Published - Thu, 04 Aug 2022

HOW TO EVALUATE ILL PEDIATRIC PATIENT

HOW TO EVALUATE ILL PEDIATRIC PATIENT

1. A primary survey should be performed immediately.

a) Airway: The patency of the airway needs to be evaluated.

— To remove tongue obstruction, the airway should be freed with external techniques.

— Obstruction from foreign bodies should be recognized and relieved.

— Gas exchange should be assessed and optimized.

— Aspiration of gastric or oral contents should be prevented.

— An artificial airway should be provided if no protective reflexes exist.

b) Breathing: The adequacy of ventilation should be assessed, including the equality of chest rise and breath sounds.

— A determination of whether air entry is impaired from a central or pulmonary cause should be made.

— Ventilation should be enhanced if necessary with mouth-to-mouth breathing, bag-mask ventilation, or endotracheal intubation with or without bag assistance.

— A surgical airway should be provided if an oral or endotracheal airway cannot be established.

c) Circulation should be assessed, including the quality and intensity of pulses in the upper and lower extremity and blood pressure.

— Hemorrhages should be controlled with direct pressure until surgical intervention can be accomplished.

— Intravenous vascular access and a resuscitative fluid bolus should be provided; if intravenous access cannot be rapidly achieved, intraosseous access should be performed.

— External cardiac massage should be provided if no pulse exists.

— Pharmacologic management of circulation should be provided if the fluid status is adequate and cardiac output is impaired because of either vascular or pump instability.

— Conversion of dangerous cardiac rhythm disturbances should be provided if hypotension and unresponsiveness ensue.

d) Neurologic examination: A preliminary assessment should be made according to the following simple scale:

— Alert and responsive to verbal stimuli

— Responsive to verbal stimuli but no spontaneous alertness.

— Responsive only to painful stimuli.

— Unresponsive to any stimuli

e) Overall examination:

— Infants should be unclothed and examined rapidly for injuries.

— Passive heat loss should be prevented by removing wet clothing and by providing external warmth.

— The patient’s core temperature should be obtained to monitor for hypo- or hyperthermia.


2. A secondary survey, entailing a detailed physical examination and history, is then performed.

a) Head

— Evidence of trauma is determined by palpating bony prominences and the maxillae and by inspecting the nose and ears for drainage of cerebrospinal fluid (CSF).

— The existence of dehydration is determined by inspecting the mucosae for evidence of decreased tearing or moisture or sunken eyes.

— The eyes should be inspected for pupillary size and extraocular movements. A funduscopic examination should be performed if possible to assess for the central nervous system (CNS) or toxic involvement.

— The oral cavity should be inspected for odor or discoloration that may imply a toxicologic basis for the condition.

b) Neck

— The neck should be palpated for midline tenderness or deformity.

— Flexion, extension, and rotation should be performed only after an injury have been excluded either clinically or by radiographic means.

c) Chest

— The chest wall should be inspected for symmetric expansion or disarticulation.

— Palpation for change in respiratory fremitus or inequality should be performed.

— Auscultation of the chest for breath sounds and evidence of adventitial sounds such as rales, rhonchi, or wheezes should be performed.

— Penetrating or blunt chest trauma is treated immediately.

d) Abdomen

— The abdominal wall should be inspected for bruising, penetration, or hematoma.

— Palpation for trauma, masses, or guarding and rigidity, which may indicate peritonitis, should be performed.

— Palpation of the flanks to search for hematoma or an expanding mass should be performed.

e) Pelvis

— The pelvis should be palpated laterally and in an anteroposterior position for tenderness or instability.

— The perineum should be inspected for lacerations, active bleeding, or hematoma. The urethra and rectum should be inspected for trauma or blood.

— In age-appropriate females, a pelvic and rectal examination should be performed, and pregnancy should be excluded.

f) Extremities

— The extremities should be inspected for signs of abrasion, hematoma, laceration, or deformity.

— Palpation of the bones for instability, tenderness, or deformity should be performed.

g) Neurologic assessment

— Attention should be focused on cranial nerve function, motor function, and sensory function, along with the patient’s level of consciousness.

— The presence or absence of reflexes should be noted.

— Serial examinations for changes in the level of consciousness or loss of neurologic function should be performed.


