Pediatric EmergenciesKevin Haughton, MD

Providence Medical Group –

East Olympia Family MedicineWith special guest Joe Pellicer, MD, Emergency Medicine

Kevin Haughton, MD

• Served as director of St. Peter Family Medicine Residency Program for 11 years.

• Providence Medical Group Primary Care Section Chief

• Enjoys making personal connections with patients and their families. Cares for all ages at East Olympia Family Medicine, to schedule an appointment call 360.486.6777

Topics we will cover

• Choking• Poisoning • Bug bites and bee stings• Rashes and sunburns• Sprains and head injuries• Heat exposure• Home medicine cabinet• Travel medical supplies

Choking

• Higher risk at younger age• Small portions• Ample time• Good posture• Cut up food: half inch maximum less than 4 yo• Limit distractions while eating• Avoid feeding while in the car• Airway the size of drinking straw

Choking

• Hidden toys in seat cushions• Coins, marbles, • Watch batteries,

pieces of other toys• American Red Cross CPR class• Medic One: 360-704-2780• Babysitter training

Poisoning

• Identify the poison• Call poison control:

1-800-222-1222• Dilute the poison: drugs,

plants, contaminated food• Avoid absorption• Do not induce vomiting in

kids who are not fully conscious and awake

Poisoning continued

• Syrup of Ipecac• Controversial• No longer made• Do not use with drain cleaner, petroleum

based products (kerosene or gasoline), or corrosive chemical product

• Do not induce vomiting if the patient is not fully conscious and coherent

• Substitute for Ipecac: drink 2 tbsp. of mild soap or 1 tbsp. of dried mustard mixed with a half liter of water; tickle the back of the throat.1-800-222-1222

Bug Bites & Bee Stings

• Mostly mosquitoes• Watch the time outdoors• Do not allow standing water

near your house• Long sleeve shirts and trousers• DEET and permethrin

Spiders Bites, Bee Stings

• Much maligned spiders• Deer and horse flies• Fleas and bed bugs• Yellow jackets and wasps• Bee stings• Remove stinger, wash thoroughly, ice, antihistamine• 911 Emergency: trouble breathing, swelling around

face or mouth, hoarse voice, feeling weak, or turning blue

Rashes

• Fewer rashes than we used to see

• Impetigo –

common

• Sick with fever and rash may need further evaluation

Sunburn

• Sunscreen, shade, cover skin, avoid 11AM –

2PM• Fluids, tylenol, ibuprofen, cool packs, aloe vera• Avoid burning

Fevers

• Febrile seizures• Can get goofy with high fevers• Tylenol or ibuprofen will lower temp

– treats symptoms only not curing underlying problem

• Ear infections may not need antibiotics

Heat injuries

• Heat exhaustion– thirsty, headache, nausea, vomiting,

irritability, muscle cramps

• Heat stroke– confusion, seizure, loss of consciousness

• Prevention– lots of fluids, light colored clothing,

avoid excessive heat with exercise

• If concerned, bring the child into a cool shady spot

Vomiting, diarrhea, and dehydration

• Fluids: popsicle, jello, pedialyte– small amounts frequently

• Abdominal pain: appendicitis usually no appetite, fever, and severe abdominal pain –

progresses rapidly

• Jump up and down test• Blood in diarrhea?

Unintentional injuries

• Falls are the most common• Being hit by something • Car accidents• Head injuries• Hope to avoid CT scans

What to say when you call:

• How old is the child?• How far did he fall?• What did she land on?• Is there any blood or broken bones?• Did he lose consciousness?• What is she acting like now?

Injury Prevention

• Helmets• Car seats• No walkers• Water can be dangerous –

do not

leave kids unsupervised

Home Medicine Cabinet First Aid Kit

• Get rid of bad stuff: old medicines• Tylenol, ibuprofen• Bandaids, antibiotic ointment• Gauze, moleskin, tape, ace wrap, safety pins• Benadryl, Hydrocortisone cream• Thermometer• List of contacts and emergency phone numbers• First Aid Manual

Travel medicine supplies

• Encourage travel –

good for kids• Basic first aid plus:

– insect repellent, sunscreen, motion sickness medication,

safety pins, Afrin or drinking for airplanes

• Wash your hands –

consider bringing hand sanitizer• Be careful of cars & dogs• Get vaccinated

Questions?