First Aid for Colleges and Universities 10th Edition Chapter 22 © 2012 Pearson Education, Inc. Pediatric and Geriatric Emergencies Slide Presentation prepared

First Aid for Colleges and Universities

10th Edition

Chapter 22

© 2012 Pearson Education, Inc.

Pediatric and Geriatric Emergencies

Slide Presentation prepared by

Randall Benner, M.Ed., NREMT-P

Learning Objectives

• Explain special assessment techniques to use with children.

• Explain how children’s vital signs differ from those of adults.

• List special emergency situations involving children.

• Describe the signs and symptoms of the following respiratory conditions: croup, epiglottitis, and asthma.


Learning Objectives

• Discuss other common emergencies among children.

• Describe how to manage a case of SIDS.• Explain how to identify child abuse and neglect.• Explain how body systems change with age.• Explain special issues to consider when assessing

the elderly.• Discuss special issues to consider when caring for

trauma in the elderly.


Introduction

• First Aiders care for victims of all ages.• The very young and very old have unique needs

that are particular to their age group.• This chapter will review the assessment and

treatment considerations for these victims.


Assessing the Child

• Not simply “small adults”• Unique psychological and physical differences• You must care for the young victim, as well as

consider the needs of their parents, family, or regular caregivers.


Physiology Unique to Children


Assessing the Child

• Special Assessment Techniques– Does the child notice me?– Does the child know the parents?– Does the child look sick?– Is the child in extreme pain?– How is the child breathing?


Assessing the Child

• Special Assessment Techniques– Display confidence, competence, and friendliness.– Stay close to the child’s eye level.– Explain your actions in terms the child understands.– Save most painful parts of assessment for last.– Incorporate the parent’s help into assessment.– Be honest, gentle, and patient.


Assessing the Child

• Obtaining a history– Don’t become unnerved by child or parents.– Get information from a reliable source.– Ask standard questions about signs/symptoms.– Ascertain the mechanism of injury and any treatment

already rendered.

• Always treat disturbances to ABC’s first.


Assessing the Child

• Taking vital signs.– Respirations– Pulse– Temperature– Neurological assessment

• Overall impressions of how a child looks and acts are more important regarding the child’s status than any one vital sign.


Emergencies Involving Children

• Treatment between adults and children is often the same, it’s how you provide treatment that differs– Heads are proportionally larger – always assume cervical

injury.– Bones tend to bend rather than break with trauma,

causing more internal injuries.– Skin surface is proportionally larger in a child, as is the

tongue.– Gastric distention is common with dyspnea.– Always stop bleeding quickly (minor bleeding can indicate

major problems).



• Common emergencies often involve dyspnea or obstructed airway– Asthma– Croup– Epiglottitis


Croup and Epiglottitis



• Asthma care guidelines– Allow child to assume position of comfort.– Be calm and reassuring.– Activate EMS or take the child to a medical facility.– If allowed and capable, help the child with their inhaler, if

prescribed.– Utilize high-flow oxygen if equipped and needed, and child

is capable.



• Cardiac arrest– Most common cause of airway/breathing failure– Be able to identify signs and symptoms of arrest.

• Cardiac arrest management– Refer to Chapter 5 for CPR guidelines for infants and

children



• Seizures– Causes are same as for adults, however children also

seize due to high body temperature

• Seizure management– Take precautions, activate EMS.– Turn the victim onto their side.– Do not restrain the victim (protect/cradle head).– Loosen tight clothing.– Sponge feverish child with lukewarm water.



• Shock– Commonly due to blood loss, airway/breathing failure,

acute infection, heart failure, and, in newborns,heat loss– Symptoms similar to adult victims

• Shock management– Take precautions, activate EMS.– Have the victim lie flat.– Support ABCs.– Keep the child warm.– Monitor vital signs.


Sudden Infant Death Syndrome

• Sudden Infant Death Syndrome (SIDS)– Commonly known as “crib death”– Occurs when an apparently healthy infant suddenly dies

in their crib– Many theories abound as to cause, nothing confirmed

• SIDS management– Even if infant is obviously dead, always activate EMS and

begin CPR.– Help parents cope.– Facilitate the transference of the patient to EMS, ensure

any other children at home are cared for.


Identifying Child Abuse

• Abuse clues


Child Abuse

• First aid care for abuse/neglect– Inform parents or other adults present that you are there

for the child’s care.– Focus attention on child, use age appropriate

assessment.– Assess and treat any injuries found.– Do not confront anyone with suspicions.– Report your suspicions promptly to appropriate

authorities.


Child Death or Abuse

• Caring for yourself– Most children who die from accidents are pronounced

dead at the scene.– Always control your emotions so you can best manage

young victims.– When the episode is over, seek assistance from a mental

health professional if you have trouble coping.


Geriatric Emergencies

• People over the age of 65• Large percentage of the population• Largest consumer group of health care and

medicine• Most have 3 or more illnesses/conditions• Also affected by the physiology of aging


Physical Changes in the Elderly



• Special assessment considerations– Older bodies compensate less well; small problems can

quickly become large ones.– Multiple medications may impede treatment or complicate

conditions.– Psychiatric disorders may complicate assessment.– Effects of aging can be hard to distinguish from disease

effects.– The elderly may underreport or fail to report symptoms.– Communication challenges are common.– Victim complaints are often vague (fatigue, headache,

loss of appetite, constipation, etc.).



• Special exam considerations– Victims fatigue easily– Several layers of clothing may be present– Explain all actions clearly to geriatric victim.– The geriatric victim may not want transport or treatment

due to fear of losing independence.



• Special trauma considerations– Increased risk and incidence of falls– Higher risk for trauma from criminal assault– Prone to head injuries– Prone to spinal cord injuries with or without a traumatic

mechanism


Summary

• With children or the elderly, speak clearly and slowly, using terms they can understand.

• Sometimes the victim is not the best source of information for history.

• Both age extremes at higher risk for brain trauma, spinal trauma, and trauma through neglect.

• Always provide support to the airway, breathing, and circulatory mechanisms (ABCs) first—then worry about minor injuries or other findings.


Documents

First Aid for Colleges and Universities 10th Edition Chapter 22 © 2012 Pearson Education, Inc. Pediatric and Geriatric Emergencies Slide Presentation prepared