First Responder EMS Curriculum for Training Centers in Eurasia

d. SeizuresSeizures are among the most common pediatric patient complaints the First Responderwill encounter. All seizures, including febrile seizures, should be considered potentiallylife threatening. They may be brief or prolonged. Brief seizures usually result in onlytemporary neurologic impairment. These seizures, however, may be associated withrespiratory compromise and injuries sustained during the seizure. Prolonged seizureslasting longer than 30 minutes can result in permanent neurologic injury. Commoncauses of seizures include fever, infections, drug or alcohol poisoning, low blood sugar,trauma, decreased levels of oxygen to the brain, and unknown causes.When evaluating an infant or child with a seizure, ask the following questions: Has thechild had a prior seizure? If yes, is this the child’s normal seizure pattern? Is the childtaking any seizure medications? Could the child have ingested any other medications oralcohol? When did the seizure start, and how long did it last?The role of the First Responder is to complete the First Responder assessment.Complete a scene size-up before initiating emergency medical care. Complete an initialassessment on all patients. Complete a physical exam as needed. Complete ongoingassessments. Observe and describe the seizure. Comfort, calm, and reassure the patientand family while awaiting additional EMS personnel.Always attempt to protect the seizing patient from the environment. Ask bystanders,except the parents, to leave the area. The first priority is assessing the patency of thepatient’s airway. Place the patient in the recovery position if there is no possibility ofspinal trauma. If the patient is blue, ensure airway patency and ventilate, if possible.Have suction available. Never put anything into the patient’s mouth (including fingers).Never restrain the patient. Instead, protect the patient from his/her surroundings. Reportthe above assessment and management to additional EMS personnel as they arrive.e. Altered Mental StatusAnother pediatric complaint the First Responder will encounter is altered mental status.Causes of altered mental status in infants and children include low blood sugar, drug oralcohol poisoning, post-seizure, infection, head trauma, and decreased oxygen levels.The role of the First Responder is to complete the First Responder assessment.Complete a scene size-up before initiating emergency medical care. Complete an initialassessment on all patients. Complete a physical exam as needed. Complete ongoingassessments. Comfort, calm, and reassure the patient and family until additional EMSpersonnel arrive. Ensure the patency of the airway. Artificially ventilate and suction, asnecessary. Place in the recovery position if breathing and circulation are effective.f. Sudden Infant Death SyndromeSudden infant death syndrome is the sudden death of an infant generally less than 1 yearold. The infant is usually found dead in the early morning. The causes of sudden infantdeath syndrome remain unidentified. It is the leading cause of death in this age group.The role of the First Responder is to complete the First Responder assessment.Complete a scene size-up before initiating emergency medical care. Complete an initialassessment on all patients. Comfort, calm, and reassure the patient and family untiladditional EMS personnel arrive. Try to resuscitate the infant unless the patient is stiff.210 First Responder EMS Curriculum/AIHA, July 2002