儿童创伤急救.ppt

Chapter 17Trauma in Children Trauma in ChildrenTrauma in Children儿童创伤 OverviewEffective techniques to gain confidence有效增加信心的技巧Injuries based on mechanisms of injury受伤机理ITLS Primary and Secondary Surveys初步及进一步检查 Consent and the need for immediate transport家长同意及需实时运送Pediatric equipment needs适合儿童之器材Various methods of SMR on child儿童脊椎固定方法EMS involvement in prevention programs参与预防意外计划2Trauma in Children - Trauma in ChildrenDifferent from adults与成人不同Different patterns of injuries不同伤势模式Different responses to those injuries不同反应Special equipment required需要特别器材 Assessment equipment and treatment equipment检查及冶疗用的器材Difficult to assess and communicate 较难评估及沟通Come with caregivers and other family members与家人或照顾者同行3Trauma in Children - Communicating沟通Family-centered care is critical.以家庭为中心Caregiver not always parent.照顾者未必是父母Involve caregivers as much as possible in care.尽量让照顾者参与Give explanations and careful instructions.必需详加解释及指示Inclusion and respect will improve stabilization.包容及尊重可稳定伤者Keep caregivers in physical and verbal contact.与照顾者保持接触Demonstrate competence and compassion.4Trauma in Children - Assessing Mental Status捡查精神状态Consoled or distracted可按抚或转注意力Most sensitive indicator of adequate perfusion 能准确反映组织灌注是否足够Caregivers best at detecting subtle changes 照顾者会较易分辩出伤者微小改变5Trauma in Children - Assessing Mental StatusInitial level of consciousness最初清醒程度Preschool child : sleeping vs. unconscious 幼儿:疲倦vs人事不醒Most will not sleep through arrival of ambulance大部份沿途不会睡觉Ask caregivers to wake child着照顾者弄醒伤者Suspect hypoxia, shock, head trauma, seizure 怀疑缺氧、休克、头部受伤、癫痫6Trauma in Children - CommunicatingInteraction strategies使用适龄的语言Appropriate language for developmental level合适的语言Speak simply, slowly, clearly说话要慢及简溸Be gentle and firm必需肯定Avoid “no” questions避免说”不”Get a favorite belonging 利用其喜爱的玩具/随身物品Get on child’s level 降下身段至与伤者视线平衡Explain SMR necessity 解释脊椎固定之需要Allow caregiver to accompany child 让照顾者与伤者同行7Trauma in Children - Caregiver Consent照顾者”同意”Critical care shou