EMS Emergencies - Pediatric Patients

EMS providers need to be well-prepared to handle pediatric emergencies as they require specialized knowledge and skills due to the unique needs of children.

Here are some key points they should know:

1. Respiratory Distress: Children commonly present with respiratory distress due to conditions such as asthma, bronchiolitis, or croup. EMS providers should be proficient in assessing respiratory status, administering oxygen, and managing airway obstructions.

2. Febrile Seizures: Febrile seizures are common in young children and are often frightening for caregivers. EMS providers should know how to assess and manage febrile seizures, including ensuring adequate ventilation and preventing injury during the seizure.

3. Trauma: Children are at risk for various types of trauma, including falls, burns, and motor vehicle accidents. EMS providers should be skilled in assessing and managing pediatric trauma, including immobilization techniques and pain management.

4. Sepsis: Sepsis can be challenging to recognize in children, as symptoms may be nonspecific. EMS providers should be vigilant for signs of sepsis, such as fever, tachycardia, and altered mental status, and be prepared to initiate early treatment.

5. Anaphylaxis: Allergic reactions, including anaphylaxis, can occur in children due to food allergies, insect stings, or medications. EMS providers should be trained in recognizing anaphylaxis and administering epinephrine as needed.

6. Dehydration: Children are at increased risk for dehydration due to factors such as vomiting, diarrhea, or fever. EMS providers should be skilled in assessing hydration status and administering fluids as needed, especially in cases of severe dehydration.

7. Seizures: Seizures can occur in children due to various causes, including epilepsy or febrile illnesses. EMS providers should know how to assess and manage seizures, including protecting the child from injury and administering appropriate medications if necessary.

8. Poisoning: Accidental poisoning is a common pediatric emergency. EMS providers should be familiar with common toxins and their effects on children, as well as appropriate decontamination and treatment measures.

9. Cardiac Arrest: While less common in children than in adults, cardiac arrest can still occur due to various causes, including congenital heart defects or respiratory failure. EMS providers should be proficient in pediatric CPR and advanced life support techniques.

10. Communication & Family Support: Effective communication with caregivers is essential in pediatric emergencies. EMS providers should be skilled in providing clear and compassionate communication, as well as offering support to families during stressful situations.

By being knowledgeable about these common pediatric emergencies and having the necessary skills to assess and manage them effectively, EMS providers can play a crucial role in providing optimal care for children in emergency situations.

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education

Peate, I. & Sawyer, S (2024) Fundamentals of Applied Pathophysiology for Paramedics. Hoboken, New Jersey:  Wiley Blackwell

EMS Neurological Emergencies - Seizure Disorder Classification

Seizure disorders can be classified into several types based on their characteristics and underlying causes. 

Here are some common types of seizure disorders:

Generalized Seizures:

Tonic-Clonic Seizures: These seizures involve loss of consciousness, muscle stiffening (tonic phase), followed by rhythmic jerking of the limbs (clonic phase). They can be associated with convulsions and may result in injuries. Formerly known as Grand Mal Seizures.

Absence Seizures: Absence seizures typically occur in children and involve brief periods of staring or "spacing out." The person may appear to be unaware of their surroundings and may not remember the seizure afterward. Formerly known as Petit Mal Seizures.

Myoclonic Seizures: These seizures involve sudden, brief muscle jerks or twitches, often affecting the arms and legs. They can occur in various epilepsy syndromes.

Atonic Seizures: Atonic seizures cause sudden loss of muscle tone, leading to the person collapsing or falling ("drop attacks"). These seizures can result in injuries due to falls. Also known as Drop Attacks.

Partial (Focal) Seizures:

Simple Partial Seizures: These seizures affect a specific area of the brain and may cause twitching, sensory changes, or other symptoms without loss of consciousness.

Complex Partial Seizures: Complex partial seizures involve altered consciousness or awareness, with or without automatisms (repetitive, purposeless movements) and other behavioral changes. They may start as simple partial seizures and progress to affect larger areas of the brain.

Focal to Bilateral Tonic-Clonic Seizures: Focal seizures that spread to involve both hemispheres of the brain, resulting in generalized tonic-clonic activity.

Other Types:

Febrile Seizures: These seizures occur in young children as a result of fever, typically between the ages of 6 months and 5 years. They are usually brief and do not cause long-term harm.

Psychogenic Non-Epileptic Seizures: Some seizures may mimic epileptic seizures but are not caused by abnormal electrical activity in the brain. These may be due to psychological factors or other medical conditions.

It's important to note that within each type of seizure, there can be variations in presentation and severity. Proper diagnosis and classification of seizures are essential for determining appropriate treatment and management strategies. 

Further Reading:

Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education

Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice Volume 2 (6th Ed) Pearson.

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education

Online Resources:

EpilepsyU

EMS Pediatric Populations - Pediatric Emergencies

EMS providers should have knowledge and skills to effectively manage pediatric emergencies.

Here are some key points they should know:

1. Pediatric Assessment: Understanding the differences in anatomy, physiology, and vital signs between adults and children is crucial. Providers should be skilled in performing a thorough pediatric assessment, including assessing airway, breathing, circulation, disability, and exposure (ABCDE).

2. Airway Management: Pediatric airways are smaller and more easily obstructed than adult airways. Providers should be proficient in managing pediatric airway emergencies, including using appropriate airway adjuncts and techniques such as bag-mask ventilation and endotracheal intubation.

3. Respiratory Distress: Common respiratory emergencies in children include asthma, bronchiolitis, and croup. Providers should be familiar with respiratory assessment, oxygen therapy, and administering nebulized medications.

4. Cardiac Arrest and CPR: Pediatric cardiac arrest requires prompt recognition and intervention. Providers must be skilled in pediatric cardiopulmonary resuscitation (CPR), including chest compressions, ventilation, and the use of automated external defibrillators (AEDs).

5. Fever and Sepsis: Fever is a common presentation in pediatric patients. EMS providers should recognize signs of serious bacterial infections, sepsis, and know how to provide appropriate supportive care during transport.

6. Allergic Reactions: Anaphylaxis and severe allergic reactions can be life-threatening. Providers should be trained in recognizing and managing allergic emergencies, including the administration of epinephrine.

7. Trauma: Pediatric trauma may present differently than adult trauma. Providers should know how to assess and manage common pediatric injuries, including fractures, head injuries, and burns. They should also consider the psychological needs of the child and provide age-appropriate support.

8. Seizures: Seizures can occur in children due to various causes. Providers should be familiar with seizure recognition, seizure management, and appropriate administration of anti-seizure medications.

9. Dehydration: Children are more prone to dehydration due to their smaller fluid reserves. Providers should be able to assess and manage pediatric patients with suspected dehydration, including fluid resuscitation if necessary.

10. Communication and Psychological Support: Effective communication with both the child and their parents or caregivers is vital. Providers should use age-appropriate language, provide reassurance, and involve parents or caregivers in the decision-making process.

These are general considerations, and ongoing training and education in pediatric emergency care are essential for EMS providers to ensure optimal care for children in emergencies.