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Published byJesus Atkinson Modified over 10 years ago
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Pediatric Assessment
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SCENE SIZE-UP & SAFETY Enter Slowly Observe for safety and mechanism of injury
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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
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Assessing The condition of a sick/injured child can change rapidly Signs or symptoms can be subtle
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INITIAL ASSESSMENT General Impression Well or sick Mental status drowsy sleepy inattentive Effort of breathing
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Skin color pale cyanotic flushed Quality of speech strong cry speak only in short sentences grunts
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Interaction with the environment or others silence listlessness unconscious
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Emotional state withdrawn emotionally flat Response to you inattention to strangers Tone and body position limpness poor muscle tone position to indicate respiratory distress Mental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
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Airway depressed mental status secretions blood vomitus trauma infections Do not hyperextend neck
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Breathing Chest expansion Effort of breathing Sounds of breathing Breathing rate Color
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Treat as you go care
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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
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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
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Compromised airway Respiratory arrest or inadequate breathing Possibility of shock Uncontrollable bleeding
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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
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ON-GOING ASSESSMENT DONT TAKE YOUR EYES OFF YOUR PEDIATRIC PAITENT FOR A MINUTE
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RESPIRATORY COMPRIMISE IS THE PRIMARY CAUSE of CARDIAC ARREST IN CHILDREN
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