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Pediatric Crisis: Mastering Rapid Assessment Skills & Unique Treatment Challenges – Robin Gilbert

Mock Code Blue: Know What to Do
Critical Lab Values & Blood Gases: The Underlying Issues
Risky Business: Street Drugs & Thugs
Pediatric Sedation: Medications & Complications
Early Clues for Respiratory Distress & Failure
Fever, Pain, & Skin Rash: How Sick is This Child?

You are caring for a child who presents with severe dyspnea, stridor, retractions, and cyanosis following a snack at daycare. On the monitor, the child’s heartrate is decreasing and oxygen saturations are dropping. His mental status is quickly deteriorating. The physician chooses to intubate. What size ET tube do you anticipate for this child? IV access is not obtainable and the decision is made to start an Intraosseous (IO). You are not sure if you have an IO on your code cart – and you have never used one. The physician orders epinephrine 0.01mg/kg IO. Epinephrine is given, the child develops ventricular tachycardia. Now what…?

This high-anxiety situation just became your worst nightmare. Nothing increases YOUR heartrate more than the pediatric patient who suddenly decompensates. What are your biggest concerns: Calculating the medication dose in a code situation? Managing the airway? Missing the subtle signs that lead to the need for a rapid response? Children have unique differences that require additional assessment skills and interventions. Become confident in your assessment skills and be prepared to handle emergent situations. You will have time to practice mock rapid response scenarios, use Broselow tape, calculate/draw up medications, and review airway management tools. Robin Gilbert, MSN, RN, CEN, CPEN, will teach you strategies to recognize and stabilize life-threatening emergencies that take place in the pediatric population.

Analyze case scenarios to determine acuity and prioritization.
Differentiate between common rashes and those that require immediate intervention.
Interpret lab values and quickly identify potential causes of abnormal values.
Determine the unique pediatric needs during presentation of respiratory distress or failure.
Assess for causes of neurological deterioration in pediatric patients.
Perform sample medication calculations.
Discuss nursing responsibilities during the use of moderate sedation.
Differentiate between clinical characteristics of acute abdominal diagnoses.

Abdominal Pain: Appendicitis and Beyond

Gastorenteritis
Intussusception/Volvulus
Pyloric stenosis
Testicular torsion/Epididymitis
Diaphragmatic hernia
Gastroschisis

The Pediatric Airway

Recognizing the child in distress
Unique characteristics of the pediatric airway
Urgent respiratory conditions
- Tracheoesophageal fistula
- Asthma
- RSV / Bronchiolitis
- Cystic Fibrosis
- Chest Trauma

ALTE vs. BRUE

Clinical manifestations
Management

Risky Business: Street Drugs, Tattoos and More

What’s trending
- Amphetamines
- Cocaine
- K2, Spice, Molly
Implications & interventions

Fever in the Neonate

Sepsis workup & when?
Antibiotics for neonate vs. infant

Head Injuries

ICP assessment
Skull fractures
Concussion/Contusion/TBI

Bruises & Fractures

Does the story fit – or is it maltreatment?

When a Rash Becomes a Risk

Varicella
Measles & More

Lab Values & Blood Gases

What impacts the numbers: Identifying potential causes
Blood gases simplified
Blood glucose, DKA, & insulin protocols

Hematologic & Coagulation Disorders

Sickle cell anemia
Hemophilia

Procedural Sedation

Medications and equipment
The nurse’s responsibilities
Prevention and management of complications

Pediatric Code Blue: Know What to Do

A, B, Cs
Arrhythmias
Med calculations

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