Chapter 35: Pediatric Emergencies

Key Learning Objectives

• Understanding the anatomical and physiological differences between children and adults.
• Appropriate assessment and care for pediatric illnesses and injuries.
• Recognizing signs of abuse and neglect and understanding EMT responsibilities.

Pediatric Considerations

• Children differ anatomically, physically, and emotionally from adults.
• Pediatric patients require special communication approaches due to potential fear and inability to express themselves.
• Parents or caregivers may be stressed, impacting the child's behavior.

Growth and Development Stages

1. Infancy (0-1 year)

   • 0-2 months: Mostly asleep, cry as main communication.
   • 2-6 months: Recognize parents, turn heads to sounds.
   • 6-12 months: Become mobile, risk for choking, stranger anxiety.

2. Toddler (1-3 years)

   • Increased risk for injury due to exploration and lack of molars.
   • Stranger anxiety, difficulty explaining pain.

3. Preschool Age (3-6 years)

   • Rich imagination, potential fear of pain.
   • Understand directions, can describe pain.

4. School Age (6-12 years)

   • Begin understanding death, physical exams similar to adults.

5. Adolescence (13-18 years)

   • Physically similar to adults but emotionally still maturing.
   • Risk-taking behavior common, involvement in care important.

Pediatric Anatomy and Physiology Differences

• Smaller airways, larger tongues, and softer bones.
• Higher heart rates, less developed circulatory systems.
• Greater head-to-body ratio, increased risk for head injuries.

Pediatric Assessment Triangle (PAT)

• Appearance: Muscle tone and mental status.
• Work of Breathing: Abnormal noises, retractions.
• Circulation to Skin: Color, temperature, perfusion.

Airway and Breathing Assessments

• Use neutral sniffing position for airway.
• Observe for abdominal movement in breathing.
• Assess for signs of respiratory distress or failure.

Circulatory Assessment

• Check central and peripheral pulses, capillary refill.
• Monitor skin temperature and moisture.

Neurological Emergencies

• Seizures: Assess using AEIOU TIPS for causes.
• Meningitis: Look for fever, altered consciousness, and stiff neck.

Specific Pediatric Emergencies

• Respiratory: Leading cause of cardiopulmonary arrest.
• Asthma: Wheezing, use of bronchodilators.
• Croup and Epiglottitis: Stridor, barking cough.

Trauma and Injury

• Head injuries are common due to head size.
• Risk of fractures due to soft bones and open growth plates.

Shock Management

• Recognize compensated vs. decompensated shock.
• Begin with basic interventions, oxygenation, and rapid transport.

Child Abuse and Neglect

• Observe for inconsistencies in injury explanations.
• Report suspicions to appropriate authorities.

Sudden Infant Death Syndrome (SIDS)

• Involves sudden, unexplained death of an infant.
• Risk factors include maternal age, smoking, and position during sleep.

Key Management and Treatment

• Reassess frequently, maintain open airway, and provide oxygen.
• Use appropriate-sized equipment and be aware of special pediatric needs.

This chapter emphasizes the importance of understanding the unique aspects of pediatric care, highlighting the need for specialized assessment and management strategies tailored to children across various developmental stages.