Components in the prioritization of pediatric emergency care (4)
PAT, Focused Assessment (objective information), Focused pediatric Hx(subjective
... [Show More] information), assignment of an acuity rating decision
Pediatric Assessment Triangle : (3) components
Appearance. Work of Breathing. Circulation to the skin. This forms the "general impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
PQRST for Pain
(pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
What age is the respiratory system considered fully developed?
8 years old
6P's Assessment for Musculoskeletal Trauma
(pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
Burn Transfer Criteria
1. Partial thickness >10% of BSA
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
6. Burn injury in pt with preexisting medical disorders that could complicate tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or mortality.
8. Burned children in hospital wo qualified equipment or personnel to care for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
Infants are obligate nose breathers. If nose is obstructed ___________
mouth then suction nose
Neutropenic pt with a temperature
Don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable Rashes of concern
Meningocoxcemia
Petiachia/Purpura
Normal Urine Output for child
1 to 2ml / Kg / Hr
Oral Rehydration for 9month old with mild dehydration.
Glucose and sodium solution, every 2 to 5min with 5 to 10ml
6week old infant, no medical hx. eating poorly, vomiting, "hard to wake up", responsive to pain. Anterior fontanel bulging, tachypnic. Diagnostic evaluation expected?
Skeletal survey
Possible shaken baby syndrome
Minimal Acceptable BP's
Newborn = 60
Infant = 70
Child = 70 + (2 x age in yrs)
Decompensated shock in children #1 sign
Hypotension
TBI considerations
MD has to say when they can return, not the pt or caregiver.
Should be a "gradual return to play"
Bradycardia pharm treatment
Epinephrine (1:10,000), 0.01mg/kg every 3-5min
A preschooler has a small laceration that required 2 stitches. The nurse covers the wound with a bandage knowing that it will comfort the child to have it covered. What is the developmental reason for this intervention?
A. Preschoolers are magical thinkers and imagine bandages keep their insides from coming out
B. Preschoolers fear physical disability and believe a bandage will prevent disability
C. Preschoolers explore orally and will likely chew or suck on the stitches if left uncovered
D. Preschoolers are concerned with body image and don't want to appear different than peers
A. Magical thinkers [Show Less]