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Discussion: Skill 6- Triage (Vitals)
Group Assignment: Pediatric Triage and Vital Signs Scenarios
Instructions:
In this group assignment, you will work together to analyze and respond to the following pediatric patient scenarios. Each group will be assigned a scenario and must complete the tasks outlined. After completing the tasks, each group will present their findings and proposed actions to the class.
Instructions:
- Form Groups:
– Group is reflective of who your supervisor is.
2. Scenario Distribution:
– Each group will receive one of the following scenarios to discuss:
- Attempt a discussion on at least one of the discussion points below.
- Respond to at least one of your colleague’s discussions.
(BreAna) Scenario 1: Respiratory Distress
A 3-year-old child is brought to the emergency department by their parents. The child has been experiencing difficulty breathing, a persistent cough, and a high fever for the past two days.
- Initial Assessment:
– Describe the steps you would take to gather information about the child’s medical history, current symptoms, and any recent illnesses or injuries.
- Prioritization:
– Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
- Vital Signs Assessment:
– List the vital signs you would assess and the methods you would use to measure them for this child. Include how you would take the child’s temperature, heart rate, respiratory rate, and any other relevant assessments.
- Immediate Interventions:
– Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
- Communication and Documentation:
– Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
(Lauryn) Scenario 2: Suspected Fracture
An 8-year-old child arrives at the clinic with their caregiver after falling off a playground structure. The child is complaining of severe pain in their right arm and is unable to move it.
- Initial Assessment:
– Describe the steps you would take to gather information about the child’s medical history, the circumstances of the injury, and the severity of the symptoms.
- Prioritization:
– Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
- Vital Signs Assessment:
– List the vital signs you would assess and the methods you would use to measure them for this child. Include how you would assess pain and any other relevant observations.
- Immediate Interventions:
– Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
- Communication and Documentation:
– Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
(Leah) Scenario 3: Dehydration
A 5-year-old child is brought to the clinic by their parents with symptoms of vomiting, diarrhea, and lethargy over the past 24 hours.
- Initial Assessment:
– Describe the steps you would take to gather information about the child’s medical history, the onset of symptoms, and any contributing factors.
- Prioritization:
– Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
- Vital Signs Assessment:
– List the vital signs you would assess and the methods you would use to measure them for this child. Include how you would assess hydration status and any other relevant observations.
- Immediate Interventions:
– Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
- Communication and Documentation:
– Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
(Fatima & Irma) Scenario 4: High Fever and Rash
A 6-year-old child presents to the clinic with a high fever, body aches, and a widespread rash. The child appears very uncomfortable and irritable.
- Initial Assessment:
– Describe the steps you would take to gather information about the child’s medical history, the onset of symptoms, and any recent exposures or illnesses.
- Prioritization:
– Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
- Vital Signs Assessment:
– List the vital signs you would assess and the methods you would use to measure them for this child. Include how you would assess the rash and any other relevant observations.
- Immediate Interventions:
– Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
- Communication and Documentation:
– Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
Discussion points:
-What are your assessment findings, proposed interventions, and documentation strategies to the class. Be prepared to answer questions and discuss the rationale behind your decisions.
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18 Replies
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(Leah) Scenario 3: Dehydration (Emmanuel N, Emmanuel T, Banessa, Apple, Koree)
A 5-year-old child is brought to the clinic by their parents with symptoms of vomiting, diarrhea, and lethargy over the past 24 hours.
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Initial Assessment:
– Describe the steps you would take to gather information about the child’s medical history, the onset of symptoms, and any contributing factors.
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If the patient’s medical history is not present in the EHR, we could inquire the patient or the parents about the child’s previous medical history. We would ask for any previous conditions, surgeries, diseases, and medications of the child.
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The onset of symptoms could be assessed by the status of the urgency level. In this scenario and based on the symptoms, the child is in an urgent care situation.
