Preparation and traige
1.State need for activation of trauma team
2. Prepare for trauma : ped equpment, length-based resuscitation tape and dosing
... [Show More] guidelines
3. State the need to don PPE
Across-the-room Observation
Assess for uncontrolled hemorrhage (C), if non go to ABC
State the three components of pediatric assessment triangle (Appeance/Airway, WOB, and Circulation
AND categorizes them as sick, sicker or sickest
Airway and Alertness
**APVU
If trauma is suspected state need for manual c-spine until collar is placed, AND demonstrate manual jaw-thrust. If isn't you can do it normally
** Determine patency of airway (four): tongue obstruction, loose or missing teeth, foreign objects, blood or other secretions, edem, snoring, gurgling or stridor and is there any bony deformity
Interventions: suction, folded towel, OPA or NPA, indicate need for intubation
4. Across the room observation and then
Assess for uncontrolled external hemorrhage and the need to re prioritize C over ABC
Breathing and Ventilation.
** Assess breathing: sponatenous, symmetrical chest, skin color, open wounds, breath sounds? Subq empysema, JVD or trach deviation or increased WOB (which would include, grunting, retractions, head bobbing, nasal flaring)
Interventions: oxygen, ventilation, intubation, chest tube or needle thoracentesis
Circulation and hemorrhage
All of these: inspects of uncontrolled hemorrhage, palpates central and peripheral pulses, inspect and palpates skins for color, temp and moisture and assess cap refill
Interventions: control of hemorrhage, initiation chest compression, IV get two, cardiac monitor if it is a dysrhythmia, fluid bolus 20mlkg - 10 mlkg for neonate or cardiogenic shock
Disability
GCS : verbal, eye and motor
Four score for unresponsive or intubated: eye, motor, brainstem and respiration status
PERRL
Interventions: glucose and if not need fo rintubation
Exposure and Environment
Remove all clothing AND inspect for hemorrhage or other signs of illness or injuries
Interventions: warming lights. warm fluid, warmed oxygen, blankets
Full set of vitals
VS and weight in KG
State need for family at bedside
Get adjuncts and give comfort
LMNOP: Labs, monitor, naso/oro, pulse oxmietry and ETCO2, assess pain using rFLACC, Nips or faces
Give comfort: repositioning, apply ice, caregiver, padding
What next
do they need to go to a high level of care or trauma center? Or prep for surgery
History
SAMPLE (symptoms, allegeries, meds, PMH, last oral, events and environments [Show Less]