3. Additional studies are often nonspecific but may provide clues to the diagnosis.

a) Laboratory studies

— Aerobic and anaerobic cultures of blood

— Arterial blood gas (ABG) determination

— Complete blood count (CBC) and differential

— Electrolytes and bicarbonate

— Blood urea nitrogen and creatinine

— Immediate fingerstick glucose and serum glucose

— Urinalysis and urine culture

— Stool culture

b) Radiologic studies

— Abdominal radiography

— Abdominal ultrasonography

— Chest radiography

— Computed tomography (CT) of the head/abdomen

c) Ancillary studies

— Echocardiography

— Electrocardiography

— Lumbar puncture

— Urine for toxicologic analysis


Created by

Rigomo Team

Rigomo is a leading online education platform that offers a wide range of courses to help individuals enhance their skills and achieve their career goals. With our user-friendly interface and expert instructors, we strive to provide high-quality education to everyone, anytime and anywhere. Join us today and take the first step towards a brighter future.

Rigomo is an e-learning platform that was founded in 2019 by a team of dedicated professionals with a passion for revolutionizing the way people learn. The platform offers a range of online courses that cover various industries, including business, technology, healthcare, and more.

Rigomo's courses are designed to be interactive and engaging, with a focus on practical skills that learners can apply in their careers. The platform uses a combination of video lectures, quizzes, and hands-on projects to help learners master the subject matter.

Rigomo is committed to providing affordable and accessible education to people around the world. The platform offers a range of pricing options, including monthly and annual subscriptions, as well as pay-as-you-go options for individual courses.

Since its launch, Rigomo has received numerous accolades for its innovative approach to e-learning. The platform has helped thousands of learners across the globe acquire new skills and advance their careers.

As Rigomo continues to grow, the team remains committed to providing high-quality education that is accessible to all. The platform is constantly updating its courses and features to ensure that learners have access to the latest tools and technologies.

View profile

Comments (0)

Search
Popular categories
Latest blogs
Transforming Emergency Care: The Story Behind Rigomo's Revolutionary PPMMP Course
Transforming Emergency Care: The Story Behind Rigomo's Revolutionary PPMMP Course
In the bustling corridors of a major hospital in Mumbai, Dr. Ayesha Khan felt the pulse of emergency medicine beating at a frantic pace. As a seasoned emergency room physician, she had seen it all — from the heartbreaking to the miraculous. Yet, despite her years of experience, Dr. Khan often felt that something was missing — a gap between the theoretical knowledge she had acquired and the real-world application of managing complex patient scenarios. It was during one critical incident, a complicated case of a diabetic emergency with multiple complications, that the idea for a comprehensive training program began to take shape.Dr. Khan observed that while her team was highly educated, they often hesitated, unsure of the best course of action when standard procedures didn’t align perfectly with the complexities presented by real-life cases. This observation was the seed that grew into the Practical Patient Management Program (PPMMP), developed in collaboration with Rigomo, a pioneer in healthcare education.The Genesis of PPMMPThe journey began with a simple question: How could healthcare professionals bridge the gap between theoretical learning and practical execution? The answer lay in creating a dynamic, interactive, and comprehensive training environment that mirrored real-life medical emergencies more closely than traditional classrooms or online courses ever could.Dr. Khan approached Rigomo with her vision, and together, they crafted a curriculum that was deeply rooted in the realities of medical practice. They decided to focus on a multi-faceted approach, incorporating simulations of emergency scenarios, step-by-step analytical techniques, and patient management strategies under pressure.What Sets PPMMP Apart?From the outset, the PPMMP was designed to be different. It wasn’t just about learning what to do; it was about understanding why, how, and when to do it. The course covers a wide range of emergencies — from metabolic crises like diabetes to respiratory emergencies and anaphylaxis. Each module is built around the latest research and clinical guidelines, ensuring that participants receive the most up-to-date information possible.However, the real magic of the PPMMP lies in its delivery. Recognizing the linguistic diversity of India, the entire course is offered in Hindi, making it accessible to a broader range of healthcare professionals. This decision has democratized access to advanced medical training, particularly benefiting those in rural or underserved areas.A Real-World ImpactOne of the most compelling testimonials comes from Dr. Manav Arora, a young doctor who enrolled in the PPMMP shortly after its launch. During an overnight shift, Dr. Arora faced a severe case of pulmonary embolism — a situation he had only read about in textbooks. Armed with knowledge and hands-on practice from the PPMMP, he was able to lead his team effectively, administer the right interventions, and save a life that night. Dr. Arora credits the PPMMP for his confidence and quick decision-making skills.Looking AheadToday, the PPMMP is not just a course but a movement. It’s about empowering doctors, nurses, and paramedics with the confidence to take bold, informed actions in critical situations. As healthcare continues to evolve, Rigomo is committed to updating the curriculum to include new findings, techniques, and technologies.The success story of the PPMMP is a testament to the power of innovative thinking in education and the profound impact it can have on healthcare delivery. It stands as a beacon for future endeavors in medical training, highlighting the crucial link between knowledge and action in saving lives.The Practical Patient Management Program has grown significantly since its inception, touching the lives of numerous healthcare professionals across India. The course’s success has encouraged other institutions to look towards similar models of integrated, practical training programs. To learn more about the PPMMP or to enroll in this transformative course, please visit PPMMP at Rigomo https://ppmp.rigomo.com. By joining this program, you not only gain access to advanced medical training but also become part of a community dedicated to excellence in healthcare services. The platform’s easy-to-navigate interface and comprehensive resources ensure that every participant can maximize their learning potential and truly make a difference in their professional environments.

