Infant CPR (1 of 2) • Place infant on firm surface and maintain airway. • Place two fingers in the middle of the sternum. • Use two fingers to compress the chest about 1/2" to 1" at a rate of 100/min.
Infant CPR (2 of 2) • Allow sternum to return briefly to its normal position between compressions. • Coordinate rapid compressions and ventilations in a 5:1 ratio. • Reassess the infant for return of breathing and pulse after 1 minute, then every few minutes.
Child CPR (1 of 2) • Place child on firm surface and maintain airway with one hand. • Place heel of other hand over lower half of the sternum. • Avoid the xiphoid process. • Compress chest about 1" to 1 1/2" at a rate of 100/min.
Child CPR (2 of 2) • Coordinate compressions with ventilations in a 5:1 ratio, pausing for ventilations. • Reassess for breathing and pulse after about 1 minute and then every few minutes. • If the child resumes effective breathing, place child in recovery position.
AED Use in Children • Children over 8 should use the adult AED protocol. • Children ages 1-8: • 1 minute of CPR before AED • Use AED with pediatric capabilities. • Adult AED may be used in local protocols. • Do not use on an infant under 1 year old.
Trauma (1 of 2) Extremity injuries in children are generally managed in the same manner as those in adults.
Trauma (2 of 2) • Be alert for airway problems on all children with traumatic injuries. • Give supplemental oxygen to all children with possible: • Head injuries • Chest injuries • Abdominal injuries • Shock • If ventilation is required, provide at 20 breaths/min.
Immobilization • Any child with a head or back injury should be immobilized. • Young children may need padding beneath their torso. • Children may need padding along the sides of the backboard.
Immobilization in a Child Safety Seat • Assess child for injuries and seat for visible damage. • If child is injured or seat is damaged, remove child to another transport device • Apply padding around child to minimize movement. • Move seat to ambulance and secure according to the manufacturer’s instructions.
Removing a Child froma Child Safety Seat • Remove both the child and the seat from the vehicle. • Place immobilization device behind the child. • Slide child into place on device.
Signs and Symptomsof Respiratory Emergencies • Nasal flaring • Grunting respirations • Use of accessory muscles • Retractions of rib cage • Tripod position in older children
Emergency Care • Provide supplemental oxygen in the most comfortable manner. • Place child in position of comfort. • This may be in caregiver’s lap. • If patient is in respiratory failure, begin assisted ventilation immediately. • Continue to provide supplemental oxygen.
Shock • Circulatory system is unable to deliver sufficient blood to organs. • Many different causes • Patients may have increased heart rate, respirations, and pale or mottled skin. • Children do not show decreased blood pressure until shock is severe.
Assessing Circulation • Pulse: Above 160 beats/min suggests shock • Skin signs: Assess temperature and moisture • Capillary refill: Is it delayed? • Color: Is skin pink, pale, ashen, or mottled?
Emergency Medical Carefor Shock • Ensure airway. • Give supplemental oxygen. • Provide immediate transport. • Continue monitoring vital signs en route. • Contact ALS for backup as needed.
Seizures • May present in several different ways • A postictal period of extreme fatigue or unresponsiveness usually follows seizure. • Be alert to presence of medications, poisons, and possible abuse.
Febrile Seizures • Febrile seizures are most common in children from 6 months to 6 years. • Febrile seizures are caused by fever. • Generally last less than 15 minutes • Assess ABCs and begin cooling measures. • Provide prompt transport.
Emergency Medical Careof Seizures (1 of 2) • Perform initial assessment, focusing on the ABCs. • Securing and protecting the airway is the priority. • Place patient in the recovery position. • Be ready to suction.
Emergency Medical Careof Seizures (2 of 2) • Deliver oxygen by mask, blow-by, or nasal cannula. • Begin BVM ventilation if no signs of improvement. • Call ALS for backup if appropriate.
Dehydration • Determine if child is vomiting or has diarrhea and for how long. • “How many wet diapers has the child had during the day?” (6 to 10 is normal) • “What fluids are the child taking?” • “What was the child’s weight before the symptoms started?” • “Has the child been normally active?”
Emergency Medical Carefor Dehydration • Assess the ABCs. • Obtain baseline vital signs. • ALS backup may be needed for IV administration.