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Advanced Study | Pediatrics

Neonate –        Birth to 1 month

Young Infant – 1 to 5 months

Infant –           6-12 months, may have fear of separation, minimize separation, decrease parental anxiety

Toddler –         1-3 years, may fear separation, loss of control, keep it simple, play with equipment, do not ask permission – they will refuse

Preschooler –   3-5 years, fear bodily injury/mutilation, loss of control, the dark, being alone, keep it simple, be honest

School Age –    6-12 years, fear bodily injury/mutilation, loss of control, death, provide choices, explain longer term consequences

Adolescent –     12 to 15 years, fear loss of control, altered body image, peers, allow them to be part of the decision regarding their care, give info sensitively, be honest, teach coping

Anatomical Differences:

Occlusion of the airway is one of the major causes of pediatric death in the prehospital setting

  • Airway is smaller and more likely to get obstructed
    • Larger tongue in proportion to the mouth
    • Large, floppy epiglottis
    • Airway is narrowest at the cricoid cartilage
    • Vocal cords are more superior and more anterior than an adult’s (around 1st or 2nd vertebra)
  • Skeletal structure is smaller
    • Internal organs packed in a smaller space
    • High incidence internal injuries – most often the liver
    • More multisystem injures
    • Bones are softer break less, bend more
  • Head is much larger in proportion to an adult
    • Large, heavy head exerts pressure on spine
    • Fontanelles (soft spots) on the tops of infant’s heads til 18-24 months
  • Bulge with pressure
  • Depressed with dehydration
  • Nervous system more immature
    • Nerves less well insulated
    • Nerves less well-developed
    • Does not know how to move out of the way of an object

Approaching the Pediatric Patient

  • Keep control of the scene
  • Keep parents informed and calm
  • Get the child’s age and weight
  • What is the level of comprehension?
  • Who can offer emotional support
  • Who knows the medical history

Family-centered Care: involves the parent/guardian in care of the pediatric patient

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