Pediatric Education for Prehospital Professionals (PEPP)

PEDIATRIC EDUCATION FOR PREHOSPITAL PROFESSIONALS
Title Page
Copyright
Brief Contents
Contents
PEPP Steering Committee
Acknowledgments
Foreword
Chapter 1 Pediatric Assessment
	Introduction
	Summary of Assessment Flowchart
	Scene Size-Up
	The Pediatric Assessment Triangle
	Primary Assessment
	Primary Assessment: The Transport Decision: Stay or Go?
	Summary of Primary Assessment
	Secondary Assessment: History Taking
	Physical Examination
	Additional Monitoring Devices
	Ongoing Reassessment
	Summary
Chapter 2 Using a Developmental Approach
	Introduction
	Pediatric Calls and Response From Family and Providers
	Communication With the Child and Family or Caregiver
	Vital Signs Through the Ages
	Anatomic Changes
	Summary of Changes in Vital Signs and Anatomy Through Childhood
	Infants
	Assessment of the Infant
	Toddlers
	Assessment of the Toddler
	Preschoolers
	Assessment of the Preschooler
	School-Aged Children
	Assessment of the School-Aged Child
	Adolescents
	Assessment of the Adolescent
	Children With Special Health Care Needs
	Assessment of a CSHCN
	Tips for the EMS Provider
	Summary
Chapter 3 Respiratory Emergencies
	Introduction
	Respiratory Distress and Failure
	Prearrival Preparation
	Scene Size-Up
	General Assessment: The PAT
	Primary Assessment: The ABCDEs
	General Noninvasive Treatment
	Summary of General and Initial Respiratory Assessment and General Noninvasive Treatment
	Specific Treatment for Respiratory Distress
	Summary of Specific Treatment for Respiratory Distress
	Management of Acute Respiratory Distress: CPAP
	Management of Respiratory Failure
	Summary of Management of Respiratory Failure
	Primary Assessment: The Transport Decision—Stay or Go?
	Additional Assessment
Chapter 4 Shock
	Introduction
	Prearrival Preparation
	Scene Size-Up
	General Assessment: The Pediatric Assessment Triangle
	Primary Assessment: The ABCDEs
	Additional Assessment
	Summary of Cardiovascular Assessment
	Using the Assessment to Identify Shock
	Hypovolemic Shock
	Distributive Shock
	Cardiogenic Shock
	Obstructive Shock
	General Noninvasive Treatment of Suspected Shock of All Types
	Specific Treatment of Hypovolemia
	Treatment of Septic Shock
	Specific Treatment of Hypotensive (Decompensated) Distributive Shock
	Treatment of Cardiogenic Shock
	Primary Assessment: Transport Decision
	Summary of Shock States
Chapter 5 Resuscitation and Dysrhythmias
	Introduction
	Prearrival Preparation
	Scene Size-Up
	General Assessment: The PAT
	Primary Assessment: The ABCDEs
	Additional Assessment
	Summary of Cardiovascular Assessment
	Dysrhythmias
	Summary of Dysrhythmias
	Cardiac Arrest
	Presenting Cardiac Arrest Rhythm and Treatment
	Summary of Cardiac Arrest
	Congenital Heart Disease
	Drowning
Chapter 6 Medical Emergencies
	Introduction
	Medication Dosing
	Seizures
	Assessment and Treatment of the Actively Seizing Child
	Assessment of the Postictal Child
	Summary of Seizures
	Altered Mental Status (AMS)
	Diabetes Mellitus
	Hypoglycemia
	Congenital Adrenal Hyperplasia
	Cortisol Deficiency
	Panhypopituitarism
	Summary of Altered Mental Status and Endocrine Disorders
	Fever
	Summary of Fever
	Nausea, Vomiting, and Diarrhea (Gastroenteritis)
	Sepsis and Meningitis
	Heat-Related Emergencies
	Summary of Heat-Related Emergencies
	Cold-Related Emergencies
	Summary of Cold-Related Emergencies
	Bites and Stings
	Summary of Bites and Stings
Chapter 7 Trauma
	Introduction
	Fatal Injury Mechanisms
	Unique Anatomic Features of Children: Effect on Injury Patterns
	Mechanism of Injury: Effect on Injury Patterns
	Assessment of the Injured Child
	The General Assessment
	The Primary Assessment
	Summary of Primary Assessment
	Special Airway Considerations in Pediatric Trauma
	The Primary Assessment
	Additional Assessment
	Summary of Additional Assessment
	Spinal Motion Restriction and Splinting for Transport
	Pediatric Burn Patients
	Summary of Burns
Chapter 8 Toxic Emergencies
	Introduction
	Age-Related Differences
	Summary of Age-Related Differences
	Prearrival Preparation and Scene Size-Up
	Role of the Poison Center
	Assessment of the Child with a Possible Toxic Exposure
	Summary of Assessment of the Child With a Possible Toxic Exposure
