Pediatric Life Support Assessment Quiz

Study Notes

Presented by Yasmeen Karam Hosny Ahmed, Lecturer of Pediatrics, Clinical Nutrition Department, Cairo University
Focuses on primary and secondary assessment of seriously ill children

Identifying seriously ill children is crucial at initial contact with healthcare services
Triage is a process of determining urgency for patient assessment and treatment based on illness severity, not order of arrival
Can begin with telephone or online consultation to a national center, or via primary care or ambulance services
In an emergency department, a brief history and vital signs (temperature, respiratory and heart rate, and oxygen saturation) form the basis of the assessment

The rapid clinical assessment follows an ABCDE approach:
- Airway and Breathing: Evaluate effort and efficacy of breathing, airway obstruction, and respiratory distress
  - Look, listen, and feel for breathing
  - Respiratory rate, stridor, wheeze
  - Auscultation for air entry, cyanosis, oxygen saturation
- Circulation: Assess heart rate, pulse volume, capillary refill time, and blood pressure (if indicated)
  - Heart rate
  - Pulse volume
  - Capillary refill time
  - Blood pressure.
- Disability: Observe level of consciousness, posture, pupil size and reactivity
  - Level of consciousness (e.g., AVPU)
  - Posture (hypotonia, decorticate, decerebrate)
  - Pupil size and reactivity
- Exposure: Evaluate for fever, rash and bruising.
Resuscitation (if necessary) includes basic/advanced life support, considering jaw and neck positioning, oxygen, suctioning, chest compressions and monitoring oxygen saturation and heart rate
Secondary assessment involves a focused survey for key features.
History from patients, witnesses, general practitioners, paramedics, and police.
Examination includes evidence of trauma, rash, smell (e.g., ketones, alcohol), scars, and MedicAlert bracelets.
Investigations include blood glucose.
Emergency treatment, detailed review and continued stabilization

Demonstrates head tilt-chin lift technique for infants, small children, and children.
Explains jaw thrust technique.
Details how to check for signs of life (pulsation, movement, cough) by palpating the carotid, brachial, or femoral arteries.
Outlines the AVPU (Alert, Verbal, Pain, Unresponsive) scale for level of consciousness assessment.
Explains capillary refill time assessment (press on skin, release, measure time for color return).

Early recognition and treatment of sudden cardiac arrest improves survival rates for children and adults
BLS is a systematic approach involving patient assessment, activation of emergency medical services, and initiation of cardiopulmonary resuscitation (CPR)
Includes adequate ventilation, chest compressions, and defibrillation.
BLS can be performed by trained lay people or healthcare providers

Explains a step-by-step procedure for performing pediatric BLS, including stimulation, airway opening (head tilt/chin lift or jaw thrust), breathing checks, chest compressions, and circulation checks.
Emphasizes positioning for chest compressions, varying based on the child’s size (infant, small children, larger children).
Includes how to use an Ambu bag / bag-mask device for infants and children if necessary.
Demonstrates how to check breathing (look, listen, feel) for 10 seconds.