In which of the following primary survey components can assessment of the fontanelle provide the most useful information?
ALERTDon appropriate personal protective equipment (PPE) based on the patient’s signs and symptoms and indications for isolation precautions. Show
Refer to the American Heart Association (AHA) interim guidelines for resuscitation of the patient with coronavirus disease 2019 (COVID-19) or a person under investigation (PUI) (Box 1).undefined#ref5">5 The presence of an environmental hazard (e.g., fire, noxious fumes, potential for explosion, active shooter) that mandates immediate evacuation of the area takes priority over the primary assessment. Stabilize the cervical spine throughout the procedure if injury is suspected. Do not proceed to the next assessment step until interventions for life-threatening conditions have been implemented. OVERVIEWThe primary assessment is intended to assess and intervene rapidly for life-threatening conditions in critically ill or injured patients. The primary assessment is done at the initial point of patient contact and may be done again after the patient is transferred from the care of one team to another (e.g., when the emergency medical services team hands off the patient to the emergency department [ED] team members). To ensure that the primary assessment is thorough, a systematic approach should be taken, for example, following the widely used A-B-C-D-E mnemonic outlined in the procedure steps. EDUCATION
PROCEDURE
A = Airway and Alertness with Simultaneous C-spine Restriction
B = Breathing and Ventilation
C = Circulation and Control of Hemorrhage
D = Disability (Neurologic Status)
E = Exposure and Environmental Control
Completing the Procedure
MONITORING AND CARE
EXPECTED OUTCOMES
UNEXPECTED OUTCOMES
DOCUMENTATION
PEDIATRIC CONSIDERATIONS
OLDER ADULT CONSIDERATIONS
REFERENCES
*In these skills, a “classic” reference is a widely cited, standard work of established excellence that significantly affects current practice and may also represent the foundational research for practice. Elsevier Skills Levels of Evidence
Which of the following is a priority intervention for a pediatric patient with diabetic ketoacidosis?Continuous, low-dose, intravenous (IV) insulin infusion is generally accepted as the safest and most effective method of insulin delivery for treating diabetic ketoacidosis.
Which physiologic response to shock has the greatest impact on improving cardiac output in the pediatric patient?Adults with septic shock have decreased ejection fraction and increased cardiac output through ventricular dilatation and increased heart rate [8]. Children with septic shock do not have ventricular dilatation [9]. Therefore, the most important way to increase cardiac output in young children is to increase heart rate.
Which of the following describes a neonates normal position Enpc?Which of the following describes a neonate's normal position? Flexion with extremities close to the body A neonate's normal position is flexion with extremities close to the body.
What is the priority intervention for symptomatic bradycardia in a four year old child?The initial interventions within the bradycardia algorithm for all infants and children with symptomatic bradycardia include the following: Identify and treat the underlying cause. Provide oxygen. Attach a cardiac monitor for rhythm identification.
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