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95 Cards in this Set
- Front
- Back
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What are some behavioral traits of newborns and infants (birth to 1 year)?
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Tolerate parental separation poorly
Exhibit minimal anxiety over presence of strangers Accept undressing, but want to feel warm Can track movement visually Do not tolerate oxygen masks |
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What are some guidelines to follow in order to properly assess newborns and infants?
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Have the parent hold the infant during the physical exam
Keep hands and tools warm Observe breathing from a distance Examine the head last If listening to lungs, do it early (before child becomes upset) |
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What are some behavioral traits of toddlers (1-3 yrs)?
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Do not tolerate parental separation
Do not like to be touched May perceive illness as punishment Sensitive about modesty Easily frightened |
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What are some guidelines to follow in order to properly assess toddlers?
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Have a parent hold the child during the physical exam
Explain that the child was not "bad" If clothing is removed, replace it Try to examine the head last Explain what you do in advance, using a child's terms |
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What are some behavioral traits of preschool children (3-6 years)?
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Do not tolerate parental separation
Do not like to be touched Sensitive about modesty May perceive illness as punishment Tend to fear blood, pain, permanent injury, or disfigurement |
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What are some guidelines to follow in order to properly assess preschool children?
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Have a parent hold the child during exam
Replace removed clothing Be calms, reassuring and respectful Explain what you do in advance Allow the child to give some of the history |
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What are some behavioral traits of school age children (6-12 yrs)?
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Cooperative, but expect to have opinions heard
Sensitive about modesty Tend to fear blood, pain, and permanent injury or disfigurement |
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What are some behavioral traits of adolescents (12 to 18 yrs)?
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Want to be treated as adults
Generally feel that they are indestructible but may have fears of permanent injury and disfigurement Adolescents vary in their emotional and physical development and may not be comfortable with their changing bodies |
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What are some guidelines to follow in order to properly assess adolescents?
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Though they wish to be treated as adults, they may need as much support as children
Present a confident, calm, respectful manner Respect modesty. You may consider assessing them away from their parents. Have the physical exam done by an EMT of the same sex if possible. |
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What are some behavioral traits of adolescents (12 to 18 yrs)?
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Want to be treated as adults
Generally feel that they are indestructible but may have fears of permanent injury and disfigurement Adolescents vary in their emotional and physical development and may not be comfortable with their changing bodies |
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What are some guidelines to follow in order to properly assess adolescents?
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Though they wish to be treated as adults, they may need as much support as children
Present a confident, calm, respectful manner Respect modesty. You may consider assessing them away from their parents. Have the physical exam done by an EMT of the same sex if possible. |
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List some anatomical differences you'll see in children and infants when comparing them to adults.
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Tongue proportionately larger
Smaller airway structures Abundant secretions Deciduous (baby) teeth present Flat nose and face Head heavier relative to body and less-developed neck structures and muscles Fontanels and open sutures palpable on top of young infant's head. Thinner, softer brain tissue Head larger in proportion to body Shorter, narrower, more elastic, less rigid trachea Short neck Abdominal breathing Faster respiratory rate Newborns breathe primarily through the nose Larger body surface relative to body mass Softer bones More flexible ribs Spleen and liver more exposed |
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What might a sunken fontanelle indicate?
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Dehydration
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What might a bulging fontanelle indicate?
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Increased intracranial pressure
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What is the normal pulse rate for a newborn?
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120-160 BPM
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What is the normal pulse rate for an infant age 0-5 months.
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90-140 BPM
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What is the normal pulse rate for an infant age 6-12 months?
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80-140 BPM
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What is the normal pulse rate for a toddler age 1-3 yrs?
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80-130 BPM
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What is the normal pulse rate for a preschooler 3-5 yrs.
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80-120 BPM
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What is the normal pulse rate for a school age child age 6-10 yrs
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70-110 BPM
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What is the normal pulse rate for an adolescent age 11-15 yrs?
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60-105 BPM
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What is the normal respiration rate for a newborn?
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30-50 breaths per minute
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What is the normal respiration rate for an infant 0-5 months?
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25-40 breaths per minute
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What is the normal respiration rate for an infant 6-12 months?
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20-30 breaths per minute
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What is the normal respiration rate for a toddler 1-3 yrs old?
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20-30 breaths per minute
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What is the normal respiration rate for a preschooler 3-5 yrs old?
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20-30 breaths per minute
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What is the normal respiration rate for a school age child age 6-10 yrs?
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15-30 breaths per minute
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What is the normal respiration rate for an adolescent age 11-14 yrs?
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12-20 breaths per minute
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What is the general formula to determine the appropriate blood pressure for young patients?
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Systolic BP = 80+(2 x age)
Diastolic BP = approx. 2/3 systolic |
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What is the proper blood pressure range for a preschooler age 3-5 yrs?
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78-116 systolic
65 diastolic |
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What is the proper blood pressure range for a school-age child 6-10 yrs?
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80-122 systolic
69 diastolic |
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What is the proper blood pressure range for an adolescent age 11-14 yrs?