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Prioritization:
– Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
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Based on the symptoms presented we would classify the child’s condition as urgent. Dehydration can cause damage to the kidneys, heart, and brain. Even though the symptoms don’t seem harmful, it is important to treat them quickly. However, compared to someone who suffered an open wound from a gunshot or stab, these people would have to be attended first due to the dangers of infection or blood loss. Therefore, urgent care is the best placement for the child, since the severity level is not the highest in the triage protocol.
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Dehydration can lead to death if not treated immediately. Some of the symptoms include confusion, dark urine, and no urine.
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Vital Signs Assessment:
– List the vital signs you would assess and the methods you would use to measure them for this child. Include how you would assess hydration status and any other relevant observations.
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A vital sign that we could use to assess the hydration status of the child would be by testing their conscious and confusion levels. If the child is completely passed out it is safe to assume that they are in a critical dehydrated situation. If the child is confused, we can assume that the children might be dehydrated to a midpoint critical situation.
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Since the child is vomiting and has diarrhea, we could use this information to assume that the child has lost more minerals and fluids. This means that the child might need urgent care, so that we could help replenish these lost fluids and minerals.
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Immediate Interventions:
– Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
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An immediate intervention that may be necessary for the child would be taking them to the ER to restore the child’s body fluid balance as quickly as possible. The rationale behind this is to keep rehydrated the child, and keep them safe!
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Communication and Documentation:
– Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
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We would respectfully communicate with the parents, and inform them that the children isn’t in a critical condition(death situation). However, for the safety of the child, we would advise the parents to pay more attention to the hydration levels of the child.
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Furthermore, we could advise the parents to buy “Electrolit” to keep the child hydrated. We could potentially give the parents a pamphlet informing them over how to avoid this situation.
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(BreAna) Scenario 1: Respiratory Distress
Brenda N.
Kaelynn H.
Jason M.
Kimberly B.
Dayanara B.
Iveth D.
1 Initial Assessment:
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– Ask the parent about the child’s medical history
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– Have them give more explanation about what symptoms their child has been
experiencing
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– What activities the child was doing before showing any symptoms
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– Also ask them if their child recently was dealing with any illness or injuries
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– Ask if the child had any recent operations
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Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
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Symptoms: difficulty breathing, a persistent cough, & high fever for the past two days
Based on the symptoms presented, the child’s condition is likely emergent. We need to see how serious their breathing problem is and we need to give them the right treatment to ensure their safety. If we put them in emergent care, healthcare professionals will treat them quickly.
2 Prioritization
3. Vital Signs Assessment:
-Check Weight and Height
-Check her oxygen levels with the oxygen meter
-Check her respiration rate, checking if it is normal or irregular
-Check her temperature to see how high her fever is
-Check Blood Pressure
-Check her pain level
-Her heart rate is important to check because we have to know if it is normal,to low, or to high
When checking all the vital signs we should make sure to make her feel comfortable because we don’t want to worsen her condition.
Each step of taking vital signs we should always tell her what we are doing so that we don’t cause her any worries but also make sure to not get her tired.
When taking the vital signs of this specific patient we should take them while she is in a position that she can breathe better in.
4. Immediate Interventions:
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– Comfort is an intervention that is necessary for this child because she is experiencing a hard time. This will help ease her distress and prevent any further difficulties/complications.
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– Positioning the child the proper way is an immediate intervention that is needed. The 3-year old is having difficulty breathing so helping the child adjust their position can make a difference in the way they breathe. By adjusting their position that can be seen by using special positions that will make it easier for the child to breathe.
– Continuous support and reassurance is an intervention that is necessary for the child because it will help reduce stress/anxiety. In addition, it will help build trust and help the child feel more safe.
5. Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
To communicate with the other members on my team about the patient’s health status I would
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– Inform them about the child’s arrival
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– Clearly state exactly what the parents have said about the child in this case it would be the
persistent coughing , difficulty breathing, and high fever.
