LP Research Resources January 22, 2018

Paramedic Training – Injuries & Children

Inevitably, EMS personnel will be called upon to perform emergency medical services for an injured child. This requires a community-based approach to emergency care of the child. Community-based due to the fact First Responders providing emergency medical services to children must be capable of recognizing a child with altered mental status, shock and respiratory distress or failure.

EMS-c is a concept that encompasses the following steps:

1. Prevention
2. Pre hospital care and transport
3. Ed, inpatient care
4. Follow up including rehabilitation

The EMT  responder must be aware of an appropriate action plan for rapid intervention.

1. Staff EMT courses and continuing education including receptionists and medical assistants, should be trained in adult and child CPR and first aid  b l s). In addition, nurses and physicians should have training in a systematic approach to pediatric medical and trauma resuscitation, through standardized courses in pals.

2. Resuscitation equipment is a vital part of an emergency response, Pediatric resuscitation cart or kit containing Drugs, Airway, Fluid and miscellaneous like cardiac arrest board, sphygmomanometer, splints, sterile dressing, color-coded tape or preprinted drug, doses, defibrillator and portable ecg monitor. Also transport how, where (destination) with check list for patient transport, access to the ems system and response and transport time.

3. The child at risk is summarized in Upper airway obstruction, Lower airway obstruction, unstable cardiovascular status, Central nervous system disorder, artificial airways and Postoperative period.

4. Assessment and monitoring is implemented by the determination of the alertness of the patient and response to stimuli. Also check cardiovascular status with the different aspects like pulse and heart rate, blood pressure and organ perfusion. It’s also vital to check respiratory status, respiratory effort, cyanosis and the gas exchange.

5. Basic life support should also be established by determining of the unresponsiveness or respiratory difficulty, call for help, airway, breathing and circulation.

6. Advanced life support is to continue basic life support by Mouth to mouth breathing, closed chest cardiac and compressions. You should also establish and maintain effective ventilation by artificial airways, ett and oxygen saturation monitoring. While obtaining vascular access (peripheral, central or intraosseous routes). Volume expansion is required while obtaining serum electrolytes value. Always monitor cardiac status by ecg monitor, pulse, blood pressure, arterial blood gas and ph determinations and confirm presence of dysrythmia. Defibrillate your patient and provide pharmacologic support.

7. Treatable conditions associated with cardiac arrest asystole, pea, vf. Using the 4hs (Hypovolemia, Hypoxia, Hypothermia and Hypo/hyperkalemia) along with the 4Ts (Tension pneumothorax, Thrombosis, Toxins and tamponade).

8. Postresuscitation care in successful resuscitation is reached by continuous picu care is usually needed to attend to the potential postischemic multiple organ dysfunction syndrome and continued need for cardiac inotropic support.

9. If resuscitation failed, attention is naturally focused on comforting the grieving family.

These skills and courses will be a vital part of your EMS education.

This article provided by AbsolutePediatrics.