinephrine administration Treatment: ALS Attach the monitor Obtain IV access Nebulized albuterol Nebulized ipratropium IM epinephrine 1:1,000 IV/PO dexamethasone IV magnesium sulfate CPAP
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Allergic Reaction & Anaphylaxis What is it? A hypersensitivity reaction to an allergen. Allergic reaction: localized. Anaphylaxis: two or more body systems. Even a mild allergic reaction can rapidly progress to a life-threatening presentation. What causes it? Antibodies signal white blood cells to release chemicals to destroy antigens (allergens). Signs & Symptoms Urticaria (hives) Itching Nausea Dyspnea Angioedema Trouble swallowing, throat tightness Wheezing Stridor Tachycardia Hypotension (late)
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Allergic Reaction & Anaphylaxis Treatment: BLS ABCs Provide oxygen and ventilations as needed Epi-Pen or IM epinephrine administration Assist with metered-dose inhaler Treatment: ALS Attach the monitor Obtain IV access IM epinephrine 1:1,000 IV/IO lactated Ringer’s IV/IO/IM diphenhydramine Nebulized albuterol Nebulized ipratropium IV/IO/PO dexamethasone* IV epinephrine drip* *Anaphylaxis only
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Croup What is it? An infection of the trachea, larynx, and bronchi. What causes it? Swelling and inflammation from the infection narrows the airway, making breathing difficult. Signs & Symptoms Mild: barking cough without stridor at rest. Moderate: barking cough with stridor at rest; mild dyspnea. Severe: stridor at rest, severe dyspnea, agitation or AMS. ***If these signs are associated with drooling, the patient may have epiglottitis***
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Croup Treatment: BLS ABCs Provide oxygen and ventilations as needed Treatment: ALS Attach the monitor. Obtain IV access. Mild: PO dexamethasone Moderate: PO dexamethasone Nebulized epinephrine 1:1,000 Severe (imminent arrest): IM epinephrine 1:1,000 IV/IM dexamethasone Nebulized epinephrine 1:1,000
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Hyperglycemia What is it? A level of sugar in the blood. Diabetic ketoacidosis (DKA): the body begins using fats for energy, releasing ketones and lactic acid. What causes it? Almost exclusively related to diabetes mellitus type 1 in pediatric patients. May have triggers. Signs & Symptoms The “3 P’s” of hyperglycemia Polyuria Polyphagia Polydipsia Headache Altered mental status Kussmaul respirations Smell of ketones GI distress and abdominal pain Hypotension Tachycardia Usually the onset is gradual
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Hyperglycemia Treatment: BLS ABCs Provide oxygen and ventilations as needed Treatment: ALS Attach the monitor Obtain IV access IV/IO lactated Ringer’s
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Hypoglycemia What is it? A blood sugar level below 40 in neonates. A blood sugar level below 70 in children over 28 days of age. What causes it? Usually a complication of insulin administration in a child with type 1 diabetes. Signs & Symptoms Hunger Irritability Altered mental status Pallor and diaphoresis Usually a sudden onset
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Hypoglycemia Treatment: BLS ABCs Provide oxygen and ventilations as needed Oral glucose Treatment: ALS Attach the monitor Obtain IV access IV/IO dextrose 10% IM/IN glucagon
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Hypovolemia What is it? An inadequate amount of fluid in the body. What causes it? Vomiting and diarrhea Blood loss Diabetic ketoacidosis Exertion and/or poor fluid intake Signs and Symptoms Generalized weakness Lethargy Altered mental status Pallor Dry skin and mucus membranes Sunken fontanelles Poor skin turgor Tachycardia Hypotension
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Hypovolemia Treatment: BLS ABCs Provide oxygen and ventilations as needed Monitor glucose Treatment: ALS Attach the monitor Obtain IV access IV/IO lactated Ringer’s IV/IO/IM ondansetron
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Apparent Life-Threatening Event (ALTE) What is it? An episode involving a child under 2 years of age that frightens the observer. What causes it? Many possible causes such as reflux, seizures, infections, trauma, or cardiac arrhythmias. Signs & Symptoms An episode of apnea Skin changes Loss of muscle tone Unexplained choking
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Apparent Life-Threatening Event (ALTE) Treatment: BLS ABCs Provide oxygen and ventilations as needed Monitor glucose Treatment: ALS Attach the monitor Obtain IV access
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Seizures What is it? An erratic firing of neurons in the brain resulting in changes in responsiveness. Generalized Partial/focal What causes it? The cause is often unknown, or idiopathic. Other causes involve TBI, hypoglycemia, hypoxia, infection, toxicity, and fever. Signs & Symptoms Altered mental status Nystagmus Convulsions Secondary trauma
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Seizures Treatment: BLS ABCs Provide oxygen and ventilations as needed Monitor glucose Oral glucose, if indicated Treatment: ALS Attach the monitor Obtain IV access Assist with prescribed benzodiazepines Administer midazolam or diazepam
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Overdose & Poisoning What is it? The exposure to a substance which causes harm to the body. What causes it? The action depends on the specific mechanism of the substance taken. Signs & Symptoms Can vary widely based on the substance taken.
