*Dealing with kids as an EMT*
25 April 2007
In the Emergency Medical Services field we sometimes have to deal with kids. Older kids (10 years or so) usually aren’t too hard because they can usually understand what’s going on. Young kids really don’t. Treating kids is an entirely different ball game than adults. Kids are easily intimidated and shamed. They don’t like strangers to be poking and prodding them doing an evaluation or looking for pain/injuries. If an adult is standing or is somehow positioned at a horizontal level above a child they will most likely feel intimidated and submissive to the care provider. Something as simple as that can make or break a care provider.
Fortunately we don’t have to deal with pediatrics here very often, but on occasion it does happen. Even as a first responder or bystander you can use the tips below to help take care of a kid.
Here’s a few tips for getting on the good side of kids-
One call I went to was for a 16 month old having a severe asthma attack and his prescription albuterol wasn’t working. Bad bad bad….toddlers have a VERY small airway. The poor critter was red faced, coughing severely and teary eyed. He didn’t understand what was happening. In the ambulance we gave him more albuterol with 10 liters per minute of oxygen. Shortly thereafter he was pretty well fixed. The coughing stopped; he was breathing good and seemed to be comfortable. His only reassurance was sitting on his mother’s lap on the way to the hospital and her helping give him the meds. At that young of an age, that’s about all that can be done. Being physically down at their level will probably help too.
Another call was an unconscious child. The kid was a 1st grader and just passed out for no reason. We arrived a few minutes after the call and she was conscious again, but a little disoriented. My partner did the on scene assessment with out too much fuss. The “mom” figure kinda helps too. Enroute to the hospital which is about ½ hour away in either direction we had to carry on assessments and treatment. A kid this age is closer to being able to understand a little more of what’s happening. Still, they can be intimidated and shamed easily. One of the first things I did was give her a teddy bear. Most young kids probably wouldn’t like having things stuck to them and then wires hooked up. I spent most of the trip to the hospital kneeling on the floor right next to her so I could be down at her physical level.
Ah…make it fun. Tell them you want to stick some stickers on them and then take a picture of their heart. Nothing says they can’t help stick them on. I told her that we had her wired up like a robot. I printed out an EKG strip and then showed it to her. Of course it means absolutely nothing. I showed her the lines going up and down and told her that tells us what her heart is doing inside. It worked, she was fascinated by it.
If they are still resistant to the monitor, PROVE to them it doesn’t hurt. Stick some patches on yourself and print off your own strip to show them. Once they see it didn’t hurt you, maybe they’ll give in. If that doesn’t work, do an EKG of their parent/relative, somebody they DEFINITELY trust.
We also have to listen for lung sounds to check for any fluids or decreased volume etc. A kid might not like you sticking a steth on them. Well, there’s ways around that too. I dug out my steth and then dug out another set. I gave the 2nd set to her. I told her we were going to listen to each other’s breathing and heart. I put the earpieces in my ears so she could see it didn’t hurt, then I put the other set in her ears. I then had her listen to my lung sounds and then moved it over so she could hear my heart. Then I had her listen to her own. When I saw a big grin go across her face, I knew I had her. I then told her that since she listened to me it was my turn to listen to her…yup, ok…not a problem.
Ok, how do you get a finger piece on a kid’s finger to measure their Oxygen Saturation? Again, stick it on your own and show them, then stick it on theirs. Tell them that it tells us how much air they have in them.
I also taught her about capillary refill. I squeezed her fingernail and had her watch. I explained that when you squeeze it and then let go and it changes from white to pink by the time you count to two, it means you’re breathing good. She thought that was pretty neat.
We even stuck her with a small needle to get a blood glucose reading. She got some high 5’s that night. As we were near the hospital I asked her what she was going to name her new bear. She (and her mom) were both surprised that she could keep it. As we were leaving the hospital they were talking about giving it my name, I dunno if that actually happened or not.
Another trick is to keep their minds occupied while doing an assessment. If they’re too busy thinking they’re probably not paying too much attention to what’s happening to them physically. I played a guessing game with her. Tried to guess her favorite food and struck out.
Pediatrics is a real PITA and nerve bender at times. When TSHTF it sucks to be working on a pedi. Sometimes it pays off and they recover, other times they’re dead and there’s not a thing anybody can do about it. Been there, done that. It sucks!
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