First Responder EMS Curriculum for Training Centers in Eurasia

the most commonly involved internal organs. Internal injury may result in significant,life-threatening blood loss. Always maintain a high suspicion for internal organ injury ina patient with unstable vital signs. Physical exam may only show distension. Abdominalpain may be undetectable if the patient is unconscious or has an altered mental status.Extremity TraumaExtremity trauma in pediatric patients is managed in the same way as in adults.Manually stabilize the injured extremity, and splint accordingly. Always remember thatthe airway, breathing, and circulation take priority over injured extremities. Manualstabilization and splinting of an injured extremity, however, will help limit any furtherblood loss and provide some reduction in pain for the patient.Role of the First ResponderComplete the First Responder assessment. Complete a scene size-up before initiatingemergency medical care. Complete an initial assessment on all patients. Complete aphysical exam as needed. Complete ongoing assessments. Comfort, calm, and reassurethe patient while waiting for additional EMS personnel.With any pediatric trauma patient, try to maintain the patient’s head in a neutralposition, and do not move the patient unless the scene is unsafe. Ensure that the airwayis open and the patient is breathing adequately. Use only the jaw-thrust maneuver toassist in opening the airway. Suction the airway as necessary with a large catheter.Provide spinal immobilization. Assess for any other injuries, and manually stabilize anyinjured extremities.8. Child Abuse and NeglectChild abuse is the improper use of excessive action by parents, guardians, or caretakers thatcauses harm or injury to an infant or child. The abuse may be physical, sexual, oremotional. Child neglect is defined as giving insufficient attention or respect to someonewho has a claim to that attention. Suspicion for neglect would be warranted in a child whois malnourished, improperly clothed for a given environment, or a child who is notreceiving appropriate health care. The First Responder must be aware of these conditions tobe able to recognize the problem.The range of signs and symptoms of child abuse is extensive. Signs and symptoms of abuseinclude:1. Multiple bruises in various stages of healing.2. An injury inconsistent with the mechanism described by the adult caretaker.3. Patterns of injury such as cigarette burns, hand prints, whip marks.4. Repeated calls to the same address for sustained injuries.5. Fresh burns that have not been treated, such as scalding burns from excessively hotwater or dip pattern burns consistent with an extremity dipped into hot water.6. Parents may seem inappropriately unconcerned.7. Parents may delay in seeking treatment for the child.8. Stories of the child and parents may conflict.9. The child may be afraid to discuss how the injury occurred.10. Central nervous system injuries may show no evidence of external trauma. However,central nervous system injuries may present with an unresponsive or seizing child.212 First Responder EMS Curriculum/AIHA, July 2002