Your most feared calls: assessing & treating pediatric patients with undiagnosed pre-existing conditions.
During the past several years, EMTs and paramedics have seen more and more children with underlying health conditions, including children with special health-care needs (CSHCN). Advances in medical knowledge, improved technology and more affordable medical equipment have allowed CSHCN to be cared for at home rather than in specialized facilities. As a result, when these children become ill or injured, EMS is called to assist the family in caring for them. The families are typically experts in providing the patient's history and assisting EMS with equipment and devices. However, some pediatric calls can keep you guessing. The patient has no known pre-existing conditions, and the family may be extremely panicked and upset by the emergency. What causes tachypnea, altered mental status (AMS) and seizures in children? How do you assess and treat those causes? The following cases involve actual patients who were seen by an urban ambulance service. Consider how each case presented to the crews, and how you would assess and treat the patients.
Warren
Linda
L
Department of Emergency Medicine, University of New Mexico, Albuquerque, USA. LWarren@salud.unm.edu
Sapien
Robert
R
D000293:Adolescent; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics