Anonymous asked:

Hey! Since you recently answered a question about the general care of children and how it differs from with adults- how is it different working with kids in emergency situations? Like if a child was in a fire or suddenly came down with a life threatening illness or broke a bone or something like that?

scriptmedic answered:

Hey there nonny! Thanks for your ask! 

(This ask is referring to [this post], by the way). 

Kids in emergencies are typically in one of two states: either they’re panicky little horrorshows who scream, cry, cling to their moms (when available), refuse to let you do ANYTHING, or else they’re pale, limp, quiet, and still. 

I will take the first kid over the second kid every single day of my life. A child crying is my favorite thing to hear coming out of an elevator. Why? Because that second child is sick as shit.  

Kids in the absolute worst emergencies are “easy” to treat, because they’re unconscious or flaccid or simply checked-out. They’re also stupendously sick, and even skilled providers with pediatric training get freaked out by really sick kids. 

So those kids are easy. Managing their parents can be extremely difficult, of course, but you can generally calm adults down at least to a point of being functional and cooperative. 

Paradoxically, the less-sick kids are a lot harder to treat, because they want to crawl, run, scream, and get as far away from you (the big scary stranger who probably has needles) as possible. 

The single best thing for providers to do is recruit the parents. (Or caretakers of whatever kind are available; someone the kid trusts. I’m as trans-positive and inclusive as they come, but I also will reach for the person the kid calls mom as the person to reach out to first. In my experience, that’s who the vast majority of kids trust the most.) 

Other things: distraction works really well with moderately-sick kids; peds docs/nurses/medics typically have some kind of shiny or toy on them. 

It also often helps to demonstrate what you’re going to do on mom/caretaker-du-jour. We’ll put pulse ox probes on mom and/or ourselves, then put them on the kid, to show them it doesn’t hurt. (We can’t do this with sharps, obviously.) 

Finally, trying to provide comforting elements, such as bright and cheery spaces with lots of cartoons, can be comforting. Here’s an exam room in [the Peds ER at Gulf Coast Regional Medical Center]: 

I’ve even watched entire staff groups sing The Wheels on the Bus to a kid who was getting an IV – as people were holding the kid’s arm down and the IV was getting put in. The kid was screaming, and I have a feeling it probably gave the kid a Pavlovian response to The Wheels on the Bus (the little droog), but hey, it’s a thing and I’ve seen it so I pass it on to you! 

Hope this helped a bit. 

xoxo, Aunt Scripty

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