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88-140 systolic
76 diastolic |
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By what age is a child's fontanelle basically gone?
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12-18 months
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What does the fontanelle usually do when an infant cries?
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It bulges
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When does an infant's "obligatory nose-breathing" become an issue?
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When their nose becomes obstructed, they don't know to breathe with their mouths.
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What muscle do children depend on more for their breathing?
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The diaphragm
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When should you perform blind finger sweeps on an infant or child?
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Never. A blind finger sweep may drive the obstruction deeper into the airway.
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What do you do when stabilizing the spine of an infant or child?
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Place a folded towel underneath the shoulders to maintain neutral position.
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Which is easier to see from a distance -- early labored breathing in an adult, or early labored breathing in an infant?
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Early labored breathing in an infant. An infant depends largely on its diaphragm to breath and also has less-developed chest muscles which tire quickly. Also, a child's ribs are very elastic. All this means that the child's chest will contract during labored breathing as well as his abdomen.
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How much blood does a newborn infant have within its body?
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Roughly 1/3 of a liter, or 300 ml, or less than 12 oz.
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How much blood does an 8-year-old have within his body?
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Roughly 2 liters
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How much blood does a 125 lb adult contain within his body?
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Roughly 4 liters
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There are a lot of psychological differences between children and adults. Put simply, what must you do to appease a child during examination and treatment?
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1) Keep them feeling safe
2) Don't frighten them 3) Think about their needs and reassure them 4) Communicate at their level |
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What is a step-by-step guide to interviewing and treating a child when you're the first one on the scene?
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1) Introduce yourself and ask their name
2) Assure them that their parents are being called 3) Determine any life-threatening problems and treat 4) Let the child have any nearby toy they want 5) Stay at child's eye level 6) Smile 7) Touch the child reassuringly until/unless they tell you not to. 8) Explain what you're doing 9) Let the child see your face 10) Ensure, from time to time, that the child understands 11) Don't lie |
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What can happen to children of all ages in times of crisis, described as the child acting younger than they are?
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Regression
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What issues are particularly touchy when interviewing/examining an adolescent?
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Sex
Drugs Pregnancy Stupid or careless acts |
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Besides an injured child, who else requires assurance during an emergency?
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The child's parents!
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What are the three components of the PAT (the pediatric assessment triangle?)
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Appearance
Breathing (apparent work) Circulation (to skin) |
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What is the PAT?
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The pediatric assessment triangle is a method of pediatric assessment that develops throughout the initial assessment. It's simplified in order to help you quickly identify life-threatening problems. The three things to look for are Appearance, Breathing, and Circulation.
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How long should capillary refill take in a healthy patient?
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Two seconds or less
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Which pulse should you check in an infant to assess circulation?
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Brachial or femoral
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Which pulse should you check in a child in order to determine circulation?
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Carotid
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Very young children generally don't care too much about modesty. At what age to children generally become very modest, even self-conscious?
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Age 5-8 yrs.
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How do you insert an oropharyngeal airway into a child?
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Push child's tongue down with a tongue depressor. Keep it down and forward, out of the airway. Insert the adjunct TIP DOWN (opposite to the way you would insert it into an adult's airway), and gently slide it into place.
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When a child has inadequate breathing, has no head injuries, and is conscious, what sort of airway and oxygen treatment should an EMT use?
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Use a nasopharyngeal airway and high concentration oxygen -- provide ventilations at a rate of 12-20 per minute for infants up to adolescents, and at 10-12 per minute for adolescents and older.
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When a child requires a bit of supplemental oxygen but their breathing is adequate, what procedure should you follow?
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Use a nasal cannula or loose oxygen tubing and just blow oxygen near the child's face. It's called "blow-by" oxygen.
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What are some special considerations to keep in mind when providing supplemental oxygen to a child or infant?
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Avoid too much pressure and volume
Use the right sized mask Do not use FROPVDs |
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What's a creative method of getting oxygen to an infant?
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Draw a little picture in the bottom of a paper cup. Punch oxygen tubing through the bottom. Give it to the kid. HA. Fooled them into breathing pure oxygen.
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How do you relieve a conscious infant of an airway blockage?
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Repeat the cycle of five back blows, then five chest thrusts
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How do you relieve a conscious child 1 yr to puberty of an airway blockage?
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Perform abdominal thrusts
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if a child (1 yr to puberty) loses consciousness when you're trying to clear an airway blockage, what do you do?
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Assist patient to floor. Open airway. Remove visible objects. Attempt to ventilate. If unsuccessful, perform CPR. If alone, call for help after 2 minutes.
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If an infant loses consciousness while you're trying to get a blockage out of his airway, what do you do?
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Open the airway. Remove visible objects. If unsuccessful, perform CPR. If alone, call for help after 2 minutes.
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If you come upon an unconscious child (1 yr to puberty), what do you do?
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Establish unresponsiveness. Open airway. Attempt to ventilate. If unsuccessful, reposition head and try again. If unsuccessful, perform CPR. If alone, call for help after 2 minutes.
