Ready for Review
 Sudden illnesses and medical emergencies are common in children and infants.
Because the anatomy of children and infants differs from that of adults, special
knowledge and skills are needed to assess and treat pediatric patients.
 Managing a pediatric emergency can be a stressful situation for emergency medical
responders. Because both the child and the parents may be frightened and anxious,
you must behave in a calm, controlled, and professional manner.
 A child’s airway is smaller in relation to the rest of the body; therefore, secretions and
swelling from illnesses or trauma can more easily block the child’s airway. Because
the tongue is relatively larger than the tongue of an adult, a child’s tongue can more
easily block the airway. Hyperextension of a child’s neck can occlude the airway.
 The child who is unresponsive, lackluster, and appears ill should be evaluated
carefully because the lack of activity and interest signal serious illness or injury. After
you conduct your primary assessment, you should carry out the routine patient
examination, paying special attention to mental awareness, activity level, respirations,
pulse rate, body temperature, and color of the skin.
 The pediatric assessment triangle is designed to give you a quick general impression
of the child using only your senses of sight and hearing. The three components of the
pediatric assessment triangle are overall appearance, work of breathing, and
circulation to the skin.
 It is important for you to open and maintain the patient’s airway and to ventilate
adequately any child with respiratory problems. Otherwise, the child may experience
respiratory arrest, followed by cardiac arrest.
 Cardiopulmonary resuscitation for children and infants differs from adult
cardiopulmonary resuscitation in several important ways. You should be certain that
you understand these differences and are able to perform the appropriate steps
confidently in the field.
 Suctioning removes foreign substances that you cannot remove with your gloved
fingers from the airway of a child. Oral airways can be used to maintain an open
airway after you have opened the child’s airway by manual means.
 Young children often obstruct their upper and lower airway with foreign objects, such
as small toys or candy. If the object is only partially blocking the airway, the child
should be able to pass some air around it. You should attempt to remove the object
only if it is clearly visible and you can remove it easily.
 In complete or severe airway obstruction in a conscious child, you should perform the
Heimlich maneuver (abdominal thrusts). If the child becomes unresponsive, you
should begin cardiopulmonary resuscitation.
 To relieve an airway obstruction in an infant, use a combination of back slaps and
chest thrusts.
 Children in respiratory distress require immediate medical attention. Signs of
respiratory distress include a rapid or slow breathing rate, nasal flaring, retraction of
the skin between the ribs and around the neck muscles, stridor, cyanosis, altered
mental status, and combativeness. Respiratory distress can lead to respiratory failure,
which in turn can lead to circulatory failure.
 Three serious respiratory problems in pediatric patients are asthma, croup, and
epiglottitis. A child who has asthma is usually already being treated for the condition






by a physician; your primary treatment consists of calming and reassuring the parents
and the child. Croup is an upper airway infection that results in a barking cough.
Although epiglottitis resembles croup, it is a serious respiratory emergency and you
must arrange for prompt transport.
Other pediatric medical emergencies include drowning, heat-related illnesses such as
heatstroke, high fevers, seizures, vomiting and diarrhea, and abdominal pain.
Children’s natural curiosity may lead them to sample medications or household items
that contain poisonous substances. The two most common types of poisonings in
children are caused by ingestion (taken by mouth) and absorption (entering through
the skin).
Sudden infant death syndrome, also called crib death, is the unexpected death of an
apparently healthy infant. You should know your local guidelines for the management
of sudden infant death syndrome. Remember that the parents could do nothing to
prevent the death.
When caring for pediatric trauma patients, remember that you may have to adapt
materials and equipment to the child’s size. Also remember that children do not show
signs of shock as early as adults, although they can progress into severe shock
quickly.
Major trauma in children usually results in multiple system injuries. Your first
priority is always to check the ABCs and then stop severe bleeding, treat for shock,
and proceed with the physical examination.
If you suspect child abuse or sexual assault, you must transport the child to an
appropriate medical facility.