InternationalTraumaLifeSupportInternationalTraumaLifeSupportforPrehospitalCareProvidersSixthEditionforPrehospitalCareProvidersSixthEditionPatriciaM.Hicks,MS,NREMTPRoyAlson,PhD,MD,FACEPDonnaHastings,EMT-PJohnEmoryCampbell,MD,FACEPandAlabamaChapter,AmericanCollegeofEmergencyPhysiciansPatriciaM.Hicks,MS,NREMTPRoyAlson,PhD,MD,FACEPDonnaHastings,EMT-PJohnEmoryCampbell,MD,FACEPandAlabamaChapter,AmericanCollegeofEmergencyPhysiciansCampbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJChapter17TraumainChildrenChapter17TraumainChildrenCampbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJTraumainChildrenTraumainChildrenTraumainChildren儿童创伤TraumainChildren儿童创伤Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJOverviewEffectivetechniquestogainconfidence有效增加信心的技巧Injuriesbasedonmechanismsofinjury受伤机理ITLSPrimaryandSecondarySurveys初步及进一步检查Consentandtheneedforimmediatetransport家长同意及需实时运送Pediatricequipmentneeds适合儿童之器材VariousmethodsofSMRonchild儿童脊椎固定方法EMSinvolvementinpreventionprograms参与预防意外计划3TraumainChildren-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJTraumainChildrenDifferentfromadults与成人不同•Differentpatternsofinjuries不同伤势模式•Differentresponsestothoseinjuries不同反应•Specialequipmentrequired需要特别器材–Assessmentequipmentandtreatmentequipment检查及冶疗用的器材•Difficulttoassessandcommunicate较难评估及沟通•Comewithcaregiversandotherfamilymembers•与家人或照顾者同行4TraumainChildren-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJCommunicating沟通Family-centeredcareiscritical.以家庭为中心•Caregivernotalwaysparent.照顾者未必是父母•Involvecaregiversasmuchaspossibleincare.尽量让照顾者参与•Giveexplanationsandcarefulinstructions.必需详加解释及指示•Inclusionandrespectwillimprovestabilization.包容及尊重可稳定伤者•Keepcaregiversinphysicalandverbalcontact.与照顾者保持接触Demonstratecompetenceandcompassion.5TraumainChildren-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJAssessingMentalStatus捡查精神状态Consoledordistracted可按抚或转注意力•Mostsensitiveindicatorofadequateperfusion能准确反映组织灌注是否足够•Caregiversbestatdetectingsubtlechanges照顾者会较易分辩出伤者微小改变6TraumainChildren-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJAssessingMentalStatusInitiallevelofconsciousness最初清醒程度•Preschoolchild:sleepingvs.unconscious幼儿:疲倦vs人事不醒•Mostwillnotsleepthrougharrivalofambulance大部份沿途不会睡觉•Askcaregiverstowakechild着照顾者弄醒伤者•Suspecthypoxia,shock,headtrauma,seizure怀疑缺氧、休克、头部受伤、癫痫7TraumainChildren-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJCommunicatingInteractionstrategies使用适龄的语言Appropriatelanguagefordevelopmentallevel合适的语言•Speaksimply,slowly,clearly说话要慢及简溸•Begentleandfirm必需肯定•Avoid“no”questions避免说”不”•Getafavoritebelonging利用其喜爱的玩具/随身物品•Getonchild’slevel降下身段至与伤者视线平衡•ExplainSMRnecessity解释脊椎固定之需要•Allowcaregivertoaccompanychild让照顾者与伤者同行8Traumain...