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– If the nursing staff or anyone else on the healthcare team has made a comment on the child
that might be relevant. Also replay those back to the rest of the team. On the documentation it would have
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– Patient basic information ( name, dob, age)
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– The complaints / reason for visit
– Again in this case as stated above which would be the persistent coughing , difficulty breathing, and high fever.
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– If the child has any previous medical history
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– Either the child’s past illnesses or diseases
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– Or if the family has had anything relevant
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– The vitals that were taking for that day
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– Oxygen
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– Temp
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– Bp
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– Heart rate
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– Respiratory
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– If the child has any pain (so on the pain scale of 1-10 but since it is a child they might do the faces scale instead)
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– The length of the symptoms and if they are taking anything for it (has it better or worsened with it) how long they have been taking it, the milligrams, and how frequent
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I like how you put the immediate interventions in bold
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I love how you have attention and great care towards to the patient.
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I agree with you, sending the child to urgent care when they need it is top priority
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Scenario 4: High Fever and Rash
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Initial Assessment:
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Introduce Yourself and Establish Rapport.
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Obtain a Detailed Medical History.
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Onset of Symptoms/ Symptom Details.
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Recent Exposures.
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Additional Symptoms.
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Family and Social History.
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Review of Systems to check for any other related symptoms.
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Document the Findings.
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Communicate with the Healthcare Team.
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Great job Odalis!!!
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Excellent work, I find it very interesting.
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Initial evaluation
To gather information about the child’s medical history, the onset of symptoms, and any recent exposures or illnesses, you would follow these steps:
1. Medical History of the Child:
– Medical History: Ask about previous illnesses, chronic conditions, allergies and current medications.
– **Immunizations:** Check if all vaccinations are up to date.
– **Family History:** Inquire about recent contagious diseases in the family or in close people.
2. Description of Symptoms:
– Onset and Progression: Ask when the fever and rash started, and how they have progressed.
-Associated Symptoms: Find out if there have been other symptoms such as vomiting, diarrhea, headache, changes in appetite or behavior.
– Recent Exposure: Investigate if the child has been in contact with sick people, has recently traveled or has had contact with animals.
Priorization
Using triage protocols, you would classify the child as urgent due to:
– High Fever: May indicate a serious infection.
– Generalized Body Aches and Rash: These symptoms can be signs of serious infectious diseases such as meningitis, scarlet fever or exanthematous diseases such as measles.
Irritability: Signals significant discomfort and potentially an infection of the central nervous system.
Vital Signs Assessment
1. Body temperature: Measure with a digital thermometer, preferably axillary or tympanic.
2. Heart Rate: Use a pulse oximeter or take the pulse manually in the radial artery.
3. Respiratory Rate: Count respirations for one full minute.
4. Blood Pressure: Use an appropriate pediatric blood pressure cuff.
5. Oxygen Saturation: Measure with a pulse oximeter.
6. Eruption Evaluation:
– Visual Inspection: Observe the distribution, type (maculopapular, vesicular, petechial) and characteristics of the rash.
– Palpation: Check for pain, heat or insufficiency in the affected areas.
Immediate Interventions
1. Fever Control:
– Antipyretics:** Administer paracetamol or ibuprofen according to the appropriate dosage for the age and weight of the child.
2. Hydration:
– Oral or Intravenous: Ensure adequate hydration, administering fluids orally or intravenously if necessary.
3. Continuous Monitoring:
– Frequent Observation: Frequently evaluate the child’s vital signs and general condition.
4. Isolation:
– Contact Precautions: If an infectious disease is suspected, isolate the child to prevent spread.
Communication and Documentation
1. Communication:
– Inform the Team: Communicate to the medical team about the child’s condition, describing vital signs, symptoms, findings and any interventions performed.
2. Documentation:
– Complete Record: Include in the medical history all relevant data: medical history, onset and progression of symptoms, results of the evaluation of vital signs, characteristics of the rash and immediate interventions carried out.
