Pediatric Assessment

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Pediatric Assessment
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• SCENE SIZE-UP SAFETY
• Enter Slowly
• Observe for safety and mechanism of injury

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• If parents interfere
• Try to persuade to assist in care
• If necessary, have friend or relative remove from
  scene
• Child may not live in traditional 2-parent home
• use tact
• Gain confidence and calm all involved
• Dont distract from care of child

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• Assessing
• The condition of a sick/injured child can change
  rapidly
• Signs or symptoms can be subtle

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• INITIAL ASSESSMENT
• General Impression
• Well or sick
• Mental status
• drowsy
• sleepy
• inattentive
• Effort of breathing

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• Skin color
• pale
• cyanotic
• flushed
• Quality of speech
• strong cry
• speak only in short sentences
• grunts

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• Interaction with the environment or others
• silence
• listlessness
• unconscious

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• Emotional state
• withdrawn
• emotionally flat
• Response to you
• inattention to strangers
• Tone and body position
• limpness
• poor muscle tone
• position to indicate respiratory distress
• Mental status
• AVPU
• never shake

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• Airway
• depressed mental status
• secretions
• blood
• vomitus
• trauma
• infections
• Do not hyperextend neck

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• Breathing
• Chest expansion
• Effort of breathing
• Sounds of breathing
• Breathing rate
• Color

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• Treat as you go care

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• FOCUSED HISTORY AND PHYSICAL
• EXAM
• Ask simple questions
• Always explain what you are doing to a child
• Base-line vital signs
• low b/p may indicate imminent cardiac arrest

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• PRIORITY PATIENTS
• Poor General Impression
• Unresponsive or listless
• Does recognize parents or primary care givers
• Not comforted when held by parent but becomes
  calm and quiet when set down

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• Compromised airway
• Respiratory arrest or inadequate breathing
• Possibility of shock
• Uncontrollable bleeding

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• DETAILED PE
• Toe-to-head exam with infants and small children
• Unless injury/illness wont permit, allow
• parent to hold child in lap
• Shelter from stares and onlookers
• Children loose heat quickly so recover quickly
  after exposing for exam

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• ON-GOING ASSESSMENT
• DONT TAKE YOUR EYES OFF YOUR PEDIATRIC PAITENT
  FOR A MINUTE

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• RESPIRATORY COMPRIMISE IS THE
• PRIMARY CAUSE of CARDIAC ARREST
• IN CHILDREN