"Responding to Emergencies" with Dr. Kevin Haughton, East Olympia Family Medicine, and Dr. Joe Pellicer, Providence St. Peter Hospital Emergency Center, May 2011 in Olympia.

1. Pediatric Emergencies
Kevin Haughton, MD
Providence Medical Group – East Olympia Family Medicine
With special guest Joe Pellicer, MD, Emergency Medicine

2. Kevin Haughton, MD
• Served as director of St. Peter Family
Medicine Residency Program for
11 years.
• Providence Medical Group Primary
Care Section Chief
• Enjoys making personal connections
with patients and their families. Cares
for all ages at East Olympia Family
Medicine, to schedule an appointment
call 360.486.6777

3. Topics we will cover
• Choking
• Poisoning
• Bug bites and bee stings
• Rashes and sunburns
• Sprains and head injuries
• Heat exposure
• Home medicine cabinet
• Travel medical supplies

4. Choking
• Higher risk at younger age
• Small portions
• Ample time
• Good posture
• Cut up food: half inch maximum less than 4 yo
• Limit distractions while eating
• Avoid feeding while in the car
• Airway the size of drinking straw

5. Choking
• Hidden toys in seat cushions
• Coins, marbles,
• Watch batteries,
pieces of other toys
• American Red Cross CPR class
• Medic One: 360-704-2780
• Babysitter training

6. Poisoning
• Identify the poison
• Call poison control:
1-800-222-1222
• Dilute the poison: drugs,
plants, contaminated food
• Avoid absorption
• Do not induce vomiting in
kids who are not fully
conscious and awake

7. Poisoning continued
• Syrup of Ipecac
• Controversial
• No longer made
• Do not use with drain cleaner, petroleum
based products (kerosene or gasoline), or
corrosive chemical product
• Do not induce vomiting if the patient is not
fully conscious and coherent
• Substitute for Ipecac: drink 2 tbsp. of mild
soap or 1 tbsp. of dried mustard mixed with
a half liter of water; tickle the back of the
throat.
1-800-222-1222

8. Bug Bites & Bee Stings
• Mostly mosquitoes
• Watch the time outdoors
• Do not allow standing water
near your house
• Long sleeve shirts and trousers
• DEET and permethrin

10. Spiders Bites,
Bee Stings
• Much maligned spiders
• Deer and horse flies
• Fleas and bed bugs
• Yellow jackets and wasps
• Bee stings
• Remove stinger, wash thoroughly, ice, antihistamine
• 911 Emergency: trouble breathing, swelling around
face or mouth, hoarse voice, feeling weak, or turning
blue

11. Rashes
• Fewer rashes than we used to see
• Impetigo – common
• Sick with fever and rash
may need further evaluation

12. Sunburn
• Sunscreen, shade, cover skin, avoid 11AM – 2PM
• Fluids, tylenol, ibuprofen, cool packs, aloe vera
• Avoid burning

13. Fevers
• Febrile seizures
• Can get goofy with high fevers
• Tylenol or ibuprofen will lower temp
– treats symptoms only not curing
underlying problem
• Ear infections may not need antibiotics

14. Heat injuries
• Heat exhaustion
– thirsty, headache, nausea, vomiting,
irritability, muscle cramps
• Heat stroke
– confusion, seizure, loss of consciousness
• Prevention
– lots of fluids, light colored clothing,
avoid excessive heat with exercise
• If concerned, bring the child into a cool shady spot

15. Vomiting, diarrhea,
and dehydration
• Fluids: popsicle, jello, pedialyte
– small amounts frequently
• Abdominal pain: appendicitis
usually no appetite, fever, and
severe abdominal pain – progresses rapidly
• Jump up and down test
• Blood in diarrhea?

16. Unintentional injuries
• Falls are the most common
• Being hit by something
• Car accidents
• Head injuries
• Hope to avoid CT scans

17. What to say
when you call:
• How old is the child?
• How far did he fall?
• What did she land on?
• Is there any blood or broken bones?
• Did he lose consciousness?
• What is she acting like now?

18. Injury Prevention
• Helmets
• Car seats
• No walkers
• Water can be dangerous – do not
leave kids unsupervised

19. Home Medicine
Cabinet First Aid Kit
• Get rid of bad stuff: old medicines
• Tylenol, ibuprofen
• Bandaids, antibiotic ointment
• Gauze, moleskin, tape, ace wrap, safety pins
• Benadryl, Hydrocortisone cream
• Thermometer
• List of contacts and emergency phone numbers
• First Aid Manual

20. Travel medicine supplies
• Encourage travel – good for kids
• Basic first aid plus:
– insect repellent, sunscreen,
motion sickness medication,
safety pins,
Afrin or drinking for airplanes
• Wash your hands – consider bringing hand sanitizer
• Be careful of cars & dogs
• Get vaccinated

21. Questions?