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Overdose & Poisoning Treatment: BLS ABCs Provide oxygen and ventilations as needed Activated charcoal Naloxone Treatment: ALS Attach the monitor Obtain IV access Specific antidotes IV/IO atropine IV/IO calcium chloride IV/IO/IN/IM naloxone IV/IO sodium bicarbonate
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Foreign Bodies What is it? An object stuck in the patient’s body. Nose Ear Throat What causes it? Children are naturally curious and unaware of the consequences of actions. Signs & Symptoms Nose Bleeding Pain Rhinorrhea Ear Hearing loss Pain Bleeding Throat Stridor Dyspnea Drooling
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Foreign Bodies Treatment: BLS ABCs. Provide oxygen and ventilations as needed. Have the patient blow through the obstructed nostril. Relieve choking. Treatment: ALS Attach the monitor Obtain IV access Direct laryngoscopy and Magill forceps
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Infections What is it? Illness due to the colonization of the body by a virus, bacteria, fungus, or parasites. What causes it? There are many potential organisms that cause illness. Respiratory syncytial virus (RSV), influenza, and staph, are just a few examples. Signs & Symptoms Largely dependent on the type and area of infection. Ear pain Headaches Fever Chills Nausea, vomiting, & diarrhea Sores Inflammation Cough Dyspnea
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Infections Treatment: BLS ABCs Provide oxygen and ventilations as needed Monitor glucose Treatment: ALS Attach the monitor Obtain IV access Treat symptoms as appropriate. Fluid resuscitation Nebulized albuterol/ipratropium Dextrose Vasopressors for hypovolemia after fluid resuscitation
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Cardiac Arrest What is it? The cessation of the mechanical activity of the heart. What causes it? Primary medical causes in children: Airway or respiratory problems Shock Signs & Symptoms Unresponsiveness Apnea No palpable pulse
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Cardiac Arrest Treatment: BLS ABCs Provide oxygen and ventilations as needed Attach AED and follow prompts. No AED use for newborns (<1 hour) Treatment: ALS Attach the monitor Secure the airway Obtain an IV/IO IV/IO epinephrine 1:10,000 IV/IO amiodarone Treat reversible causes
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Transport Decisions Potential Dispositions Local emergency department Pediatric emergency department without inpatient capability Hospitals with inpatient pediatric units Hospitals with pediatric intensive care units Specialty centers “Medical home” Refusals Am I comfortable the child’s issue has been resolved? Is there a potential for a bad outcome? Can the patient be safely transported by car? Do I need to consult with a pediatric base station?
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Transport Decisions The Pediatric Decision Tree (PDTree) Pilot protocol developed by Johns Hopkins. Serves as a guide to decision making for transport dispositions. Five levels of care recognized by the PDTree: Local emergency department Specialty centers Comprehensive centers Medical home Regional centers
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The Maryland Medical Protocols for Emergency Medical Services Providers
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Review Pediatric emergencies are low-frequency, high-risk incidents. Proper patient assessment is the foundation of treating any medical emergency. Children compensate well at first but their condition can rapidly deteriorate. Use of a field guide is highly encouraged. Reading one protocol a day can help you to stay on top of your pediatric emergencies skills. When in doubt: vitals, oxygen, monitor, IV, and transport! Pediatric cardiac arrest is scary- but completely manageable in the out-of-hospital scenario. Make an informed transport decision. If in doubt consult or defer to a higher level facility.
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Remember: we owe it to ALL of our patients to provide the highest quality care EVERY time. This means kids too!
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References MIEMMS.org. (2018). The Maryland medical protocols for emergency medical services providers. The Maryland Institute for Emergency Medical Services Systems. Retrieved on March 4, 2019 from http://www.miemss.org/home/Portals/0/Docs/Guidelines_Protocols/MD-Medical-Protocols-2018-WEB.pdf?ver=2018-04-11-134820-493 Pollak, MD, FAAOS, A., Aehlert, MSED, BSPA, RN, B., Elling, MPA, EMT-P, B. (2018). Nancy Caroline’s emergency care in the streets (8th ed). Burlington, MA: Jones & Bartlett Learning Thank you for participating in this presentation! I hope you found it insightful.