Pediatric Education for Prehospital Professionals
American Academy of Pediatrics
Pediatric Education for Prehospital Professionals (PEPP) - 4th Edition - MA Jones & Bartlett Learning 2021 - 490 pages
Chapter 1 Pediatric Assessment 1
Introduction 2
Summary of Assessment Flowchart 2
Scene Size-Up 3
The Pediatric Assessment Triangle 3
Primary Assessment 11
Primary Assessment: The Transport Decision: Stay or Go? 19
Summary of Primary Assessment 19
Secondary Assessment: History Taking 20
Physical Examination 21
Additional Monitoring Devices 26
Ongoing Reassessment 26
Summary 27
Chapter 2 Using a Developmental Approach 31
Introduction 31
Pediatric Calls and Response From Family and Providers 32
Communication With the Child and Family or Caregiver 33
Vital Signs Through the Ages 33
Anatomic Changes 35
Summary of Changes in Vital Signs and Anatomy Through Childhood 37
Infants 37
Assessment of the Infant 38
Toddlers 39
Assessment of the Toddler 40
Preschoolers 40
Assessment of the Preschooler 41
School-Aged Children 41
Assessment of the School-Aged Child 42
Adolescents 42
Assessment of the Adolescent 43
Children With Special Health Care Needs 43
Assessment of a CSHCN 44
Tips for the EMS Provider 45
Summary 45
Chapter 3 Respiratory Emergencies 49
Introduction 49
Respiratory Distress and Failure 50
Prearrival Preparation 51
Scene Size-Up 51
General Assessment: The PAT 51
Primary Assessment: The ABCDEs 52
General Noninvasive Treatment 54
Summary of General and Initial Respiratory Assessment and General Noninvasive Treatment 56
Specific Treatment for Respiratory Distress 56
Summary of Specific Treatment for Respiratory Distress 65
Management of Acute Respiratory Distress: CPAP 66
Management of Respiratory Failure 66
Summary of Management of Respiratory Failure 70
Primary Assessment: The Transport Decision-Stay or Go? 70
Additional Assessment 71
Chapter 4 Shock 75
Introduction 75
Prearrival Preparation 76
Scene Size-Up 76
General Assessment: The Pediatric Assessment Triangle 76
Primary Assessment: The ABCDEs 77
Additional Assessment 79
Summary of Cardiovascular Assessment 80
Using the Assessment to Identify Shock 80
Hypovolemic Shock 81
Distributive Shock 82
Cardiogenic Shock 83
Obstructive Shock 85
General Noninvasive Treatment of Suspected Shock of All Types 85
Specific Treatment of Hypovolemia 86
Treatment of Septic Shock 87
Specific Treatment of Hypotensive (Decompensated) Distributive Shock 88
Treatment of Cardiogenic Shock 88
Primary Assessment: Transport Decision 89
Summary of Shock States 89
Chapter 5 Resuscitation and Dysrhythmias 93
Introduction 94
Prearrival Preparation 94
Scene Size-Up 94
General Assessment: The PAT 94
Primary Assessment: The ABCDEs 95
Additional Assessment 96
Summary of Cardiovascular Assessment 96
Dysrhythmias 97
Summary of Dysrhythmias 102
Cardiac Arrest 102
Presenting Cardiac Arrest Rhythm and Treatment 103
Summary of Cardiac Arrest 107
Congenital Heart Disease 107
Drowning 108
Chapter 6 Medical Emergencies 111
Introduction 111
Medication Dosing 112
Seizures 113
Assessment and Treatment of the Actively Seizing Child 116
Assessment of the Postictal Child 119
Summary of Seizures 120
Altered Mental Status (AMS) 120
Diabetes Mellitus 123
Hypoglycemia 123
Congenital Adrenal Hyperplasia 124
Cortisol Deficiency 125
Panhypopituitarism 125
Summary of Altered Mental Status and Endocrine Disorders 126
Fever 126
Summary of Fever 127
Nausea, Vomiting, and Diarrhea (Gastroenteritis) 128
Sepsis and Meningitis 129
Heat-Related Emergencies 130
Summary of Heat-Related Emergencies 131
Cold-Related Emergencies 132
Summary of Cold-Related Emergencies 133
Bites and Stings 133
Summary of Bites and Stings 134
Chapter 7 Trauma 137
