Continuing Professional Development: Assessment of the acutely or seriously ill child or young person in the prehospital setting

Kerry Cook
Wednesday, April 21, 2010

OverviewChildren and young people (CYP) have distinctive needs within emergency and urgent care. Clinical presentations can often be confusing with non-specific symptoms and numerous potential diagnoses which may require a variety of assessment, management and treatment strategies. For the inexperienced practitioner, assessing CYP can be daunting. Applying clinical reasoning to these situations requires the practitioner to have an understanding of child-specific anatomy, physiology, pathophysiology and psychology; as well as the ability to consider other contributing factors such as the child's ability to communicate.Furthermore, it has been recommended that every professional who is involved in the care of a child and/or young person, should, as a minimum, be competent in: recognition of the sick child; basic lifesupport skills; initiation of treatment using protocols for the management of common conditions; recognition of rare but treatable conditions; effective communication; recognition of and response to any concerns about safeguarding and understanding the need for play and recreation activities.In this article, a case presentation will be used to demonstrate how initial observations require critical thinking in order to identify alternatives to the most obvious rationale for the presenting signs and symptoms.Learning OutcomesAfter completing this module you will be able to:• Have an understanding of the factors involved in critical thinking and clinical reasoning and begin to further develop these.• Recognition of different models of assessment that can be incorporated into your practice. Have an understanding of the importance of using a structured approach to assessment of children and young people.• Further develop your knowledge and understanding of key anatomical and physiological differences in children and young people and how these impact on their clinical presentation.• Use a case presentation to explore the numerous potential diagnoses for paediatric presentations.• Have an appreciation of the current NICE guidelines and how these should impact upon your practice.

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