practical

General Impression: Respiratory Distress Primary Survey: 1. Scene Size ^Up 2. Safety BSI is child is unconscious (if resp: present self as friendly health care provider) 3. LOC / CAB / PAT 4. Reassure patient 5. Child appearance (can i fix it?) if cyanotic: if 60 bpm below start cpr; pulse 12 above is carotid load and go if not (turn on siren if deteriorating LOC) not if responsive to reduce anxiety 6. Work of breathing (notice cough or sounds for obstruction) loud barking cough/seal bark ; croup (swelling airway) -notice nasal flaring -retraction of chest RR PR NB: 30-50 120-160 6m-1y 30-40 120-140 2-4 20-30 100-110 5-8 14-20 90-100 8-12 12-20 80-100 >12 12-16 80-100 8. Circulation, Secondary Survey: reassess 1. assess SPO2 and ETCO2 2. give o2 as needed (if child refuse ask mother to handle o2, 2i3 inches blowby) 3. ask for medical records load and go if not (turn on siren if deteriorating LOC) not if responsive to reduce anxiety