NREMT EMT 2: Primary Assessment - Pediatric Primary Assessment Considerations

What This Is: Pediatric Primary Assessment Considerations

When a child is injured or ill, every minute counts. A pediatric primary assessment is a quick check to see if the child is okay. It's like doing a "status check" on a car before driving it – you want to make sure everything is working properly. If you're a parent, caregiver, or bystander, knowing what to do in an emergency can save a child's life.

Key Steps / Core Facts:

• Scene Safety: Check for danger (oncoming traffic, fire, etc.). This matters because you don't want to put yourself or others at risk. Example: If a child is lying in the middle of the road, move them to a safe spot first.
• Child's Airway: Check if the child's airway is clear (no blockages). This matters because if the airway is blocked, the child can't breathe. Example: If a child is choking, try to dislodge the object with the back of a spoon.
• Breathing: Check if the child is breathing normally (rate, depth, effort). This matters because abnormal breathing can be a sign of a serious problem. Example: If a child is breathing only 6-8 times per minute, it's not normal.
• Circulation: Check if the child's heart is beating normally (pulse, blood pressure). This matters because poor circulation can lead to organ damage. Example: If a child's pulse is less than 60 beats per minute, it's not normal.
• Pain: Check if the child is in pain (ask them, look for signs). This matters because pain can indicate a serious injury. Example: If a child is holding their arm and crying, they might be in pain.
• Neurological: Check if the child is alert and responsive (AVPU: Alert, Voice, Pain, Unresponsive). This matters because neurological problems can be life-threatening. Example: If a child is unresponsive, start CPR.
• Medical History: Ask about the child's medical history (allergies, conditions). This matters because some conditions require special treatment. Example: If a child has a peanut allergy, avoid giving them peanut products.
• Injury Assessment: Look for signs of injury (cuts, bruises, broken bones). This matters because some injuries require immediate attention. Example: If a child has a broken arm, immobilize it to prevent further injury.
• Vital Signs: Check the child's vital signs (temperature, pulse, breathing rate). This matters because abnormal vital signs can indicate a serious problem. Example: If a child's temperature is over 104°F, it's not normal.
• Red Flags: Watch for danger signs (seizures, difficulty breathing, etc.). This matters because red flags can indicate a life-threatening condition. Example: If a child is having a seizure, call 911 immediately.

What Laypeople Can Do:

• If a child is choking, try to dislodge the object with the back of a spoon.
• If a child is unresponsive, start CPR (30:2 ratio).
• If a child is bleeding, apply pressure to the wound with a clean cloth.
• If a child is having a seizure, turn them onto their side and clear the area.
• If a child is having difficulty breathing, call 911 and try to keep them calm.

Common Mistakes:

• Mistake: Not checking the child's airway first.
• Fix: Always check the airway before checking breathing. This is because a blocked airway can prevent the child from breathing.
• Mistake: Not calling 911 immediately in an emergency.
• Fix: Call 911 right away if you think the child is seriously injured or ill. This is because every minute counts in an emergency.
• Mistake: Not asking about the child's medical history.
• Fix: Ask about the child's medical history to make sure you're providing the right treatment. This is because some conditions require special care.

Quick Practice Scenarios:

• A 2-year-old child is lying on the floor, unresponsive, and not breathing. What should you do first?
• Answer: Start CPR (30:2 ratio) because the child is unresponsive and not breathing.

• Reason: CPR can help restore blood flow and breathing in the child.

• A 5-year-old child is having a seizure and is foaming at the mouth. What should you do first?

• Answer: Turn the child onto their side and clear the area because seizures can cause the child to choke on their own saliva.

• Reason: This can help prevent the child from choking and make it easier for them to breathe.

• A 10-year-old child is bleeding profusely from a cut on their arm. What should you do first?

• Answer: Apply pressure to the wound with a clean cloth because bleeding can lead to shock.
• Reason: This can help stop the bleeding and prevent the child from going into shock.

Last-Minute Exam Cram:

• Normal breathing rate for a child: 12-20 breaths per minute.
• Normal pulse rate for a child: 70-100 beats per minute.
• CPR ratio: 30:2 (30 chest compressions, 2 breaths).
• AVPU: Alert, Voice, Pain, Unresponsive.
• SAMPLE: Situation, Activity, Medications, Allergies, Last meal, Events.
• OPQRSTI: Onset, Provocation, Quality, Region, Severity, Time, Insurance.
• Agonal breathing is NOT normal breathing – start CPR.
• If a child is having a seizure, call 911 immediately.
• If a child is bleeding profusely, apply pressure to the wound with a clean cloth.
• If a child is having difficulty breathing, call 911 and try to keep them calm.