Systematic Approach to Pediatric Assessment Respiratory Circulatory Initial Impression Respiratory Distress Compensated Shock Consciousness Or Or Respiratory Failure Hypotensive Shock Breathing Upper airway obstruction Hypovolemic shock Color Lower airway obstruction Distributive shock Lung tissue disease Cardiogenic shock Evaluate Identify - Intervene – Disordered control of Obstructive shock breathing A continuous sequence. Cardiopulmonary Failure **Determine if problem is life threatening. Cardiac Arrest INTERVENE EVALUATE Positioning the child to maintain a patent airway PRIMARY ASSESSMENT Activating emergency response Airway Starting CPR Breathing Obtaining the code cart and monitor Circulation Placing the on a cardiac monitor and Disability pulse oximeter Exposure Administering 02 Supporting ventilation SECONDARY ASSESSMENT Starting medications and fluids Pediatric Assessment Flowchart nebulizer, IV/IO fluid bous SAMPLE History S- Signs & symptoms (What hurts?) An intubated patient’s condition deteriorates; A- Allergies consider the following possibilities (DOPE): M- Medications Displacement of the tube from the trachea P- Past medical history Obstruction of the tube L- Last meal Pneumothorax E- Events Preceding the Injury Equipment failure What Happened 6 Hs 5 Ts -Search for Reversible Causes DIAGNOSTIC TESTS Hypoxia or ventilation problems ABG, Venous blood gas, arterial lactate Hypovolemia Central venous 02 saturation, CVP Hypothermia CXR, ECG, Echo Hypoglycemia Peak expiratory flow rate Hypo /hyper kalemia Hydrogen ion (acidosis) T amponade, cardiac T ension pneumothorax IDENTIFY T oxins poisons, drugs – T hrombosis coronary (AMI) – T hrombosis pulmonary (PE) Categorize Illness by Type and Severity – Shock
Systematic Approach to Pediatric Assessment Initial Impression Consciousness Breathing Color Evaluate – Identify - Intervene A continuous sequence. **Determine if problem is life threatening. EVALUATE PRIMARY ASSESSMENT Airway Breathing Circulation Disability Exposure SECONDARY ASSESSMENT Pediatric Assessment Flowchart SAMPLE History S- Signs & symptoms (What hurts?) A- Allergies M- Medications P- Past medical history L- Last meal E- Events Preceding the Injury What Happened DIAGNOSTIC TESTS ABG, Venous blood gas, arterial lactate Central venous 02 saturation, CVP CXR, ECG, Echo Peak expiratory flow rate IDENTIFY Categorize Illness by Type and Severity Respiratory Circulatory Respiratory Distress Or Respiratory Failure Compensated Shock Or Hypotensive Shock Upper airway obstruction Lower airway obstruction Lung tissue disease Disordered control of breathing Hypovolemic shock Distributive shock Cardiogenic shock Obstructive shock Cardiopulmonary Failure Cardiac Arrest INTERVENE Positioning the child to maintain a patent airway Activating emergency response Starting CPR Obtaining the code cart and monitor Placing the on a cardiac monitor and pulse oximeter Administering 02 Supporting ventilation Starting medications and fluids nebulizer, IV/IO fluid bous An intubated patient’s condition deteriorates; consider the following possibilities (DOPE): Displacement of the tube from the trachea Obstruction of the tube Pneumothorax Equipment failure 6 Hs 5 Ts -Search for Reversible Causes Hypoxia or ventilation problems Hypovolemia Hypothermia Hypoglycemia Hypo /hyper kalemia Hydrogen ion (acidosis) T amponade, cardiac T ension pneumothorax T oxins – poisons, drugs T hrombosis – coronary (AMI) T hrombosis – pulmonary (PE) Shock
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