You are a Paramedic working as part of a Para/Tech crew when you are sent a call for a 7-year-old not breathing properly. The address is 8 minutes away, and you respond in the Ambulance. Control updates you on the way that there isn’t currently any further back up available, and if you can update them to the situation so they can try and arrange further help.
You arrive on scene and directed by the patients’ mum to the living room. Mum explains her son, James, has had Diarrhoea and Vomiting for the past week. She took him to the GP, but the doctor told her to let the illness run its course. Initially James was coping well, but the past 3 days he hasn’t been able to eat or drink anything and has not been passing any urine or stools. This morning, mum has left James on the sofa to watch cartoons while she did some home office meetings. After and our or so, she checked on her son and found him in a poorly state.
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As you walk into the living room, you see the patient laying on the sofa looking very pale and not responding to any of the adults around him. His breathing is noisy and noticeable slow. What first primary survey management will you look to manage
You investigate the airway and see a lot of secretions and vomit. Using lateral positioning and visualised suction, you clear the airway as best you can. You quickly assess breathing and note a respiratory rate of 6 breaths per minute. At what respiratory rate should a 7-year-old sit between
You note that the patients’ breathing isn’t maintaining adequate ventilation. What actions must be taken to try and manage
You manage the patients’ ventilations while your colleague brings in the stretcher and updates control of the seriousness of the situation. Where a poorly child is involved, which is advised when looking at the overall management of the patient
You quickly stretcher the patient into the Ambulance. You explain to mum the seriousness of the situation and that you will be quickly transporting the patient to hospital. Control informs you that an RRV with a Paramedic has come clear around the corner and is on their way to assist. In the back of the ambulance you continue to manage airway and breathing while your colleague gets observations: HR 63, RR 4, SPO2 90% on O2 and ventilated, temperature 39.3°C, unable to get a BP reading but a very weak brachial pulse, GCS 6 (2/2/2). With the information, what POPS score would this patient have
The second Paramedic arrives and jumps on the back. The Technician jumps in the front and prepares to blue light you to hospital. You handover to them and they get busy trying to manage the further elements of the primary survey. As you assist ventilations, you note the patient has stopped breathing and you cannot palpate a carotid pulse. You confirm the patient is in cardiac arrest, what initial actions do you conduct in a paediatric arrest (multiple answers)
Your colleague administers the adrenaline and now looks to give a fluid bolus due to the history. What paediatric fluid bolus ml per kg is it for a medical scenario
Your colleague administers the adrenaline and now looks to give a fluid bolus due to the history. What paediatric fluid bolus ml per kg is it for a medical scenario
You administer the fluid bolus and continue with your ALS management. Following 2 cycles you gain ROSC and review your primary survey again. The patient still has a weak brachial pulse and blood pressure, and you decide to give further fluid boluses. What is the maximum amount of fluid available to give in a paediatric medical scenario
Following a further fluid bolus, you are nearing the hospital. Your colleague has already placed a pre alert, and a team is awaiting your arrival. You arrive and are ushered into a resus bay where the patient is transferred to the hospital bed. You give a handover of the events, which of the following are correct
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