- Editorial – Jana Šeblová
THEME OF THE YEAR: CHILD AS A PATIENT IN EMERGENCY CARE
- A system approach to paediatric prehospital and hospital emergency care –Jana Šeblová, Jitka Dissou
- Paediatric Emergency department – Jitka Dissou
- Basic evaluation and intervention in critically ill child – Jana Djakow
- The ABCDE approach to emergencies in children – Katarína Veselá
- Paediatric Life Support – Jana Djakow
- Cardiac arrest caused by chest impact by a football ball – Jana Kubalová, Petr Štourač
- Shock condition in paediatry – Petr Dominik
- Multiple trauma in children – Pavel Heinige, Martin Prchlík, Martin Fajt
- Head trauma in children – Kateřina Fabichová, Júlia Miklóšová
- Prehospital analgesia and sedation in paediatric patients – František Kolek, Vladimír Mixa
- Paediatric protocol and its use in practice – Petr Kolouch, Katarína Veselá
- Transport of newborns – Václav Vobruba
- Transport of a premature newborn – Jan Širc, Zbyněk Straňák
A system approach to paediatric prehospital and hospital emergency care
JANA ŠEBLOVÁ, JITKA DISSOU
The authors present possible system models of acute and emergency care of paediatric patients. They analyse advantages and drawbacks of each of the presented model of care and they compare the situation in the Czech Republic with some other European countries. They also mention specific features of children´s age and differences which influences provision of emergency care compared with care of adult population.
Key words: Emergency care – paediatric patient – emergency department – anatomical and physiological differences of children
Basic evaluation and intervention in critically ill child
This review recapitulates recent knowledge on recognition and treatment of critically ill child. It describes steps summarized in ABCDE approach and the most important strategies to stabilize child with respiratory or circulatory failure.
Key words: Children – respiratory failure – circulatory failure – ABCDE – paediatric life support
The ABCDE approach to emergencies in children
The following text provides a brief overview of the ABCDE approach from the perspective of a medical practitioner to the most common emergencies in children. Foreign body aspiration and acute epiglottitis are the main threats of the airways during childhood. Respiratory disorders are the most frequently caused by outbreaks of acute laryngitis, exacerbation of bronchial asthma, or bronchiolitis in prehospital emergency care. In the field of cardiovascular failure, the paper focuses on the management of arrhythmias and hypovolemia in children. Paediatric patients are mainly treated for convulsions when facing CNS disorders. The last part is devoted to traumatic conditions in children and intoxications.
Key words: ABCDE approach – emergencies – child – child in pre-hospital care – paediatric patient – emergency medicine
Paediatric Life Support
This review recapitulates recent knowledge on paediatric life support. It summarizes possible pathways leading to the cardiorespiratory arrest in children and European Resuscitation Council Guidelines for paediatric cardiac arrest (updated in 2017).
Key words: Life support – children – cardiac arrest – paediatric basic life support – paediatric advanced life support
Cardiac arrest caused by chest impact by a football ball
JANA KUBALOVÁ, PETR ŠTOURAČ
Introduction: Direct precordial impact by a ball can lead to sudden cardiac death even without structural myocardial illness or trauma, especially in children and young people. There are numerous case reports published and the diagnose of „myocardial commotion“ is stated in these cases. The presented case report meets these criteria – cardiac arrest in 16 years old young man occurred immediately after precordial football´s ball impact.
Methods: case report, literary search
Results: ROSC emerged after delivering one defibrillation shock 250 J for ventricular fibrillation.
Conclusion: Up to tens of similar case reports can be found in literature. Children and young people, mostly men, are the most frequently affected. The published events happened during organised competitions in most of the cases. Collapse immediately following a precordial blunt trauma of the chest which caused ventricular fibrillation was the unifying feature of the published cases. The impact was relatively common not suggesting that it can cause death. Despite life support was provided early, within 3 minutes, the survival rates were low. Experimental study in piggs proved that ventricular fibrillation is caused by the impact with timing 30–15 msec before ECG T wave peak.
Key words: cardiac commotion – cardiac arrest in young people – ventricular fibrillation – organised sport competitions
Shock condition in paediatry
Worldwide, shock is a leading cause of morbidity and mortality in the paediatric population. Shock is defined as a state of acute energy failure due to inadequate glucose substrate delivery, oxygen delivery or mitochondrial failure at the cellular level. The clinical state of shock is diagnosed on the basis of vital signs, physical examination, and laboratory data, although its recognition in the paediatric patient can be difficult.
This article reviews different pathophysiologic classifications of shock and their etiologies. I try to show current diagnostic and therapeutic strategies which can help to guide the most effective and appropriate treatment for resuscitating the child in shock.
Key words: shock condition – division and etiology of shock – examination – volume resuscitation – child
Prehospital analgesia and sedation in paediatric patients
FRANTIŠEK KOLEK, VLADIMÍR MIXA
Analgesia and sedation are the important part of prehospital emergency care. Analgosedation is different for each age group. The paediatric patient requires another dosage of sadatives, the substances have different pharmacokinetics, doctors and paramedics often use alternative ways of administration and some drugs are contraindicated for children. This article presents the list of the medications and the appropriate combinations for different clinical situations for children.
Key words: analgesia – sedation – children – prehospital emergency care
Paediatric protocol and its use in practice
PETR KOLOUCH, KATARÍNA VESELÁ
The paediatric protocol is a way of ensuring that health workers who do not routinely deal with children will use appropriate equipment and administer safe doses of medication when treating children. It is conceptually based on the original work of James Broselow and Robert Luton, who in 1985 described the correlation between the height and weight of children to the 50th percentile. On this basis a so-called Broselow tape was created where the children are divided into coloured categories according to their height. The paediatric protocol is a Czech adaptation of this tape.
Key words: Broselow – Broselow tape – paediatric care – paediatric protocol
Transport of newborns
Transport of newborns and low-weight newborns has specific demands for treatment, management of care and technical equipment needed for interhospital transports. The transports of these patients are provided by specialised transport services of perineonatal centers in cooperation with regional Emergency medical service.
Key words: newborn – low-weight newborn – transport