❤️‍🩹First Aid Unit 15 – Emergencies: Pediatric, Geriatric & Pregnancy

Key Concepts

• Understand the unique physiological differences in pediatric, geriatric, and pregnant patients that impact emergency care
• Recognize age-specific vital signs and normal ranges for pediatric and geriatric patients
• Identify common medical emergencies and injuries specific to each patient population
• Adapt assessment techniques and treatment protocols to accommodate the special needs of these patient groups
• Consider the emotional and psychological impact of emergencies on pediatric, geriatric, and pregnant patients and their families
• Maintain a calm and reassuring demeanor while providing care to these vulnerable populations
• Prioritize the safety and well-being of both the patient and the first responder during emergency situations

Pediatric Emergencies

• Respiratory emergencies (croup, epiglottitis, asthma) are common in children due to their smaller airways and increased susceptibility to infections
• Choking is a significant risk in young children, as they may put small objects in their mouths or have difficulty chewing and swallowing food properly
  • Perform age-appropriate choking interventions (back blows, chest thrusts, or abdominal thrusts) based on the child's size and age
• Febrile seizures can occur in children aged 6 months to 5 years due to rapid changes in body temperature during a fever
• Accidental poisoning is a concern in pediatric patients, as they may ingest harmful substances or medications
  • Contact poison control and follow their guidance for treatment based on the substance ingested
• Fractures and dislocations in children may involve growth plates, requiring specialized care to prevent long-term complications
• Burns are a common pediatric injury, with scalds from hot liquids being the most prevalent
• Children are more susceptible to heat-related illnesses (heat exhaustion, heat stroke) due to their underdeveloped thermoregulatory systems

Geriatric Emergencies

• Falls are a leading cause of injury in older adults, often resulting in fractures (hip, wrist, vertebrae), head trauma, and internal bleeding
• Cardiovascular emergencies (heart attack, stroke, arrhythmias) are more common in geriatric patients due to age-related changes and underlying health conditions
  • Recognize atypical symptoms of heart attack and stroke in older adults, such as confusion, weakness, or dizziness
• Polypharmacy (taking multiple medications) increases the risk of adverse drug reactions and interactions in geriatric patients
• Dehydration can occur more quickly in older adults due to decreased thirst sensation, medication side effects, and chronic health conditions
• Hypothermia is a concern in geriatric patients, as they may have impaired thermoregulation and be more susceptible to cold environments
• Cognitive impairment (dementia, Alzheimer's disease) can complicate assessment and treatment of geriatric patients in emergency situations
• Skin tears and pressure ulcers are common in older adults due to fragile skin and reduced mobility, requiring careful handling and wound care

Pregnancy-Related Emergencies

• Vaginal bleeding during pregnancy can indicate complications such as miscarriage, placental abruption, or placenta previa
  • Assess the amount and nature of the bleeding and provide appropriate care based on the stage of pregnancy and suspected cause
• Preterm labor (before 37 weeks gestation) can lead to premature birth and associated complications for the mother and baby
• Eclampsia is a severe complication characterized by seizures in pregnant women with pre-eclampsia (high blood pressure and protein in the urine)
• Postpartum hemorrhage is excessive bleeding following childbirth, which can lead to rapid blood loss and shock
  • Perform fundal massage, administer medications (oxytocin, misoprostol), and prepare for potential blood transfusion
• Ectopic pregnancy occurs when a fertilized egg implants outside the uterus (usually in the fallopian tube), causing pain and potentially life-threatening bleeding
• Amniotic fluid embolism is a rare but severe complication in which amniotic fluid enters the mother's bloodstream, causing respiratory distress and cardiovascular collapse
• Trauma during pregnancy requires careful assessment and treatment to ensure the safety of both the mother and the fetus

Assessment Techniques

• Use age-appropriate communication strategies and language when assessing pediatric, geriatric, and pregnant patients
• Obtain a thorough medical history, including medications, allergies, and pre-existing conditions, from the patient or caregiver
• Assess vital signs using age-specific normal ranges and techniques (e.g., using a pediatric blood pressure cuff for children)
• Perform a focused physical examination based on the patient's chief complaint and suspected condition
  • Be gentle and explain each step of the examination to minimize discomfort and anxiety
• Utilize pain scales appropriate for the patient's age and cognitive abilities (e.g., FACES scale for children, numeric rating scale for adults)
• Assess mental status and cognitive function in geriatric patients using tools like the Mini-Mental State Examination (MMSE) or the Glasgow Coma Scale (GCS)
• Monitor fetal heart rate and uterine contractions in pregnant patients presenting with abdominal pain or vaginal bleeding
• Adapt assessment techniques to accommodate sensory impairments (hearing loss, vision problems) or mobility limitations in geriatric patients

Treatment Protocols

• Follow age-specific dosing guidelines for medications and fluids in pediatric and geriatric patients
  • Use weight-based dosing for pediatric patients and adjust doses based on renal function in geriatric patients
• Prioritize airway management and oxygenation in all patient populations, using age-appropriate equipment (pediatric-sized masks, nasal cannulas)
• Provide age-specific pain management techniques, such as distraction or comfort measures for children and non-pharmacological interventions for geriatric patients
• Administer glucose for pediatric and geriatric patients presenting with altered mental status or suspected hypoglycemia
• Follow obstetric emergency protocols for managing pregnancy-related complications, such as positioning the patient on their left side to alleviate pressure on the vena cava
• Collaborate with medical control or specialty resources (pediatric, geriatric, or obstetric consultants) for guidance on complex cases or treatment decisions
• Ensure proper immobilization and splinting techniques for fractures and dislocations, taking into account the patient's age and size
• Provide emotional support and reassurance to patients and their families throughout the treatment process

Special Considerations

• Be aware of the potential for abuse or neglect in pediatric and geriatric patients, and report suspicions to the appropriate authorities
• Consider cultural, religious, or personal beliefs that may impact treatment preferences or decision-making in these patient populations
• Recognize the importance of family-centered care and involve caregivers or support persons in the assessment and treatment process when appropriate
• Address the unique emotional and psychological needs of pediatric, geriatric, and pregnant patients, providing reassurance and age-appropriate explanations
• Ensure proper consent is obtained for treatment, taking into account the patient's age, cognitive abilities, and legal guardianship status
• Consider the impact of sensory impairments, mobility limitations, or communication barriers on the patient's ability to understand and participate in their care
• Maintain patient privacy and dignity during assessment and treatment, particularly with sensitive examinations or procedures
• Plan for safe transport and transfer of care to age-appropriate facilities or specialists when necessary

Common Mistakes to Avoid

• Failing to recognize age-specific differences in anatomy, physiology, and normal vital sign ranges, leading to misdiagnosis or inappropriate treatment
• Overlooking the potential for atypical presentations of common conditions in pediatric, geriatric, and pregnant patients
• Underestimating the severity of pain or discomfort in patients who may have difficulty communicating or expressing their symptoms
• Neglecting to consider the impact of pre-existing medical conditions, medications, or allergies on the patient's current presentation and treatment options
• Inadequate monitoring of vital signs, mental status, or fetal well-being during assessment and treatment
• Failing to provide age-appropriate emotional support and reassurance to patients and their families, leading to increased anxiety and distress
• Overlooking the potential for abuse, neglect, or domestic violence in these vulnerable patient populations
• Neglecting to involve medical control, specialty resources, or other healthcare providers when needed for complex cases or treatment decisions