HOCKENBERRY: WONG’S CLINICAL MANUAL OF PEDIATRIC NURSING, 9TH EDITION 2024(TRAUMA,SHOCK, SEIZURES, POISONING, HYPOGLYCEMIA, HEAD INJURY ,FOREIGN BODY INGESTION , BURNS, FRACTURE , AVULSED TOOTH ) EMERGENCY TREATMENT GUIDELINES

Emergency Treatment Guidelines Trauma Before entering the trauma area, observe for potential threats or dangers to rescuers and bystanders. Be aware of the potential for further injuries to the child. Observe the scene for signs and mechanism of injury (e.g., head-on motor vehicle injury), which helps determine the proper course of action for treating the child’s injuries. Do not move the child before the arrival of emergency medical services (EMS) personnel unless the child is in danger of further injury. If it is necessary to move the child, follow appropriate steps to prevent further injury (e.g., stabilize the cervical spine to avoid exacerbation of spinal injury during movement). Primary Assessment and Intervention Assess the level of consciousness. Use the AVPU method: A—child is alert. V—child responds to verbal stimulus. P—child responds to painful stimulus. U—child is unresponsive to any stimulus. Open the airway, using the appropriate method: • In the child with head, trunk, or multisystem trauma, modified jaw thrust is the preferred method. • At this point, the cervical spine should be manually immobilized and held in alignment with the rest of the spinal column and should not be released until EMS personnel have immobilized the child with appropriate equipment. Activate the EMS system if the child appears to be pubertal or older or if witnessed a sudden collapse. If the child has not reached puberty, perform 2 minutes of cardiopulmonary resuscitation (CPR) (as per assessment); then activate EMS and call for an automatic external defibrillator (AED). If no response to stimulation and no pulse is detected, begin chest compressions. Compress at a rate of at least 100 compressions per minute.* After 30 compressions, administer two breaths—each breath is administered over 1 second. Avoid overventilating.* Continue chest compressions and ventilations until the child shows signs of responsiveness and breathing, or EMS arrives. If an AED is available, turn on the AED and follow the AED directions. Avoid interrupting chest compressions for more than 10 seconds.* A pulse check may be made if five cycles of 30 compressions and two breaths have been administered.* • Palpate carotid artery in children 1 year or older. • Palpate brachial artery in infants younger than 1 year. If the pulse