Pediatric emergency medicine trisk 0160 0160
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The vast majority (>80%) of children are seen in community (nonpediatric) EDs.
Indeed, 50% of U.S. EDs see fewer than 10 children per day, and most encounter
critically ill children only a few times per year. There are several strategies that can be
implemented in general EDs in order to increase readiness for pediatric patients and
to help standardize key components of pediatric care for common medical diseases.
Evidence- and consensus-based guidelines facilitate translation of evidence into
bedside care. Some examples include: AAP guidelines for treatment of bronchiolitis,
acute otitis media, and febrile UTI; IDSA guidelines for treatment of skin and soft
tissue infections and community-acquired pneumonia; NHBLI guidelines for
management of asthma. Additionally, several pediatric institutions have developed
evidence-based pathways for treatment of common pediatric conditions. Both Seattle
Children’s Hospital and The Children’s Hospital of Philadelphia have made these
pathways available to all clinicians on the internet.
KEY POINTS
In the primary survey, clinicians should rapidly assess ABCDEs (airway,
breathing, circulation, disability, exposure and environment) and address
threats to airway, breathing, circulation, or neurologic status.
An efficient secondary survey—including a targeted history—offer clues to
the assessment and diagnosis of an acutely ill child.
Healthcare providers should offer a child’s family the opportunity to be
present during resuscitations and procedures whenever a support person
is available.
Institutions should invest time and resources into periodic multidisciplinary
training sessions for their providers to refresh pediatric resuscitation skills
in their own environment with their own equipment and resources.
Suggested Readings and Key References
Advanced Trauma Life Support Student Course Manual: Chapter 10: Pediatric
Trauma
.
10th
ed.
2018.
Available
at
.
Ahmed OZ, Webman RB, Sheth PD, et al. Errors in cervical spine immobilization
during pediatric trauma evaluation. J Surg Res 2018;228:135–141.
American Academy of Pediatrics, American College of Emergency Physicians. In:
Fuchs S, Yamamoto L, eds. APLS: The Pediatric Emergency Medicine Resource .
5th ed. Sudbury, MA: Jones and Bartlett Learning, 2012.
de Caen AR, Berg MD, Chameides L, et al. Part 12: pediatric advanced life support:
2015 American heart association guidelines update for cardiopulmonary