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If you come upon an unconscious infant, what do you do?
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Establish unresponsiveness. Open airway. Attempt to ventilate. If unsuccessful, reposition head and try again. If unsuccessful, perform CPR. If alone, call for help after 2 minutes.
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How do you care for a child with a mild airway obstruction (perfusion OK, breathing adequate)?
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Put child in position of comfort, give oxygen, transport.
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What are some signs of shock in a child?
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Rapid respiratory rate
Pale, cool, clammy skin, Weak or absent peripheral pulses Delayed capillary refill Decreased urine output Absence of tears |
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What are some common causes of shock in a child or infant?
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Diarrhea/vomiting
Infection Trauma (especially abdominal injuries) Blood loss |
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How does one differentiate an airway obstruction from a respiratory disease when assessing a child or an infant?
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Look for signs of croup, epiglottitis, and other diseases.
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What are some signs of croup?
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During the day:
Mild fever and hoarseness At night: A loud "seal bark" cough, difficulty breathing, signs of respiratory distress, restlessness, and paleness or cyanosis |
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How do you care for a child with croup?
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Place patient in comfortable position, usually sitting up.
Administer oxygen Walk to the ambulance Do not delay transport |
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What are some signs of epiglottitis?
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A sudden onset of high fever
Painful swallowing Tripod position Patient sitting very still but accessory muscles moving -- obvious respiratory effort Child appears very ill, generally. |
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How do you care for a child with epiglottitis?
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Immediately transport! Put child on parent's lap.
Provide oxygen from a humidified source, but if humidified oxygen is unavailable, don't delay therapy in order to get it humidified. Constantly monitor child Do NOT place anything into child's mouth -- this could set off airway spasms that could totally obstruct the airway. |
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What is a febrile seizure?
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A seizure that occurs in a child due to high fever
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What steps do you take to care for a child with a high fever?
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Remove child's clothes, but DO NOT expose to hypothermia-inducing conditions
Monitor for shivering and hypothermia. If shivering begins, cover child with light blanket. DO NOT submerge child in cold water of any sort DO NOT use rubbing alcohol to cool patient Follow local protocols |
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What are some signs and symptoms of meningitis?
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High fever
Lethargy Irritability Headache Stiff neck Sensitivity to light Fontanelles may bulge Movement is painful Sensitivity to touch Seizures Rash |
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How do you care for a child with meningitis?
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Monitor ABCs and vitals
Provide oxygen Ventilate Provide CPR if necessary Look for seizures Transport fast. This is a true emergency |
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What are some signs of aspirin poisoning in a child?
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Hyperventilation
Vomiting Sweating |
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What are some signs of acetaminophen poisoning in a child?
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Restlessness
Nausea Vomiting Sweating |
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What are some signs of lead poisoning in a child?
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Nausea
Abdominal pain Vomiting Cramps Headache Weakness |
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What are some signs of iron poisoning in a child?
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Nausea
Bloody vomiting Diarrhea |
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What are some signs of petroleum poisoning in a child?
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Vomiting
Cough Distinctive odor |
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How do you care for a pediatric patient in cases of suspected poisoning?
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Contact medical direction of poison control
Consider activated charcoal Provide oxygen Transport Rule out trauma |
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What do you do if you come upon an infant and a suspected case of SIDS?
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1) Unless there is rigor mortis, provide resuscitation and transport
2) Support the patients |
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When is it OK to provide condolences to parents of a suspected SIDS-inflicted child?
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ONLY after a physician has informed them of the baby's death
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What is the number one cause of death in infants and children?
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Trauma, especially blunt trauma
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What do you do when you suspect child abuse?
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Report it to the medical staf
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What should you do when you suspect sexual abuse?
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1) Dress and provide care for injuries
2) Preserve evidence of sexual abuse (discourage child from using bathroom, give child nothing by mouth, do not have the child wash or change clothes). 3) Transport |
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With whom are you allowed to share details of suspected abuse?
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Hospital staff, police, your superiors. MAINTAIN CONFIDENTIALITY.
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What are the most common complications surrounding tracheostomy tubes?
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Obstruction
Bleeding from in or around the tube Air leak around the tube Infection Dislodged tube |
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How do you care for a child with tracheostomy complications?
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Maintain airway
Suction as needed Keep child comfortable Transport |
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How do you care for a child with problems with a home ventilator?
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Maintain airway
Ventilate Transport |
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What are some possible complications that arise from central IV lines?
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Infection
Bleeding Clotting Cracked lines |
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How do you care for a patient with central IV complications?
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Apply pressure if there's bleeding
Transport |
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How do you care for a patient with complications arising from a GI tube?
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Be alert for mental changes in diabetic patients
Ensure open airway Suction as needed Provide oxygen as needed Transport patient in position of comfort, and elevate head to reduce risk of aspiration |
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How do you care for a child with complications arising from a shunt?
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Maintain open airway
Ventilate Transport |
