1. Pediatric emergencies

2. Introduction Pediatric patients are not just little adults
Many providers have a level of discomfort responding to and caring for pediatrics
Pediatric patients respond differently to stressful events and that response will differ based on developmental levels
Common problems in adults do not occur in children
Communication with child and caregiver is paramount
Remain calm , professional and sensitive
A calm parent contributes to a calm child

3. Growth and development
Infancy – First year of life
Toddler – 1-3 years
Preschool Age – 3-6 years
School age – 6-12 years
Adolescence – years

4. Anatomical differences
Airway is smaller in diameter and shorter
Lungs are smaller
The occiput is larger and rounder
Tongue is proportionally larger
Cartilage rings on trachea less developed
Children have an oxygen demand double that of an adult
Gastric distension can interfere with air movement
If SOB muscles fatigue easily resulting in respiratory failure
Respiratory issues are leading cause of cardiac arrest in pediatric patients

6. Circulatory system Pulse rates differ from adults
Children have ability to constrict blood vessels and increase heart rate to compensate for poor perfusion
A small amount of blood loss can lead to shock. May be in shock despite normal BP

8. Nervous system
Pediatric nervous system is immature, underdeveloped and not well protected
Head to body ratio larger
Brain tissue and vasculature are fragile and prone to bleeding form shear forces
Pediatrics brains require higher blood flow, oxygen and glucose
Secondary brain damage from hypotension and hypoxia more likely
Spinal injuries are less common in pediatric patients

9. Gastrointestinal
Liver spleen and kidneys are larger in proportion and situated more anteriorly and organs are closer to each other
Multiple organ injury is a higher risk
Liver and splenic injuries are more common in pediatric patients
Large amounts of bleeding can occur without signs of shock
Be alert for signs of shock
AMS
Tachypnea
Tachycardia
bradycardia

10. Musculoskeletal injuries
Growth plates on bones allow for growth
Make bones flexible
More prone to stress factures
Injuries to growth plates can alter bone growth
Immobilize all strains sprains or injury complaints

11. Skin Skin is thinner Higher ratio of body surface to body mass
Skin burns more easily and deeper
Higher ratio of body surface to body mass
Results in larger fluid and heat losses
More prone to hypothermia
Keep them warm

12. Primary assessment Form a general impression.
Use pediatric assessment triangle (PAT).
15- to 30- second structured assessment tool

13. PAT Does not require equipment
Does not require you to touch the patient
Three steps:
Appearance
Work of breathing
Circulation

14. Appearance Note LOC, muscle tone, interactiveness.
TICLS mnemonic helps determine if patient is sick or not sick.
Tone
Interactiveness
Consolability
Look or gaze
Speech or cry

15. Work of breathing Increases body temperature
May manifest as tachypnea, abnormal airway noise, retractions of intercostal muscles or sternum

16. Circulation to the skin
Pallor of skin and mucous membranes may be seen in compensated shock.
Mottling is sign of poor perfusion.
Cyanosis reflects decreased level of oxygen.

17. Stay or go
From PAT findings, you will decide if the patient is stable or requires urgent care.
If unstable, assess ABC’s, treat life threats, and transport immediately.
If stable, continue with the remainder of the assessment process.

18. History Investigate chief complaint How long have they been sick
Any fever
Eating drinking and urine output
Activity
Vomiting diarrhea
Rashes

19. Secondary assessment
Infants, toddlers, and preschool-aged children should be assessed started at the feet and ending at the head.
School-aged children and adolescents should be assessed using the head-to-toe approach.

20. Transport safety
Use a restraint system appropriate for pt age, unless treatment of patient precludes that