Chapter 43: Ready for Review
 Children differ anatomically, physiologically, and emotionally from adults.
 Sick or injured children present unique challenges in evaluation and management. Their
perceptions of their illness or injury, of their world, and of paramedics differ from the
perceptions of adults.
 The majority of children you treat will come with at least one parent or caregiver. Thus,
in many pediatric calls, you will be dealing with more than one patient—even if only the
child is ill or injured.
 Serious illness or injury to a child is one of the most stressful situations caregivers can
face.
 An assessment tool called the Pediatric Assessment Triangle (PAT) has been developed
to help EMS providers form a from-the-doorway general impression of pediatric patients.
 Respiratory problems are among the medical emergencies that you will most frequently
encounter in children. Pediatric patients with a respiratory chief complaint will span the
spectrum from mildly ill to near death.
 In pediatrics, respiratory failure and arrest precede the majority of cardiopulmonary
arrests.
 The types of shock that you may encounter are the same in adults and children. Because
children typically have strong cardiovascular systems, they are able to compensate for
inadequate perfusion more efficiently than adults.
 Cardiovascular emergencies are relatively rare in children. When such problems arise,
they are often related to volume or infection rather than to a primary cardiac cause, unless
the child has congenital heart disease.
 Through the PAT and primary assessment, you can quickly identify a cardiovascular
emergency, understand the likely pathologic cause, and institute potentially lifesaving
treatment.
 Children are particularly difficult to assess neurologically because they can often be
uncooperative during the assessment.
 The ingestion of foreign bodies is a common cause of gastrointestinal complaints in
pediatrics.
 Children and young adults are much more commonly diagnosed with type 1 diabetes;
therefore, they are susceptible to diabetic ketoacidosis (DKA), a life-threatening event.
 Hematologic and immunologic diseases are common in pediatric patients, and because of
the altered immunity of many of these children, often result in severe presentations of
illness and even shock.
 Toxic exposures account for a significant number of pediatric emergencies. Toxic
exposures can take the form of ingestion, inhalation, injection, or application of a
substance.
 Behavioral and psychiatric problems relating to pediatric patients may range from out-ofcontrol behavior to a suicide attempt.
 Most pediatric fevers are caused by viral infections that are often mild and self-limiting.
In other cases, fever is a symptom of a more serious bacterial infection.
 Child abuse or maltreatment comes in many forms: physical abuse, sexual abuse,
emotional abuse, and child neglect.
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The sudden death of an apparently healthy baby is devastating to families and the EMS
crew that responds to the call.
An apparent life-threatening event (ALTE) is an episode during which an infant becomes
pale or cyanotic; chokes, gags, or has an apneic spell; or loses muscle tone.
Pediatric trauma is the leading cause of death among children older than 1 year.
Motor vehicle crashes cause the most deaths in this age group, followed by falls and
submersions.
Among adolescents, homicide and suicide are major causes of death.
The initial assessment and management of pediatric burn victims is similar to that of
adults, with a few key differences.
The larger skin surface–body mass ratio of children makes them more susceptible to heat
and fluid loss.
Worrisome patterns of injury or suspicious circumstances should raise concerns of child
abuse.
Children with special health care needs include children with physical, developmental,
and learning disabilities.
These disabilities have a broad range of causes, including premature birth, traumatic
brain injury, congenital anatomic anomalies, and acquired illnesses.
Advances in technology and drugs have enabled an increasing number of children with
disabilities to receive care in the community, leading to a corresponding increase in the
number of EMS calls for this medically complex population.
Emergency care for children involves a team approach by health care professionals in the
community and in the hospital.