Chapter 34: Emergency Care of the Child

The foundational approach centers on family-centered care, recognizing that parental presence reduces anxiety and supports coping; nurses must communicate honestly and use language appropriate to the child's developmental stage while maintaining a calm demeanor. The primary assessment framework follows the ABCDE sequence, beginning with airway evaluation while accounting for pediatric anatomical variations including a proportionally larger tongue, narrower trachea, and different airway angles that increase obstruction risk. Respiratory compromise represents a primary pathway to cardiopulmonary collapse in children, making airway assessment critical. Shock recognition requires understanding that early compensatory mechanisms mask severity; tachycardia and prolonged capillary refill serve as more sensitive indicators than blood pressure, which remains normal until shock becomes severe and decompensated. Cardiopulmonary resuscitation follows the C-A-B sequence with compressions preceding airway management, and the Broselow tape enables rapid calculation of weight-based medication doses when normal weight is unknown. Trauma assessment incorporates understanding common injury mechanisms such as motor vehicle collisions and pedestrian strikes, with particular attention to cervical spine protection through immobilization protocols. Toxicological emergencies require knowledge of management strategies for common ingestions including acetaminophen, corrosive substances, and button batteries, utilizing interventions such as activated charcoal and specific antidotes. Environmental emergencies encompass submersion injuries where hypoxia correction takes priority, along with protocols for animal and snake bites, and heat-related conditions ranging from heat exhaustion to life-threatening heat stroke. The chapter concludes with management of dental trauma, particularly reimplantation of permanent teeth to preserve the periodontal ligament and restore tooth viability.