– Action Plan: Document the monitoring plan and any additional consultation required.
Class Discussion Points
1. Evaluation Findings:
– High fever, generalized skin rash, body aches and irritability.
2. Intervention Proposals:
– Administration of antipyretics, ensuring adequate hydration, continuous monitoring and isolation in case of suspected infectious disease.
3. Documentation Strategies:
– Detailed record in the medical history, clear and concise communication with the medical team and monitoring of the child’s condition.
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Really good answers!
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(Ms.Irma) High fever and Rash-
Initial Assessment-To gather info about the patient I would ask parents/Guardians about the child medical history,symptoms and recent exposures to others that are sick around family/school.
Prioritization-Based on any rashes or any irritation are considered an urgent condition,These require immediate attention so no infections or allergies cause during the future.
Vital signs Assessment-I would measure temp using a electrical thermometer I would also check heart rate (pulse) ,respiratory rate,blood pressure.
Immediate Interventions-Apply a cool ice pack and show the physician the symptoms so they can identify any medications needed.
Communication and Documentation-i would communicate with my co-workers and with the physician informing them clear information.Documenting the patients symptoms clearly.
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A 6-year-old child presents to the clinic with a high fever, body aches, and a widespread rash. The child appears very uncomfortable and irritable.
- Initial Assessment: Describe the steps you would take to gather information about the child’s medical history, the onset of symptoms, and any recent exposures or illnesses.
to gather the child information first would ask the parents a few questions about the kid, like what’s allergic to and has he been injure before because some wounds cannot be healed properly if no care enough and also the how long has the child been sick.
– Prioritization:Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
- if the child with high fever would vomit it would be urgent due to losing body fluids and if the rash is causing the kid to get irritable pain
- Vital Signs Assessment: List the vital signs you would assess and the methods you would use to measure them for this child. Include how you would assess the rash and any other relevant observations.
- if the rash becomes bloody then we would take him to emergency and if the fever is way to high we would find a way to cool off the kid without being to fast as that would have shock in quick temperature changed.
- Immediate Interventions: Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
- I would ask the parents would be ok if the child is waiting and see if we can see the root of the problem why they sick
- Communication and Documentation: Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
i would communicate with the rest of the team with how is the patient doing and we should either put the child in the top priority list. or if patient would be check every time we pass
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I agree with you Elvis, all of the things you have listed are very accurate ways to assess a patient.
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like how you explain everything great answers
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(Ms.Lauryn)
An 8-year-old child arrives at the clinic with their caregiver after falling off a playground structure. The child is complaining of severe pain in their right arm and is unable to move it.
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Initial Assessment: – Describe the steps you would take to gather information about the child’s medical history, the circumstances of the injury, and the severity of the symptoms.
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Ask the parent/caregiver what there age and date of birth is and ask if they are new or old patient
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Ask the patient what there pain is from one to ten
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Ask the parent if they are allergic to anything or any medication
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Prioritization: – Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
Looking at the child’s condition it is slightly urgent because they could possibly have broken their arm but might have some nerve damage if they are unable to move it completely.
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Vital Signs Assessment: – List the vital signs you would assess and the methods you would use to measure them for this child. Include how you would assess pain and any other relevant observations.
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I would give them pain medication that they are not allergic to
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I would see if it is swollen and if it is, give them an ice pack
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I would see if they could move their fingers or if there arm is numb
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I would then start with vitals like the Bp, O2, respiration at the same time
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Then temperature, then ask the parent what was there last height and weight or measure them yourself
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Then move them to the waiting room to get examined
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Immediate Interventions: – Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
The arm might be completely broken, like shattered and there might be some nerve damage because they said that they fell off a playground and they could have fallen directly on it and that they can’t move can indicate those 2 things.
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Communication and Documentation: – Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
The patient is suffering from a possible broken arm and is unable to move it and it is currently swollen and visibly bruised, gave them an ice pack and “liquid ibuprofen” Medication. Also give them their vitals and the pain level.