Sun, 12 May 2024

Empowering Rural Healthcare: How Pogiko's AI is Bridging the Gap in Medical Services
Empowering Rural Healthcare: How Pogiko's AI is Bridging the Gap in Medical Services
Access to quality healthcare remains a significant challenge in rural regions, where the scarcity of medical resources and professionals exacerbates health disparities. Pogiko, an innovative AI-powered tool from Rigomo Technologies, is emerging as a transformative solution to these challenges. This article delves deeper into how Pogiko is enhancing healthcare delivery in underserved areas.Technological Innovation Meets Rural Medicine Pogiko utilizes advanced AI algorithms to perform functions like disease diagnosis, medical report analysis, and case management, traditionally reserved for specialists in well-equipped urban centers. By automating these complex tasks, Pogiko provides rural doctors with the capabilities of a virtual specialist team, enabling them to offer comprehensive medical care even in resource-limited settings.Immediate Benefits of AI in Rural HealthcareEnhanced Diagnostic Accuracy: Pogiko's AI quickly interprets symptoms and medical data, providing accurate diagnostics that are crucial in areas where specialist consultation is rare or delayed.Decision Support: It offers real-time decision support to healthcare providers, aiding them in treatment planning and management, thus minimizing the risks associated with delayed care.Education and Training: Through regular updates and learning tools, Pogiko keeps rural healthcare providers abreast of the latest medical advancements and treatment protocols, significantly improving their knowledge base without the need for frequent travel for training.Case Management and Remote Assistance With Pogiko, rural healthcare practitioners can manage multiple cases efficiently, with AI suggesting the most effective treatment plans based on the latest guidelines and patient data. Additionally, its ability to facilitate remote consultations helps bridge the distance between rural practitioners and specialists in urban centers, fostering a collaborative approach to patient care.Long-Term Impact and Scalability The scalability of AI tools like Pogiko promises a broader reach, potentially transforming healthcare delivery in remote areas globally. By providing high-quality medical advice and support, Pogiko helps reduce healthcare inequalities, ensuring that rural populations have better health outcomes and access to advanced care practices.Pogiko exemplifies how AI can play a pivotal role in not just supporting but significantly enhancing healthcare in rural areas. As technology advances, the potential for AI to serve as a cornerstone in rural healthcare systems becomes increasingly evident, offering a beacon of hope for regions still struggling with the basics of medical care.

Thu, 25 Apr 2024

Advancements in the Treatment of Pulmonary Embolism: What's New in 2024?
Advancements in the Treatment of Pulmonary Embolism: What's New in 2024?
Artificial Intelligence in DiagnosisAdvancements in Endovascular TherapiesPersonalized Treatment ApproachesNew Pharmacological TreatmentsMultidisciplinary Care TeamsThe landscape of pulmonary embolism treatment in 2024 is characterized by rapid advancements in technology, personalized medical approaches, and the development of safer, more effective therapies. These innovations not only improve the quality of care received by patients but also significantly increase survival rates and enhance the quality of life following a PE diagnosis. As research continues and technologies evolve, we can expect even more impressive strides in the treatment of this challenging condition.

Wed, 24 Apr 2024

All blogs