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  • Assessment of Children in Emergencies: Committee On Pediatric Resuscitation, The Indonesian Society of Pediatrician

    Diunggah oleh

    La Ode Rinaldi
    43 tayangan36 halaman
    1. The document provides guidelines for assessing children in emergencies using the PAT (appearance, breathing, circulation) method and ABCDEs (airway, breathing, circulation, disability, exposure). 2. It describes how to evaluate breathing/respiration, circulation, neurologic status, and exposure and classify a child's physiologic status as stable, respiratory dysfunction, shock, or cardiopulmonary failure. 3. Priorities for initial management are outlined depending on classification as stable, respiratory dysfunction, shock, or cardiopulmonary failure and include oxygen, ventilation, vascular access, volume expansion, and monitoring vital signs.

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    1. The document provides guidelines for assessing children in emergencies using the PAT (appearance, breathing, circulation) method and ABCDEs (airway, breathing, circulation, disability, exposure). 2. It describes how to evaluate breathing/respiration, circulation, neurologic status, and exposure and classify a child's physiologic status as stable, respiratory dysfunction, shock, or cardiopulmonary failure. 3. Priorities for initial management are outlined depending on classification as stable, respiratory dysfunction, shock, or cardiopulmonary failure and include oxygen, ventilation, vascular access, volume expansion, and monitoring vital signs.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PPT, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    43 tayangan36 halaman

    Assessment of Children in Emergencies: Committee On Pediatric Resuscitation, The Indonesian Society of Pediatrician

    Diunggah oleh

    La Ode Rinaldi
    1. The document provides guidelines for assessing children in emergencies using the PAT (appearance, breathing, circulation) method and ABCDEs (airway, breathing, circulation, disability, exposure). 2. It describes how to evaluate breathing/respiration, circulation, neurologic status, and exposure and classify a child's physiologic status as stable, respiratory dysfunction, shock, or cardiopulmonary failure. 3. Priorities for initial management are outlined depending on classification as stable, respiratory dysfunction, shock, or cardiopulmonary failure and include oxygen, ventilation, vascular access, volume expansion, and monitoring vital signs.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PPT, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 36

    Assessment of Children

    in Emergencies

    Committee on Pediatric Resuscitation, The


    Indonesian Society of Pediatrician
    1. PAT
    2. ABCDE
    The PAT

    Wo
    rk
    e
    nc

    of
    ra

    Br e
    ea
    p

    at h
    Ap

    i ng
    Circulation to Skin
    Appearance
    (“Tickles” =TICLS)
    Tonus

    e
    Interactiveness

    nc
    ara
    Consolability

    pe
    Ap
    Look/Gaze
    Speech/Cry
    Young infants
    Work of Breathings
    Wo Abnormal airway
    sounds
    rk
    of

    Abnormal positioning
    Bre

    Retractions
    a
    thi
    ng

    Nasal flaring
    s
    Applying The PAT for WOB
    Seesaw Respiration
    Respiratory Effort

    Retraction The Sniffing Position The Tripod Position


    Circulation to Skin

    Pallor
    Mottling
    Cyanosis
    Circulation to Skin
    Respiratory distress Shock

    N  N N

    N N
    Primary CNS dysfunction/
    metabolic abnormality Cardiopulmonary failure

    N N N /

    N N
    The ABCDEs
    Airway
    Breathing
    Circulation
    Disability
    Exposure
    Airway Assessment
    Clear
    Maintainable
    Unmaintainable
    without
    intubation
    Obstructed
    Breathing Assessment

    Rate
    Effort / mechanics
    Air entry
    Skin color
    Respiratory Rate by Age

    Age Respiratory rate


    (years) (breaths per minute)
    <1 30-40
    2-5 20-30
    5-12 15-20
    >12 12-16
    Retraction and the use of Accessory Muscle
    Circulation Assessment

    Heart rate
    Systematic perfusion
     Peripheral pulses
     Skin perfusion

     Appearance

     (Urine output)

    Blood pressure
    Heart Rate by Age

    Age Range
    Newborn – 3 mos 85 – 200 bpm
    3 mos – 2 yrs 100 – 190 bpm
    2 – 10 yrs 60 – 140 bpm
    Central & Distal Pulses
    Skin Perfusion
    Extremity temperature
    Capillary refill
    Color
     Pink
     Mottled

     Pale

     Blue
    Skin Perfusion Examination
    Minimal Systolic Blood
    Pressure by Age
    Age Fifth percentile
    mmHg
    Systolic BP
    0 – 1 Mo 60
    > 1 mo – 1 yr 70
    > 1 yr 70 + (2 x age in
    years)
    Disability
    (neurologic status)
    Cerebral cortex
    Brain Stem
    Motor activity
    Level of Consciousness

    A = Awake
    V = Responsive to voice
    P = Responsive to pain
    U = Unresponsive
    Brain Stem
    Posture
    Central respiration
    Pupil response
    Cranial nerve
    Motor Activity
    Symmetrical movements
    Seizures
    Posturing
    Flaccidity
    Exposure
    Skin rashes
    Bruises
    Excoriation
    etc.
    Classification of Physiologic
    status
    Stable
    Respiratory dysfunction
    Potential respiratory failure
    Probable respiratory failure
    Shock
    Compensated
    Decompensated
    Cardiopulmonary failure
    Decompensated Shock
    Definition of Cardiopulmonary Failure
    Deficits in
    Ventilation
    Oxygenation
    Perfusion
    Resulting in
    Agonal respiration
    Bradycardia
    Cardiopulmonary arrest
    Priorities in Initial Management of Stable Child

    Begin further workup


    Provide specific therapy as indicated
    Reassess frequently
    Priorities in Initial Management of
    Respiratory Dysfunction
    Potential Respiratory Failure Probable Respiratory Failure
    Keep with caregiver Separate from caregiver
    Position of comfort Control airway
    Oxygen as tolerated 100 % FiO2
    Nothing by mouth Assist ventilation
    Monitor pulse oximetry Nothing by mouth
    Consider cardiac monitor Monitor pulse oxymetry
    Cardiac monitor
    Establish vascular access
    Keep with
    Caregiver !!
    Priorities in Initial
    Management of Shock
    Administer oxygen (FiO2 = 1.0) and ensure
    adequate airway and ventilation
    Establish vascular access
    Provide volume expansion
    Monitor oxygenation, heart rate, and urine output
    Consider vasoactive infusions
    Priorities in Initial Management of
    Cardiopulmonary failure

    Oxygenate, ventilate, monitor


    Reassess for
    Respiratory failure
    Shock
    Obtain vascular access

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