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Group Assignment: Pediatric Triage and Vital Signs Scenarios
Scenario 4: High Fever and Rash
A 6-year-old child comes to the clinic with a high fever, body aches, and a widespread rash. The child looks very uncomfortable and irritable.
Initial Assessment
Steps to Gather Information:
- Ask the parents about the child’s past health problems, allergies, and any ongoing medications.
- Find out when the fever, body aches, and rash first appeared.
- Ask if the child has been in contact with anyone who is sick or if they have traveled recently.
Prioritization
Determine Urgency:
If the child’s condition is severe, like showing signs of serious illness or distress.
If the child has concerning symptoms.
If the symptoms are mild and not serious.
Immediate attention needed if symptoms suggest a serious illness.
Vital Signs
- Check for fever using a thermometer.
- Measure the pulse to see if it’s normal or elevated.
- Count how many breaths per minute the child takes.
- Check blood pressure
- Look at the rash’s appearance, location, and any changes.
Documentation
- Share details about the child’s symptoms, medical history, and any initial findings.
- Record the child’s temperature, heart rate, respiratory rate, blood pressure, and details about the rash. Note any immediate actions taken and the child’s response.
- High fever, body aches, rash details.
- Temperature, pulse, breaths, and blood pressure.
- Medications given, comfort measures, and any observations about the rash.
Presentation Preparation
Summarize the child’s symptoms, vital signs, and overall condition
Explain what actions you took and why.
Show how you recorded the patient’s details and communicate
Kiara, Krystal, Kaylee
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This reply was modified 1 year, 9 months ago by Kiara.
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(Lauryn) Scenario 2: Suspected Fracture
An 8-year-old child arrives at the clinic with their caregiver after falling off a playground structure. The child is complaining of severe pain in their right arm and is unable to move it.
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Initial Assessment:
– Start by ensuring the child is in a comfortable position and reassure them to help reduce anxiety.
– Perform a quick visual inspection to identify any obvious deformities, swelling, or bruising.
– Medical History- Ask the parent or guardian about the child’s medical history, including previous injuries or conditions that might be relevant.
– Inquire about any medications the child is currently taking, allergies, and any chronic illnesses.
-Circumstance of the Injury- Ask the child and the parent or guardian about how the injury occurred. Was it due to a fall, a direct blow, or some other incident?
– Determine the exact time and place of the injury to understand the context better.
-Symptom Severity- Ask the child to describe their pain, using a pain scale if appropriate 1-10
– Note any specific symptoms like numbness, tingling, or inability to move the arm.
Prioritization:
– Based on the symptoms presented, determine the urgency of the child’s condition using triage protocols. Explain why you categorized the patient as emergent, urgent, or non-urgent.
Based on the symptoms presented-severe pain in the right arm and inability to move it – the child’s condition should be categorized as urgent.
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Vital Signs Assessment:
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Temperature- measure the child’s temperature to check for signs of infection or inflammation, which could be causing the pain.
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Pulse Rate- Monitor the child’s respiratory rate to ensure they are breathing normally and to rule out any respiratory issues related to pain.
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Blood pressure- Check the child’s blood pressure to assess their cardiovascular health and rule out any potential complications related to the severe pain.
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Weight- Check the patient’s weight
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Immediate Interventions:
These interventions are critical to managing the child’s condition, providing relief, preventing further damage, and ensuring proper medical evaluation and treatment.
– Identify any immediate interventions that may be necessary for this child and explain the rationale behind them.
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Assessment of circulation
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Medical evaluation
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Pain management
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immobilization
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Communication and Documentation:
– Outline how you would communicate the patient’s status to the healthcare team and what information would be included in the documentation.
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Clear and concise information
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Active listening
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Empathy and compassion
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Nonverbal communication
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Accuracy
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Timeliness
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Hi Hailey i really liked how you put kindness and professionalism into your answers, everything was so organized and well said!
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