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Emergency Care

Emergency Care. Emergency Care. Triage. To “pick or sort”. Goals of triage: Rapidly identify seriously injured. Prioritize all patients using the emergency department. Initiate therapeutic measures. Airway Breathing Circulation Disability Exposure Fahrenheit. Get vital signs

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Emergency Care

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  1. Emergency Care

  2. Emergency Care

  3. Triage • To “pick or sort”. • Goals of triage: • Rapidly identify seriously injured. • Prioritize all patients using the emergency department. • Initiate therapeutic measures.

  4. Airway Breathing Circulation Disability Exposure Fahrenheit Get vital signs Head to toe Inspect isolate Assessment

  5. Focused Health History • History of complaint • Identifying data • Allergies • Current medications including OTC • Past medical history • Immunizations / tetanus • Health care provider

  6. CBC to detect infection, immune response, or blood loss. Increase WBC = infection Decrease WBC = neutropenia Decreased hgb / hct = blood loss Type and cross match Electrolytes Glucose Laboratory Tests

  7. Diagnostic Tests • X-rays • CT scan • ultrasound

  8. Poisoning • Over a million children are poisoned annually. • Ages of risk are 2 to 4 years and adolescents. • Common poisons ingested: • Iron, lead, acetaminophen, hydrocarbons, liquid Drano, and plants.

  9. Focus History • What was ingested? • How much was ingested? • When did it occur? • What therapy was initiated before arrival in the ER?

  10. AAP Recommendations • AAP – American Academy of Pediatrics • Syrup of Ipecac no longer be used routinely in the home to induce vomiting. • Research has failed to show benefit for children who were treated with Ipecac. • Prevention is the best defense against unintentional poisoning

  11. Parent Teaching • Post the universal phone number for poison control center near the telephone • 1-800-222-1222 • Call 911 in the case of convulsions, cessation of breathing or unconsciousness • Do not make your child vomit

  12. Emergency Treatment • Always assess the child to determine the care: airway, breathing, LOC • History of what substance was swallowed • Ask parent to bring in container or sample of substance swallowed • Activated charcoal may be given to help absorb substance ingested

  13. Lead Poisoning • There are about 1.7 million children with elevated lead levels. • A large proportion are poor, African-American, Mexican-American, and living in urban areas. • Children are more susceptible because they absorb and retain lead.

  14. Lead Poisoning • Lead interferes with normal cell function, and adversely affects the metabolism of vitamin D and calcium. • Clinical manifestations depend on degree of toxicity. • Neurologic effects include decreased IQ scores, cognitive deficits, impaired hearing, and growth delays.

  15. Lead Poisoning • Sources of lead: • Lead based paint • Soil and dust • Drinking water from lead lined pipes • Food growth in contaminated fields • Contamination from occupations or hobbies

  16. Lead Levels • 10 to 19 dL mild lead poisoning • Do a home assessment / repeat in 3-4 months • 20 to 44 dL moderate lead poisoning • May start oral chelation therapy • 45 to 69 dL severe lead poisoning • Considered medical emergency

  17. Prevention of Lead Poisoning • Washing hands and toys • Low-fat diet • Check home for lead hazards • Regularly clean home • Take precautions when remodeling or working on old cars, furniture, or pottery. • Call 1-800-424-lead for guidelines

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