IV Insertion in Pediatric Patients: Minimizing Pain and Discomfort

Delivery Complications and Gynecological Emergencies

• Support perineum controlled descent: a crucial step in delivery to prevent complications
• Head resistutes: a critical moment in delivery that requires careful attention
• Check for nuchal cord: a potential complication during delivery
• Oxytocin 10U IM: a medication used to manage delivery complications
• Delivery of posterior shoulder: a crucial step in delivery that requires careful attention
• Delivery of lower body and umbilical cord: a critical step in delivery that requires proper technique
• Clamp and cut cord at 30-60 seconds: a crucial step in delivery to prevent complications

Ruptured Ovarian Cysts and Endometriosis

• Ruptured ovarian cysts: a gynecological emergency that requires prompt attention
• Ectopic pregnancy: a potential complication that requires rule-out
• Pain management: a crucial aspect of managing gynecological emergencies
• Endometriosis: a common complication that requires proper diagnosis and management
• Diagnostic tools: US or CT scan are used to diagnose endometriosis
• Management: pain and bleeding can be managed with contraceptives, and in some cases, DNC or surgery is required to remove some of the cells

Highly Infectious Diseases and High Consequence Pathogens

• Highly infectious disease or pathogen: a serious hazard that requires specific control measures
• Three steps for success:
  • Identify: recognition of outbreaks and pathogens is crucial
  • Isolate: isolation is a critical step in controlling the spread of disease
  • Contain: containment is key to preventing further spread of disease

Infectious Disease Outbreaks

• US-based outbreaks: listeria, Covid-19, fungal meningitis, measles, monkeypox
• International outbreaks: ebola, dengue, diphtheria, chikungunya, marburg
• Nursing role:
  • Identification and isolation
  • Real-life anecdote: Covid-19 symptoms and travel advisories
  • Current state: remaining hypervigilant to symptoms and masking policies

Mass Casualty Incidents and Triage

• Mass casualty incident: a serious situation that requires immediate attention and response
• START Triage Algorithm: a critical tool for managing mass casualty incidents
• JumpSTART Pediatric Triage: a triage system specifically designed for pediatric patients
• Management of Mass Casualty Incidents:
  • Decon team comms drills
  • Functional exercise: focus on triage and decanting
  • Full-scale decontamination scenario

Trauma and Emergency Department Management

• Trauma team structure and roles: a critical aspect of emergency department management
• Communication:
  • Debriefing
  • Trauma?Huddle: teamwork SBAR for escalating a concern
• Patient Safety in the Emergency Department:
  • Nursing Teamwork Survey Subscales
  • Key Concepts for Success: communication, improvement models, continuous learning, accountability, transparency

Pediatric Triage and Care

• Pediatric triage: a standardized approach that takes into account appearance, work of breathing, and circulation
• Airway, breathing, circulation, disability, exposure (ABCDE)
• Pertinent history, vaccination, vital signs, fever, and pain
• Pediatric high-risk situations:
  • Seizures
  • Accessory muscle use, retractions, nasal flaring
  • Sepsis
  • Burns, suspected child abuse
  • Fever in newborns
  • Head trauma

Pediatric Vital Signs and Management

• Pediatric vital signs: pulse, RR, SpO2, and temperature
• Management of pediatric emergencies:
  • Distributive shock
  • Anaphylactic shock
  • Neurogenic shock
  • Septic shock
• IV insertion in pediatric patients:
  • Minimize pain of the procedure
  • Positioning and comfort measures
  • Numbing options and distractions
  • Sucrose use