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Pediatric Emergency Care Tips

By: Firefighter Michael O. McLeieer, President – E.S.C.A.P.E. Inc.
Adjunct Instructor National Fire Academy,
Training Coordinator Massachusetts Firefighting Academy
(Article from ECSI eNews: February 2013)

Injuries, especially those to children, occur when we least expect them. In fact, many children cannot seem to complete a day without the occasional scrape, bruise, or bump.

As an ECSI instructor, one of the most frequently asked questions I receive from students is, “How do you properly and effectively treat injuries to children?”

The specific treatment will depend on the type of injury or illness , and what type of pain tolerance the child possesses.

Children are likely to become less verbal, crankier, and louder when they are injured or in pain. This can make talking to the child and determining what is wrong quite difficult.

Here are some tips you might share with your students when discussing childhood injuries:

  1. Assess the scene to make sure it is safe to approach the child.
  2. Approach the child slowly and determine the mechanism of injury.
  3. Use a calm voice when speaking with the child and be aware of your own feelings. Children may sense the charged emotions of adults.
  4. Many children are afraid of emergency medical responders because they are strangers. Children may also become scared when injured. Great ways to build rapport include providing stuffed animals to younger children, or bringing up interesting topics to older children, to distract them from their injury or illness.
  5. Acknowledge how the child feels. An injured or ill child will calm down more readily if the child feels that he or she has been heard and that the first aid care provider understands. Sometimes simply saying, “I know,” or, “Uh huh,” is enough. Too many words can be distracting to a young child.
  6. When adults are injured and there are children present (eg,  in an automobile crash), provide a stuffed animal to the uninjured child. This can provide a calming effect.
  7. Most children respond favorably to humor, a song, or a game during the assessment or treatment process.
  8. Depending on the injured child’s maturity level, consider allowing him or her the opportunity to assist in the treatment process (eg, holding a bandage or placing a burn under cool water).

Finally, it will be essential to know the location of the nearest emergency department  equipped to handle pediatric cases that require advanced medical attention.

Remember, caring for a child requires pre-planning, remaining calm, and using good common sense when the unexpected occurs.


Asthma Action Plans

By: Sally Becker, President, EMT I/C
Becker Training Associates

(Article from ECSI eNews: January 2013)

Do you remember the “Vial of Life” and “File of Life” initiatives, started in the early 1980s? These two programs were created to remind people of the importance of having their medical information easily accessible in case of an emergency. The programs, still used today, encourage people to keep their medical information in a “vial” inside of their refrigerator, or in a “file” on the front of their refrigerator. Both initiatives create a simple way to give EMS providers, and other medical personnel visiting a home, an up-to-date medical history, a description of prescription medications, and some information about other pertinent issues that the patient might have. With this information in hand, the medical providers may be able to deliver more accurate patient care.

Asthma Action Plans are similar to the Vial and File of Life programs in that they focus on quickly providing accurate information to caregivers and EMS providers in order to help a patient receive more accurate care during an emergency. Each color on an Asthma Action Plan helps to determine the status of the asthmatic. The patient’s family and caregivers can use the color system to decide whether there is a need to transport the patient to the family provider, or to activate the 911 system. 

When teaching students, make sure they are aware of asthma facts, and encourage them to talk about Asthma Action Plans with their own medical providers. EMS providers should be sure to ask each patient or family about their Asthma Action Plan – and encourage them to ask for one if they don’t have one already! 

Part of our job as educators is to educate our students! They in turn will educate their family, friends, and patients!

Asthma is a chronic disease that can be serious and sometimes life threatening, and can start at any age. It is important that patients are educated about and understand asthma triggers such as allergens, viral infections, air pollution, and aerosolized irritants. Patients should also know how to monitor their symptoms with a peak flow meter. Poor management of asthma can cause airway changes, which can result in permanent scarring and obstruction of the airway. 

Asthma Action Plans guide self-management. They should include the patient’s name, emergency contact, medical provider, asthma severity classification, and a list of personal triggers. Symptoms should be outlined, including: cough, wheeze, chest tightness, decrease in daily functional level, and/or increase of symptoms at night.

Levels of an Asthma Action Plan include the following:

• The GREEN ZONE patient is asymptomatic. This zone is where
   a patient should be on a daily basis. 

• The YELLOW ZONE patient presents with symptoms that are
   relieved with quick-acting meds.

• The RED ZONE patient has severe symptoms that cannot be
   relieved by short acting beta agonist drugs. This patient requires
   immediate medical evaluation or intervention.

The Asthma Action Plan should include a list of medications and indications for using them, as well as directions for what to do in an emergency – call 9-1-1!

Encourage patients to place the Asthma Action Plan on their refrigerator and to have it ready for quick access by EMS.

EMS providers, and family and friends of the patient can ask what ZONE the patient is in. The answer tells it all – it can make a difference in the care and transport of the patient, and can determine the need for advanced level providers. Having an Asthma Action Plan can help eliminate unnecessary 9-1-1 calls, and it can help patients feel that they have more control over their asthma.

Source: American Lung Association.

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