Chapter 34 Pediatric Emergencies Part 1 You and your EMT partner are dispatched to 818 Nicole Lane for a pedestrian struck. While en route, dispatch provides a patient update stating that your patient is a 6-year-old boy who has been struck
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Presentation Transcript
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Chapter 34 Pediatric Emergencies<br>
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Part 1 You and your EMT partner are dispatched to 818 Nicole Lane for a pedestrian struck. While en route, dispatch provides a patient update stating that your patient is a 6-year-old boy who has been struck by a pick-up truck. He is conscious and breathing. ALS has been dispatched as well but is 15 minutes from the scene.<br>
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Part 1 1. What is your first consideration in the treatment of this patient?
2. Of what significance is it that your patient is a child rather than an adult?<br>
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Part 2 While en route, you and your partner discuss some of the anatomic differences between children and adults. You also discuss some of the differences in the injury patterns of a child struck by a vehicle compared with those of an adult. You begin forming a treatment plan for this patient prior to your arrival on scene.<br>
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Part 2 3. What are some of the anatomic differences between children and adults?
4. Would the age of your patient change the treatment plan?
5. What is your first step in treatment of this patient?<br>
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Part 3 Upon arrival, you find a 6-year-old boy lying in the arms of his crying mother. He is approximately 4-feet tall and weighs about 65 lb. The vehicle that struck him has no visible damage from the impact. The mother states that she thinks the truck was going about 25 miles an hour when it struck her son. The boy is conscious, alert, and oriented. He is crying uncontrollably and clutching his midsection.<br>
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Part 3 6. Considering the MOI, should this patient be placed in a full spinal immobilization device?
7. Is the height and weight of the patient pertinent information to document?<br>
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Part 4 While gaining additional information about the incident, your partner manually stabilizes the boy’s head and neck. You assess his airway, breathing, and circulation. He has a patent airway and is breathing at a rate of 22 labored breaths/min. His pulse is 156 beats/min and bounding. Capillary refill is 4 seconds and his BP is 88/44 mm Hg. He has numerous small abrasions and lacerations on his extremities. There is no apparent major external bleeding. You apply high-flow oxygen via a nonrebreathing mask.<br>
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Part 4 8. What does your index of suspicion tell you about this patient?
9. What is your next step in treatment?<br>
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Part 5 During your secondary assessment, you find that your patient’s abdomen is rigid and tender and also warm to the touch. Although your patient is conscious and responsive, he is showing signs of an altered mental status. Given the change in your patient, you contact dispatch again and get an updated ETA for the ALS unit. Dispatch notifies you that ALS is approximately 4 minutes out.<br>
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Part 5 10. What do the patient’s signs and symptoms indicate?
11. What are your treatment options?<br>
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Summary It is important that you take into consideration the age and size of your patient, the anatomic differences between children and adults, and the possible differences in their injury patterns. Trust your index of suspicion and treat for the worst possible condition. It is always better to do too much than not enough for a patient.<br>
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Summary When dealing with a pediatric patient, keep in mind that children’s bodies tend to compensate longer than an adult’s but decompensate much faster, with little to no advance warning. Always consider the possibility of shock and treat accordingly.<br>