Introduction 137
Fatal Injury Mechanisms 138
Unique Anatomic Features of Children: Effect on Injury Patterns 138
Mechanism of Injury: Effect on Injury Patterns 142
Assessment of the Injured Child 143
The General Assessment 144
The Primary Assessment 145
Summary of Primary Assessment 152
Special Airway Considerations in Pediatric Trauma 152
The Primary Assessment 153
Additional Assessment 153
Summary of Additional Assessment 154
Spinal Motion Restriction and Splinting for Transport 154
Pediatric Burn Patients 155
Summary of Burns 158
Chapter 8 Toxic Emergencies 161
Introduction 161
Age-Related Differences 161
Summary of Age-Related Differences 163
Prearrival Preparation and Scene Size-Up 164
Role of the Poison Center 165
Assessment of the Child with a Possible Toxic Exposure 165
Summary of Assessment of the Child With a Possible Toxic Exposure 170
Toxicologic Management 170
Organophosphates 174
Summary of Toxicologic Management 174
Medicolegal Issues 174
Chapter 9 Behavioral Emergencies 179
Introduction 179
Common Pediatric Psychiatric and Behavioral Conditions 180
Suicide Attempt/Intentional Ingestions or Exposures 185
Adverse Reactions of Psychiatric Medications 186
Assessment and Transport of the Child with a Behavioral Emergency 187
Chapter 10 Children with Special Health Care Needs 193
Introduction 193
Cognitive and Physical Disabilities 194
Assessment of CSHCN 195
Summary of Assessment of CSHCN 198
Transport 198
Summary of Transport 199
Children Assisted by Technology 199
Summary of Children Assisted by Technology 208
The Medical Home for CSHCN 209
Additional EMS Considerations for CSHCN 209
Chapter 11 Child Maltreatment 213
Introduction 213
Background, Cost, and Definition 213
Definition of Child Maltreatment 214
High-Risk Groups 215
Duties and Communication by the Prehospital Professional 216
Communicating With the Child and Caregivers 218
Patient Assessment 218
Summary of Duties, Communication, and Assessment in Suspected Maltreatment 223
Legislation, Principles, and Protocols 223
Pediatric Human Trafficking 225
Chapter 12 Emergency Delivery and Newborn Stabilization 233
Introduction 233
Obstetric Delivery in the Prehospital Setting 234
Complications During Pregnancy 234
Triage of a Patient in Labor 236
Summary of Triage of Patient in Labor 239
Preparation for Delivery 240
Performing the Delivery 242
Summary of Vaginal Delivery 245
Immediate Care of the Newborn 246
General Principles of Newborn Resuscitation 248
Specific Newborn Complications 251
Summary of Resuscitation of the Newborn 254
Transport Considerations 254
Summary 255
Chapter 13 Sudden Unexpected Infant Death and Death of a Child 259
Introduction 259
Definition of SUID 259
SUID Epidemiology 260
Common Clinical Presentation of SUID 260
Actions in Suspected SUID 261
Summary of SUID 263
Definition of Brief Resolved Unexplained Event 264
Common Clinical Presentation of BRUE 264
Actions in Suspected BRUE 264
Summary of BRUE 265
Responses to an Infant Death 265
Critical incident Stress 267
Chapter 14 Children in Disasters 271
Children in Disasters 271
What Is a Disaster? 272
Roles of the Prehospital Professional in a Disaster 273
Pediatric Response Considerations 274
Vulnerable Pediatric Physiologic and Psychologic Characteristics in Disasters 280
Effects of Chemical, Biologic, Radiation, Nuclear, and Explosive Disasters on Children 281
Summary 287
Chapter 15 Medicolegal and Ethical Considerations 291
Introduction 291
Consent 291
Summary of Consent 295
Confidentiality 295
Respect for Cultural or Religious Differences 295
Patient Rights and Advocacy 296
End-of-Life Issues 296
Pediatric Policies and Procedures 301
Medical Control for Pediatrics 302
