Children with Special Health Care Needs. Lesson 8.
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Mother states that a new nurse was on duty when the trouble began. The new nurse had trouble operating the suction unit and called mother to return home and called 911 as well.
Mother asks to use your suction unit, and is successful in clearing the excess mucous in a matter of seconds. Immediately, the child looks more relaxed, has easier breathing and the pulse oximeter reads 98%.
At the request of mother, you transport the child to the hospital.
Children with special health care needs (CSHCN)refers to children who have or are suspected of having a serious or chronic condition of:
physical, developmental, behavioral, or emotional health that requires health- related services of a type or amount beyond that generally required by children (based on nat’l defn.).
Children with congenital heart disease or chronic illness may be unable to compensate for even mild respiratory distress.
Signs of hypoperfusion may be masked because the baseline heart rate of the child may be accelerated.
Look for other signs including AMS.
Child who has
respiratory distress or
signs of hypoperfusion
is treated as an urgent condition.
Transport ASAP with oxygen.
Additional assessment while en route.
Use a sensitive approach:
Determine the child's normal abilities and behavior in the following areas:
Central Intravenous Catheters
Colostomies and IlleostomiesSPECIAL TECHNOLOGY
A surgical opening into the trachea through which a tracheostomy tube can be passed. The child then breathes through this opening.
EMTs should follow assessment priorities with additional focus on the airway:
To correct respiratory distress for a patient with a tracheostomy:
A mask covers the child’s mouth and nose, providing constant pressure, ensuring an open airway.
There are two common types of catheters used for this purpose:
Pacemakers regulate heart rate. A pacemaker is needed if the natural heart rate is not fast enough to ensure adequate perfusion.
There are three types of pacemakers:
A feeding catheter provides a route for nutritional support when the child is unable to take food by mouth
Used for temporary support of the child
EMTs should consider: