Emergency Care of Children and Young People (eBook)

Karen Cleaver is Head of Department, Family Care and Mental Health and Principal Lecturer Children's Nursing, at the University of Greenwich. Janet Webb is Professional Lead Child Health & Welfare and Programme Leader for the PG Cert in Child Protection in the Department of Family Care and Mental Health at the University of Greenwich.

Emergency Care of Children and Young People 1
Contents 7
Contributors 10
Preface 11
Acknowledgements 14
Table of Cases 15
Table of Statutes 16
Chapter 1 Setting the Scene: The Context of Emergency Care for Children and Young People 17
Children and family life in the UK 17
Children's health and well-being 17
Legislative and policy context 18
Emergency services for children 18
References 21
Chapter 2 Principles of Emergency Care for Children and Young People 24
Introduction 24
The principles of assessing children 24
Conclusion 29
References 30
Chapter 3 Legal and Ethical Emergency Care of Children 31
Introduction 31
Article 2: the right to life 33
Article 3: the right to humane treatment 35
Article 5: the right to freedom 37
Article 8: the right to privacy 39
Article 9: the right to freedom of thought 43
Article 10: the right to freedom of expression 44
Article 14: the right not to be discriminated against 46
Conclusion 46
References 46
Useful websites 47
Chapter 4 Safeguarding and Protecting Children: The Roles and Responsibilities of the Emergency Care Practitioner 48
Introduction - child protection work - prevention and early intervention 48
Constituents of abuse 51
Recognition and response 53
Recognition, risk indicators and intervention 53
Children of concern or risk indicators 54
Recognising physical abuse 55
Burns and scalds 56
Recognising emotional abuse 56
Recognising sexual abuse 57
Recognising neglect 58
The unborn child 58
The legislative framework 58
Contemporary policy and legislation 59
The Children Act 2004 59
Assessment issues in child protection and implications for emergency care practitioners 60
Assessment and the Common Assessment Framework 60
Professional responsibility and response - frequently asked questions 61
Summary of key points 68
Conclusion 68
References 68
Chapter 5 Meeting the Specific Needs of Young People Attending the Emergency Department 71
Introduction 71
Adolescence and health care 71
Substance misuse 73
Alcohol 74
Sexual health and emergency contraception 78
Young people who self harm 80
Conclusion 83
References 83
Chapter 6 Treatment and Management of Minor Injuries 86
Introduction 86
The principles of assessing children with minor injuries 86
Specific injuries 87
Example patient group directive for the management of minor head injuries within a minor injuries unit 87
Wound management in the emergency department 90
Tetanus 91
Wound cleansing - some general principles 92
Wound closure - some general principles 92
Cuts and lacerations 92
Bites 93
Abrasions 94
Minor burns and scalds 95
Foreign bodies 98
Ears and noses 100
Insect bites and stings 101
Anaphylaxis 101
Bruises and haematomas 103
Soft tissue injuries 103
Fractures 104
X-ray 106
Management of specific fractures 107
Summary and conclusion 110
References 111
Chapter 7 The Principles of Assessment and Management of Pain in Children and Young People Attending an Emergency Department 115
Introduction 115
Definitions of pain 115
What is pain? 116
Pain transmission 117
Theories of pain 118
Children in the emergency department 119
Pain and its assessment 120
The challenge of managing pain with paediatric patients 122
Non-pharmacological methods 123
Pharmacological management of pain 124
Conclusion 124
References 125
Chapter 8 Emergency Care of the Critically Ill or Seriously Injured Child 127
Introduction 127
Rapid assessment of ABCD 128
The seriously injured child in accident and emergency 134
Stabilisation, retrieval and transfer 141
Summary 141
References 141
Chapter 9 Paediatric Resuscitation 143
Introduction 143
Definitions 143
Why are children different? 143
Anatomy and physiology of the respiratory tract 144
Pathways leading to cardiac arrest in children 146
Basic life support 147
When to go for help 149
Foreign body obstruction sequence 149
Advanced life support 150
Intra-osseous access 152
Heat loss 153
Post-resuscitation care 153
Exposure 154
Care of the family 154
When to terminate resuscitation 154
Equipment 154
Newborn resuscitation 155
Useful guesstimates 156
Pre-terminal signs 156
Four H's and Four T's 156
Key points 156
Bereavement 157
Conclusion 157
Appendix 1 Resources and organisations available to families who have had had a sudden bereavement (following the death of their child) 158
References 159
Chapter 10 Emergency Care and Management of Children with Acute Respiratory Illness 161
Introduction 161
The anatomy and physiology of the respiratory tract in infants and children 161
Respiratory assessment and examination of the chest 163
Respiratory problems that may be encountered in the accident and emergency department 163
Upper respiratory tract problems 164
Lower respiratory tract problems 165
Inhaled street drugs 167
Conclusion 168
References 169
Chapter 11 The Assessment and Management of Paediatric Fever in the Emergency Setting 171
Introduction 171
Fever phobia 171
Physiological aspects of fever 172
Bacterial meningitis 173
Temperature taking 173
Fever management 174
Conclusion 174
References 176
Chapter 12 Emergency Care of Children with Sickle Cell Disease: One Family's Experience 178
Introduction 178
Pain 180
Fever 180
Anaemia 180
'Sickling' 181
Splenic sequestration 181
Aplastic crisis 181
Priapism 181
Dactylitis 181
Osteomyelitis 181
Enuresis 182
Ulcers 182
The parental perspective 182
Acknowledgement 184
References 185
Further reading 186
Chapter 13 Emergency Care of Children and Young People with Diabetic Ketoacidosis 187
Pathophysiology of Type 1 diabetes 187
Causes of diabetic ketoacidosis 188
Conclusion 191
References 191
Index 193