Pediatric emergency medicine trisk 0148 0148
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TABLE 7.4
HIGH-RISK VITAL SIGNS BY AGE
PRIMARY SURVEY
The goal of the primary survey is to identify and treat impending or existing
respiratory, circulatory, and neurologic failure. This is initiated as soon as the patient
arrives to the ED and is ideally completed in less than 5 minutes, as early recognition
and treatment of deficiencies in ventilation, perfusion, or neurologic function
frequently prevents deterioration to respiratory or cardiac arrest. After each
intervention, it is important to monitor and reassess patients in order to assess for
improvement and to recognize deterioration. All patients with severe trauma are at
risk for cervical spinal injury, and cervical spine immobilization should be maintained
throughout the primary and secondary surveys (see Chapter 112 Neck Trauma ).
The clinician performing the survey should be loud, clear, and organized, while
verbalizing the ABCDE assessment of the patient; other team members perform lifesaving procedures based on the findings of the surveyor (see Chapter 8 Airway ,
Chapter 9 Cardiopulmonary Resuscitation , Chapter 10 Shock , and Chapter 86
Cardiac Emergencies ; Table 7.5 ).
Airway
The treatment of extrathoracic airway compromise includes repositioning the patient
in the sniffing position, suctioning the airway, and placement of a nasopharyngeal or
an oropharyngeal airway. When disease primarily involves the lung and intrathoracic
airways, supplemental oxygen and positive end-expiratory pressure are the mainstay