Summary of Rationale for Protocols, Policies, and Procedures 303
Chapter 16 Transportation Considerations 307
Pediatric Transport 307
How to Begin Transport 308
Taking Caregivers in the Ambulance 309
Child Restraint Systems in Ambulances 310
Transport Mode 315
Transport Destination 315
Multiple Patients 315
Summary of Transport Mode and Multiple Patients 315
Chapter 17 Making a Difference 319
Introduction 319
Emergency Medical Services for Children 320
Summary of EMSC 320
Public Health Interface 322
Prevention and Injury Control 322
Summary of Prevention and Injury Control 325
The Medical Home 325
Summary of the Medical Home 326
Quality and Safety in EMSC 326
Data and Information Management 328
Summary of Quality, Safety, Data Collection, and Information Management 329
Prevention: The Prehospital Professional's Role 329
Summary of Roles in Prevention 331
Call to Action: Advocacy for EMSC 331
Procedures 335
1 Field Reporting 336
2 Length-Based Resuscitation Tapes 340
3 Oxygen Delivery 342
4 Suctioning 347
5 Airway Adjuncts 353
6 Foreign Body Obstruction 356
7 Bronchodilator Therapy 360
8 Bag-Mask Ventilation 363
9 Pulse Oximetry 367
10 Orogastric and Nasogastric Tube Insertion 369
11 Endotracheal Intubation 373
12 Confirmation of Endotracheal Intubation and End-Tidal Capnography 383
13 Advanced Airway Techniques 389
14 Intramuscular Injections 398
15 Intranasal Medication Administration 402
16 Intravenous Access 405
17 Intraosseous Needle Insertion 409
18 Cardiopulmonary Resuscitation 415
19 AED and Defibrillation 420
20 Endotracheal Tube Drug Instillation 425
21 Rectal Administration of Benzodiazepines 427
22 Spinal Motion Restriction 430
23 Needle Thoracostomy 435
24 Removing and Replacing a Tracheostomy Tube 437
25 Tourniquet Application 441
Medication Formulary 445
Glossary 459
Index 473
9781284194579
Emergencies.
Infant
Child
WS 205 / A471 2021
Pediatric Education for Prehospital Professionals (PEPP) - 4th Edition - MA Jones & Bartlett Learning 2021 - 490 pages
Chapter 1 Pediatric Assessment 1
Introduction 2
Summary of Assessment Flowchart 2
Scene Size-Up 3
The Pediatric Assessment Triangle 3
Primary Assessment 11
Primary Assessment: The Transport Decision: Stay or Go? 19
Summary of Primary Assessment 19
Secondary Assessment: History Taking 20
Physical Examination 21
Additional Monitoring Devices 26
Ongoing Reassessment 26
Summary 27
Chapter 2 Using a Developmental Approach 31
Introduction 31
Pediatric Calls and Response From Family and Providers 32
Communication With the Child and Family or Caregiver 33
Vital Signs Through the Ages 33
Anatomic Changes 35
Summary of Changes in Vital Signs and Anatomy Through Childhood 37
Infants 37
Assessment of the Infant 38
Toddlers 39
Assessment of the Toddler 40
Preschoolers 40
Assessment of the Preschooler 41
School-Aged Children 41
Assessment of the School-Aged Child 42
Adolescents 42
Assessment of the Adolescent 43
Children With Special Health Care Needs 43
Assessment of a CSHCN 44
Tips for the EMS Provider 45
Summary 45
Chapter 3 Respiratory Emergencies 49
Introduction 49
Respiratory Distress and Failure 50
Prearrival Preparation 51
Scene Size-Up 51
General Assessment: The PAT 51
Primary Assessment: The ABCDEs 52
General Noninvasive Treatment 54
Summary of General and Initial Respiratory Assessment and General Noninvasive Treatment 56
Specific Treatment for Respiratory Distress 56
Summary of Specific Treatment for Respiratory Distress 65
Management of Acute Respiratory Distress: CPAP 66
Management of Respiratory Failure 66
Summary of Management of Respiratory Failure 70
Primary Assessment: The Transport Decision-Stay or Go? 70
Additional Assessment 71
Chapter 4 Shock 75
