Pediatric emergency medicine trisk 3030 3030

Initial life support phase
Airway: Maintain patency, assess protective reflexes
Breathing: Adequate tidal volume?
ABG or ETCO2 ?
Circulation: Secure IV access, assess perfusion
Disability: Level of consciousness (AVPU or GCS)
Pupillary size, reactivity
Drugs: Dextrose (rapid bedside test)
Oxygen
Naloxone
(Other ALS medications)
Decontamination: Ocular—copious saline lavage
Skin—copious water, then soap and water
GI—consider options
Evaluation and detoxification phase
History —Brief, focused
Known toxicant: Estimate amount
Elapsed time
Early symptoms
Home treatment
Significant underlying conditions
Suspected but unknown toxicant—consider poisoning if:
Patient: Acute onset of illness
Pica-prone age
History of pica, ingestions
Current household “stress”
Multiorgan system dysfunction
Significantly altered mental status
Puzzling clinical picture
Family: Medications at home
Recent illness (under treatment)

Social: Grandparents visiting
Holiday parties, other events, new baby
Physical examination
Vital signs