	Toxicologic Management
	Organophosphates
	Summary of Toxicologic Management
	Medicolegal Issues
Chapter 9 Behavioral Emergencies
	Introduction
	Common Pediatric Psychiatric and Behavioral Conditions
	Suicide Attempt/Intentional Ingestions or Exposures
	Adverse Reactions of Psychiatric Medications
	Assessment and Transport of the Child with a Behavioral Emergency
Chapter 10 Children with Special Health Care Needs
	Introduction
	Cognitive and Physical Disabilities
	Assessment of CSHCN
	Summary of Assessment of CSHCN
	Transport
	Summary of Transport
	Children Assisted by Technology
	Summary of Children Assisted by Technology
	The Medical Home for CSHCN
	Additional EMS Considerations for CSHCN
Chapter 11 Child Maltreatment
	Introduction
	Background, Cost, and Definition
	Definition of Child Maltreatment
	High-Risk Groups
	Duties and Communication by the Prehospital Professional
	Communicating With the Child and Caregivers
	Patient Assessment
	Summary of Duties, Communication, and Assessment in Suspected Maltreatment
	Legislation, Principles, and Protocols
	Pediatric Human Trafficking
Chapter 12 Emergency Delivery and Newborn Stabilization
	Introduction
	Obstetric Delivery in the Prehospital Setting
	Complications During Pregnancy
	Triage of a Patient in Labor
	Summary of Triage of Patient in Labor
	Preparation for Delivery
	Performing the Delivery
	Summary of Vaginal Delivery
	Immediate Care of the Newborn
	General Principles of Newborn Resuscitation
	Specific Newborn Complications
	Summary of Resuscitation of the Newborn
	Transport Considerations
	Summary
Chapter 13 Sudden Unexpected Infant Death and Death of a Child
	Introduction
	Definition of SUID
	SUID Epidemiology
	Common Clinical Presentation of SUID
	Actions in Suspected SUID
	Summary of SUID
	Definition of Brief Resolved Unexplained Event
	Common Clinical Presentation of BRUE
	Actions in Suspected BRUE
	Summary of BRUE
	Responses to an Infant Death
	Critical Incident Stress
Chapter 14 Children in Disasters
	Children in Disasters
	What Is a Disaster?
	Roles of the Prehospital Professional in a Disaster
	Pediatric Response Considerations
	Vulnerable Pediatric Physiologic and Psychologic Characteristics in Disasters
	Effects of Chemical, Biologic, Radiation, Nuclear, and Explosive Disasters on Children
	Summary
Chapter 15 Medicolegal and Ethical Considerations
	Introduction
	Consent
	Summary of Consent
	Confidentiality
	Respect for Cultural or Religious Differences
	Patient Rights and Advocacy
	End-of-Life Issues
	Pediatric Policies and Procedures
	Medical Control for Pediatrics
	Summary of Rationale for Protocols, Policies, and Procedures
Chapter 16 Transportation Considerations
	Pediatric Transport
	How to Begin Transport
	Taking Caregivers in the Ambulance
	Child Restraint Systems in Ambulances
	Transport Mode
	Transport Destination
	Multiple Patients
	Summary of Transport Mode and Multiple Patients
Chapter 17 Making a Difference
	Introduction
	Emergency Medical Services for Children
	Summary of EMSC
	Public Health Interface
	Prevention and Injury Control
	Summary of Prevention and Injury Control
	The Medical Home
	Summary of the Medical Home
	Quality and Safety in EMSC
	Data and Information Management
	Summary of Quality, Safety, Data Collection, and Information Management
	Prevention: The Prehospital Professional’s Role
	Summary of Roles in Prevention
	Call to Action: Advocacy for EMSC
Procedures
	1 Field Reporting
	2 Length-Based Resuscitation Tapes
	3 Oxygen Delivery
	4 Suctioning
	5 Airway Adjuncts
	6 Foreign Body Obstruction
	7 Bronchodilator Therapy
	8 Bag-Mask Ventilation
	9 Pulse Oximetry
	10 Orogastric and Nasogastric Tube Insertion
	11 Endotracheal Intubation
	12 Confirmation of Endotracheal Intubation and End-Tidal Capnography
	13 Advanced Airway Techniques
	14 Intramuscular Injections
	15 Intranasal Medication Administration
	16 Intravenous Access
	17 Intraosseous Needle Insertion
	18 Cardiopulmonary Resuscitation
	19 AED and Defibrillation
	20 Endotracheal Tube Drug Instillation
	21 Rectal Administration of Benzodiazepines
	22 Spinal Motion Restriction
	23 Needle Thoracostomy
	24 Removing and Replacing a Tracheostomy Tube
	25 Tourniquet Application
Medication Formulary
Glossary
Index