Introduction 75
Prearrival Preparation 76
Scene Size-Up 76
General Assessment: The Pediatric Assessment Triangle 76
Primary Assessment: The ABCDEs 77
Additional Assessment 79
Summary of Cardiovascular Assessment 80
Using the Assessment to Identify Shock 80
Hypovolemic Shock 81
Distributive Shock 82
Cardiogenic Shock 83
Obstructive Shock 85
General Noninvasive Treatment of Suspected Shock of All Types 85
Specific Treatment of Hypovolemia 86
Treatment of Septic Shock 87
Specific Treatment of Hypotensive (Decompensated) Distributive Shock 88
Treatment of Cardiogenic Shock 88
Primary Assessment: Transport Decision 89
Summary of Shock States 89
Chapter 5 Resuscitation and Dysrhythmias 93
Introduction 94
Prearrival Preparation 94
Scene Size-Up 94
General Assessment: The PAT 94
Primary Assessment: The ABCDEs 95
Additional Assessment 96
Summary of Cardiovascular Assessment 96
Dysrhythmias 97
Summary of Dysrhythmias 102
Cardiac Arrest 102
Presenting Cardiac Arrest Rhythm and Treatment 103
Summary of Cardiac Arrest 107
Congenital Heart Disease 107
Drowning 108
Chapter 6 Medical Emergencies 111
Introduction 111
Medication Dosing 112
Seizures 113
Assessment and Treatment of the Actively Seizing Child 116
Assessment of the Postictal Child 119
Summary of Seizures 120
Altered Mental Status (AMS) 120
Diabetes Mellitus 123
Hypoglycemia 123
Congenital Adrenal Hyperplasia 124
Cortisol Deficiency 125
Panhypopituitarism 125
Summary of Altered Mental Status and Endocrine Disorders 126
Fever 126
Summary of Fever 127
Nausea, Vomiting, and Diarrhea (Gastroenteritis) 128
Sepsis and Meningitis 129
Heat-Related Emergencies 130
Summary of Heat-Related Emergencies 131
Cold-Related Emergencies 132
Summary of Cold-Related Emergencies 133
Bites and Stings 133
Summary of Bites and Stings 134
Chapter 7 Trauma 137
Introduction 137
Fatal Injury Mechanisms 138
Unique Anatomic Features of Children: Effect on Injury Patterns 138
Mechanism of Injury: Effect on Injury Patterns 142
Assessment of the Injured Child 143
The General Assessment 144
The Primary Assessment 145
Summary of Primary Assessment 152
Special Airway Considerations in Pediatric Trauma 152
The Primary Assessment 153
Additional Assessment 153
Summary of Additional Assessment 154
Spinal Motion Restriction and Splinting for Transport 154
Pediatric Burn Patients 155
Summary of Burns 158
Chapter 8 Toxic Emergencies 161
Introduction 161
Age-Related Differences 161
Summary of Age-Related Differences 163
Prearrival Preparation and Scene Size-Up 164
Role of the Poison Center 165
Assessment of the Child with a Possible Toxic Exposure 165
Summary of Assessment of the Child With a Possible Toxic Exposure 170
Toxicologic Management 170
Organophosphates 174
Summary of Toxicologic Management 174
Medicolegal Issues 174
Chapter 9 Behavioral Emergencies 179
Introduction 179
Common Pediatric Psychiatric and Behavioral Conditions 180
Suicide Attempt/Intentional Ingestions or Exposures 185
Adverse Reactions of Psychiatric Medications 186
Assessment and Transport of the Child with a Behavioral Emergency 187
Chapter 10 Children with Special Health Care Needs 193
Introduction 193
Cognitive and Physical Disabilities 194
Assessment of CSHCN 195
Summary of Assessment of CSHCN 198
Transport 198
Summary of Transport 199
Children Assisted by Technology 199
Summary of Children Assisted by Technology 208
The Medical Home for CSHCN 209
Additional EMS Considerations for CSHCN 209
Chapter 11 Child Maltreatment 213
Introduction 213
Background, Cost, and Definition 213
Definition of Child Maltreatment 214
High-Risk Groups 215
Duties and Communication by the Prehospital Professional 216
Communicating With the Child and Caregivers 218
