September 2014 CE

Site code # 107200E-1214

Pediatric Evaluation and Resuscitation

Objectives by

Reviewed/revised by Sharon Hopkins, RN, BSN, EMT-P

To view on the Advocate Condell website visit:

http://www.advocatehealth.com/condell/2014-ems-continuing-education

Date of CE presentation: September, 2014 Topic: Pediatric Evaluation and Resuscitation Behavioral Objectives: Upon successful completion of this module, the EMS provider will be able to:

1. Describe physiological differences between the adult and pediatric populations. 2. Describe assessment of the pediatric patient starting with the Pediatric Assessment Triangle. 3. Describe the differences between respiratory distress and respiratory failure 4. Describe the 4 general classes of shock 5. List the signs of compensated shock 6. List the signs and symptoms of anaphylactic shock 7. Review the Broselow Tape and Region X SOP pediatric medication reference sheets for the pediatric population. 8. Actively participate in review of selected Region X SOP’s. 9. Actively participate in case scenario discussion. 10. Actively participate in a pediatric code based on your license level. 11. Successfully complete the post quiz with a score of 80% or better. Bibliography: Bledsoe, B., Porter, R., Cherry, R. Paramedic Care Principles & Practices, 4th edition. Brady. 2013. Mistovich, J., Karren, K. Prehospital Emergency Care 9th Edition. Brady. 2010. Region X SOP’s; IDPH Approved April 10, 2014. http://dhss.alaska.gov/dph/Emergency/Documents/ems/assets/EMSC/pediatric_trauma.pdf http://emsconedonline.com/pdfs/PEDSASSESSMENT.pdf

Pediatric Assessment Triangle Respiratory Distress vs Respiratory Failure Respiratory Distress

Respiratory Failure

Increased work of breathing Increased respiratory rate Use of accessory muscles Nasal flaring Effectively compensating

Exhausted energy reserves Cannot maintain adequate oxygenation and ventilation Low respiratory rate Decreased effort Usually with bradycardia, agitation or lethargy and cyanosis

4 Classes of Shock � Hypovolemic � Distributive �Obstructive �Cardiogenic

EpiPen™ & EpiPen Jr™

Rule of Nines – Infant / Child / Adult

OPQRST of Assessment O – onset – what were they doing at the time of onset P – provocation/palliation – what makes it worse/better Q – quality – in their own words, describe the situation R – radiation- does the pain radiate anywhere S – severity – on a scale of 1 – 10, how does the patient rank the pain T – time – what time did this incident begin

The H’s The T’s Hypovolemia

Tablets/toxins

Hypoxia

Tamponade, cardiac

Hydrogen ion – acidosis

Tension pneumothorax

Hyper/hypokalemia

Coronary thrombosis

Hypothermia

Pulmonary thrombosis

Hypoglycemia

File: CE, EMS; CE Packets; 2014; Sept CE Handout; Peds