Resuscitation follows after the primary survey by conducting a definitive airway assessment and the application of a hard collar for cervical spine immobilization. The patient should be given supplemental oxygen and IV fluid administration (Mitchell, 2007). The secondary survey begins after vital signs are normalized and resuscitation is underway. History taking is done identifying allergies, medications, past illnesses, and events related to the injury. Thorough physical examination of the head, cervical spine, and neck, chest, abdomen, perineum, musculoskeletal, and neurological assessments is conducted. Definitive treatment is applied after in-depth assessment and initial management that may include surgical management or may require transfer to a more appropriate facility (Mitchell, 2007). In the case, Martin complained of tightness in his chest and mentioned that he has a history of asthma.
Ask the patient (or folks) if when did he have last asthma and what medicines does he usually uses. According to Smith et al. (n. d.), management of patients showing signs of respiratory distress or a history of asthma and inadequate ventilation includes the administration of 2.5 mg albuterol via nebulizer over a 10 to 15-minute period and repeat administration at 15-minute intervals throughout transport if the symptoms persist.
Also, a systemic agent for bronchodilation is administered via a subcutaneous route using either epinephrine 1:1000 at 0.01 mg/kg (maximum individual dose 0.3 mg) or terbutaline at 0.01 mg/kg (maximum individual dose 0.4 mg) (Smith et al. , n. d.). Paediatric Assessment TriangleThe paediatric assessment triangle (PAT), according to Horeczko and Hill (2011), is an internationally accepted tool in pediatric life support for the initial emergency assessment of infants and children including the three components: (1) appearance, (2) work of breathing, and (3) circulation to the skin.
PAT employs a rapid assessment of the child without the use of the hands, yet answers the questions whether the child is sick or not, what is the most likely physiological abnormality, and if the child requires emergency treatment (Pante, 2010, p. 253). Note for signs of abnormalities: as to appearance, note for abnormal or absent cry or speech, decreased response to parents or environmental stimuli, floppy or rigid muscle tone or not moving; as to work of breathing, note for nasal flaring, retractions, or abdominal muscle use in increased or excessive breathing, or decreased/absent respiratory effort.
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