Patient Assessment 218
Summary of Duties, Communication, and Assessment in Suspected Maltreatment 223
Legislation, Principles, and Protocols 223
Pediatric Human Trafficking 225
Chapter 12 Emergency Delivery and Newborn Stabilization 233
Introduction 233
Obstetric Delivery in the Prehospital Setting 234
Complications During Pregnancy 234
Triage of a Patient in Labor 236
Summary of Triage of Patient in Labor 239
Preparation for Delivery 240
Performing the Delivery 242
Summary of Vaginal Delivery 245
Immediate Care of the Newborn 246
General Principles of Newborn Resuscitation 248
Specific Newborn Complications 251
Summary of Resuscitation of the Newborn 254
Transport Considerations 254
Summary 255
Chapter 13 Sudden Unexpected Infant Death and Death of a Child 259
Introduction 259
Definition of SUID 259
SUID Epidemiology 260
Common Clinical Presentation of SUID 260
Actions in Suspected SUID 261
Summary of SUID 263
Definition of Brief Resolved Unexplained Event 264
Common Clinical Presentation of BRUE 264
Actions in Suspected BRUE 264
Summary of BRUE 265
Responses to an Infant Death 265
Critical incident Stress 267
Chapter 14 Children in Disasters 271
Children in Disasters 271
What Is a Disaster? 272
Roles of the Prehospital Professional in a Disaster 273
Pediatric Response Considerations 274
Vulnerable Pediatric Physiologic and Psychologic Characteristics in Disasters 280
Effects of Chemical, Biologic, Radiation, Nuclear, and Explosive Disasters on Children 281
Summary 287
Chapter 15 Medicolegal and Ethical Considerations 291
Introduction 291
Consent 291
Summary of Consent 295
Confidentiality 295
Respect for Cultural or Religious Differences 295
Patient Rights and Advocacy 296
End-of-Life Issues 296
Pediatric Policies and Procedures 301
Medical Control for Pediatrics 302
Summary of Rationale for Protocols, Policies, and Procedures 303
Chapter 16 Transportation Considerations 307
Pediatric Transport 307
How to Begin Transport 308
Taking Caregivers in the Ambulance 309
Child Restraint Systems in Ambulances 310
Transport Mode 315
Transport Destination 315
Multiple Patients 315
Summary of Transport Mode and Multiple Patients 315
Chapter 17 Making a Difference 319
Introduction 319
Emergency Medical Services for Children 320
Summary of EMSC 320
Public Health Interface 322
Prevention and Injury Control 322
Summary of Prevention and Injury Control 325
The Medical Home 325
Summary of the Medical Home 326
Quality and Safety in EMSC 326
Data and Information Management 328
Summary of Quality, Safety, Data Collection, and Information Management 329
Prevention: The Prehospital Professional's Role 329
Summary of Roles in Prevention 331
Call to Action: Advocacy for EMSC 331
Procedures 335
1 Field Reporting 336
2 Length-Based Resuscitation Tapes 340
3 Oxygen Delivery 342
4 Suctioning 347
5 Airway Adjuncts 353
6 Foreign Body Obstruction 356
7 Bronchodilator Therapy 360
8 Bag-Mask Ventilation 363
9 Pulse Oximetry 367
10 Orogastric and Nasogastric Tube Insertion 369
11 Endotracheal Intubation 373
12 Confirmation of Endotracheal Intubation and End-Tidal Capnography 383
13 Advanced Airway Techniques 389
14 Intramuscular Injections 398
15 Intranasal Medication Administration 402
16 Intravenous Access 405
17 Intraosseous Needle Insertion 409
18 Cardiopulmonary Resuscitation 415
19 AED and Defibrillation 420
20 Endotracheal Tube Drug Instillation 425
21 Rectal Administration of Benzodiazepines 427
22 Spinal Motion Restriction 430
23 Needle Thoracostomy 435
24 Removing and Replacing a Tracheostomy Tube 437
25 Tourniquet Application 441
Medication Formulary 445
Glossary 459
Index 473
9781284194579
Emergencies.
Infant
Child
WS 205 / A471 2021