Care of the Family and Child MIKE PYORALA RCP, P.A.L.S, A.C.L.S., B.L.S., 12-LEAD ECG A.H.A....
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Transcript of Care of the Family and Child MIKE PYORALA RCP, P.A.L.S, A.C.L.S., B.L.S., 12-LEAD ECG A.H.A....
Care of the Family and Care of the Family and ChildChild
MIKE PYORALARCP, P.A.L.S, A.C.L.S., B.L.S., 12-LEAD ECG
A.H.A. INSTRUCTOR
Care of the Family and ChildCare of the Family and Child
Psychological aspects
Developmental issues
Approach
Assessment
Objectives
Care of the Family and ChildCare of the Family and Child
Why are psychological and emotionalneeds difficult to manage?
Care of the Family and ChildCare of the Family and Child
Child’s viewpoint
Parent’s viewpoint
Health Care Provider’s viewpoint
Psychological Aspects
Care of the Family and ChildCare of the Family and Child
Frightened
Guilty
Exhausted
Parent’s Viewpoint
Care of the Family and ChildCare of the Family and Child
Scared
Inexperienced
Empathetic
Health Care Provider’s Viewpoint
Care of the Family and ChildCare of the Family and Child
Be honest
Give real choices
Support family relationship
Maintain self-control
Respect right to privacy
Key Points
Care of the Family and ChildCare of the Family and Child
Assume the child can hear you.
Do not introduce fear/anxiety.
Praise children.
Key Points
Care of the Family and ChildCare of the Family and Child
Decreased ability to: accept and understand incoming information think clearly and to solve problems
Helplessness Anxiety Hysteria Anger Guilt
Parental Responses
Care of the Family and ChildCare of the Family and Child
Perception of the event
Previous experience
Family relationships
Culture/religion
Support systems
Assessment
Care of the Family and ChildCare of the Family and Child
Include the parents and child
Ask for the parent’s assistance
Acknowledge feelings
Be honest
Stay calm
Familiarize family with the environment
Give control
Prepare the family
Strategies
Care of the Family and ChildCare of the Family and Child
The child’s chronological age may not always match the developmental age.
Developmental Issues
Care of the Family and ChildCare of the Family and Child
Does the child look sick?
Does the child sound sick?
Physical Examination
Care of the Family and ChildCare of the Family and Child
Appearance
Airway and C-spine
Breathing
Primary Survey
Care of the Family and ChildCare of the Family and Child
Many problems, especially respiratory distress, are made worse by agitation.
Remember:
Care of the Family and ChildCare of the Family and Child
Respond to Soothing voice Gentle hands Pacifier
Keep warm Exam chest and abdomen first
Less than 1 month of age
Care of the Family and ChildCare of the Family and Child
Unafraid of strangers Responds to cooing and tickling Keep warm Exam chest and abdomen first
Infant (1-6 Months)
Care of the Family and ChildCare of the Family and Child
Afraid of strangers Separation anxiety Examine in parent’s lap Examine trunk then proceed to head
Infant (6-12 Months)
Care of the Family and ChildCare of the Family and Child
Independent Strong distrust of strangers Patient but firm approach Keep parents nearby Limit exam to bare essentials
Toddler (1-3 Years)
Care of the Family and ChildCare of the Family and Child
Frightened of bodily injury Need explanations and reassurance May be more cooperative Modest Examine in presence of parents Examine chest and abdomen first
Preschooler (3-5 Years)
Care of the Family and ChildCare of the Family and Child
Cooperative More aware of death Need reassurance Modest Examine with parents present Examine in an adult fashion
School-Age Child (6-12 Years)
Care of the Family and ChildCare of the Family and Child
Expect to be treated as an adult
Many of the same fears as younger children
Body image Excessively modest Examine as an adult
Adolescent (12-18 Years)
The approach to the unconscious child of any age is the same as for the unconscious adult, with rapid
performance of the primary survey and institution of priority
treatments.
Care of the Family and ChildCare of the Family and Child
Care of the Family and ChildCare of the Family and Child
Talk to all patients of all ages Give explanations in simple language Be honest Be sympathetic Offer reassurance Carefully document
Tips on Treatment
Care of the Family and ChildCare of the Family and Child
Critical measurement (Age in years x 2) + 8 = weight in kilograms
Weight
Care of the Family and ChildCare of the Family and Child
Count respirations before touching the child. Count for 1 full minute to assess:
quantity quality effort
Respirations
Care of the Family and ChildCare of the Family and Child
Newborn Infant/young child Older child
Umbilical Cord
Brachial artery
Carotid artery
Heart Rate
Care of the Family and ChildCare of the Family and Child
Heart rate rises long before blood pressure falls!!!!!!
In Shock,
Remember :
Bradycardia in an ill child indicates extreme distress, requiring URGENT intervention.
Care of the Family and ChildCare of the Family and Child
Remember:
Care of the Family and ChildCare of the Family and Child
Wide range of normals May see up to 25% decrease in blood volume before BP
decreases. Over one year may estimate minimum systolic:
(Age in years x 2 ) + 70 = minimum systolic blood pressure
Blood Pressure
Care of the Family and ChildCare of the Family and Child
Never wait until the child is hypotensive to initiate volume resuscitation!!!!!!
Remember:
Care of the Family and ChildCare of the Family and Child
Children cool quickly Exposure and low cardiac output lower core temperature
Temperature
Care of the Family and ChildCare of the Family and Child
Anterior Fontanel Bulging or tense Sunken
Neurological
Care of the Family and ChildCare of the Family and Child
Alertness Eye contact Recognition of parents Playing Withdrawal to pain
LOC