3.  Recognize the acuity and implement
appropriate emergency
management
 Discuss the etiology and natural history
of common pediatric emergencies
 Communicate effectively with
patients, families, nursing staff, EMS
personnel, ancillary service
personnel, referring physicians and
consultants.

4.  Asthma
 Bronchiolitis
 Pneumonia
 Croup
 Foreign Body

5.  Pathophysiology
 Chronic recurrent lower airway disease with
episodic attacks of bronchial constriction
 Precipitating factors include exercise, psychological
stress, respiratory infections, and changes in weather &
temperature
 Occurs commonly during preschool years, but also
presents as young as 1 year of age
 Decrease size of child’s airway due to edema &
mucus leads to further compromise

6.  Assessment
 History
 When was last attack & how severe was it
 Fever
 Medications, treatments administered
 Physical Exam
 SOB, shallow, irregular respirations, increased or decreased
respiratory rate
 Pale, mottled, cyanotic, cherry red lips
 Restless & scared
 Inspiratory & expiratory wheezing, rhonchi
 Tripod position

7.  Management
 Assess & monitor ABC’s
 Big O’s (Humidified if possible)
 IV of LR or NS at a TKO rate
 Assist with prescribed medications
 Prepare for vomiting
 Pulse oximeter
 Intubate if airway management
becomes difficult or fails

8.  Basics
 Respiratory infection of the bronchioles
 Occurs in early childhood (younger than 1 yr)
 Caused by viral infection
 Assessment/History
 Length of illness or fever
 has infant been seen by a doctor
 Taking any medications
 Any previous asthma attacks or other allergy
problems
 How much fluid has the child been drinking

9.  Signs & Symptoms
 Acute respiratory distress
 Tachypnea
 May have intercostal and suprasternal
retractions
 Cyanosis
 Fever & dry cough
 May have wheezes - inspiratory &
expiratory
 Confused & anxious mental status
 Possible dehydration

10.  Management
 Assess & maintain airway
 When appropriate let child pick POC
 Clear nasal passages if necessary
 Prepare to assist with ventilations
 IV LR or NS TKO rate
 Intubate if airway management becomes
difficult or fails

11.  Basics
 Upper respiratory viral infection
 Occurs mostly among ages 6 months to 3
years
 More prevalent in fall and spring
 Edema develops, narrowing the airway
lumen
 Severe cases may result in complete
obstruction

12.  Assessment/History
 What treatment or meds have been
given?
 How effective?
 Any difficulty swallowing?
 Drooling present?
 Has the child been ill?
 What symptoms are present & how have
they changed?

13.  Physical Exam
 Tachycardia, tachypnea
 Skin color - pale, cyanotic, mottled
 Decrease in activity or LOC
 Fever
 Breath sounds - wheezing, diminished
breath sounds
 Stridor, barking cough, hoarse cry or
voice

14.  Management
 Assess & monitor ABC’s
 High flow humidified O2; blow by if child
won’t tolerate mask
 Limit exam/handling to avoid agitation
 Be prepared for respiratory arrest, assist
ventilations and perform CPR as needed
 Do not place instruments in mouth or
throat
 Rapid transport

15.  Basics
 Common among the 1-3 age group who
like to put everything in their mouths
 Running or falling with objects in mouth
 Inadequate chewing capabilities
 Common items - gum, hot dogs, grapes
and peanuts

16.  Assessment
 Complete obstruction will present as
apnea
 Partial obstruction may present as labored
breathing, retractions, and cyanosis
 Objects can lodge in the lower or upper
airways depending on size
 Object may act as one-way valve
allowing air in, but not out

17.  Management – Complete
Obstruction
 Attempt to clear using BLS
techniques
 Attempt removal with direct
laryngoscopy and Magill forceps
 Cricothyrotomy may be indicated

18.  Management - Partial Obstruction
 Make child comfortable
 Administer humidified oxygen
 Encourage child to cough
 Have intubation equipment
available
 Transport to hospital for removal with
bronchoscope

19.  Physical Assessment/Signs & symptoms
 Onset very abrupt
 Sudden jerking of entire body, tenseness, then
relaxation
 LOC or confusion
 Sudden jerking of one body part
 Lip smacking, eye blinking, staring
 Sleeping following seizure

20.  Management
 If mild or moderate
 Give fluids orally if there is no abdominal pain,
vomiting or diarrhea and is alert
 Severe
 High flow O2
 IV/IO with NS or LR
 Fluid bolus of 20 ml/kg IV/IO push
 Repeat fluid bolus if no improvement

22. The care of the normal
newborn child, he
understands a special
evaluation in four moments.

23. IMMEDIATE ATTENTION
•Evaluation of the
breathing, cardiac frequency and
color,Test de Apgar.
•Anthropometry and the first
evaluation of age gestational.
CARE OF TRANSITION
•The first hours of life of the newborn
child need of a special supervision
of his temperature, vital signs and
clinical general condition.

24. ATTENTION OF THE NCH IN PUERPERIO
• Spent the immediate period of transition
the NCH remains together with his
mother in puerperal.
• This period has a great importance from
the educational and preventive point of
view.
PREVIOUS TO BE HIGH OF WITH HIS MOTHER
OF THE HOSPITAL
• It is necessary to give a last general
review
• The mother needs to interest and to
catch knowledge that will facilitate to
him the care of his son.

26. PAEDIATRIC CONTROLS
• There will be realized pediatrics controls of healthy
children by major frequency when the child is
developing
CONTROL OF THE HEALTHY CHILD
• In this examination, the doctor checks the growth and
development of the baby or of the small child and tries
to find problems in time.
CONSULTATIONS OR CONTROLS
• They serve to receive information about the normal
development, nutrition, dream, safety, infectious
diseases " and other important topics.

28. After the birth
of the
baby, the
following
consultation
must be
between 2 and
3 days after.

29. 1 MONTH. 2 YEAR
2 MONTH. 3 YEAR
4 MONTH. 4 YEAR
Of there in forward, the 6 MONTH. 5 YEAR
consultations must
happen to the following 9 MONTH. 6 YEAR
ages
1 YEAR. 8 YEAR
15 MONTH. 10 YEAR
18 MONTH. 10-21 EVERY
YEAR

31. AUSCULTATION
RESPIRATORY
NOISES

32. INFANTILE
REFLECTIONS
JAUNDICE
NEWBORN CHILD