Identification, Assessment, Stabilization and Transport (IAST) Manual for Acutely Ill Children Kundan Mittal
INDEX
A
Abdomen 32
Acute bronchial asthma 90
Acute bronchiolitis 89
Acute renal failure 115
Advanced communication skills 142
Advantages of effective communication skills 142
Agonal breaths 37
Airway 72
Airway and cervical spine 30, 94
Airway devices 14
Anaphylaxis 87
Antibiotics 62
Arterial oxygen content 58
Assess responsiveness 35
Assessment
airway 23
breathing 23
circulation: 24
degree dehydration 111
Asystole 65
B
Basic life support skills 34
Behavioral considerations 11
Blood glucose 59
Body surface area method 110
Breathing 30,72
oxygenation 30
ventilation 30
Burns 115
C
Calculation
electrolyte deficit in dehydration 111
FiO2 during normal ventilatory pattern 105
fluid deficit 112
fluid deficit therapy 111
life of cylinder in minutes 104
FiO2 during respiratory distress 105
patient inspiratory flow demands 107
Calgary Cambridge guide 143
Cardiac arrest 64
Cardiac output 58
Cardiac tamponade 99
Cardiovascular considerations 7
Categories
communication skills 142
shock 57
Caution 140
Cervical spine injury 95
Check
before transfer 125
breathing 37
signs of circulation 38
Chest 32
Chest compression 39,53
Child with abdominal injury 101
Child with meconium stained amniotic fluid 47
Children 123
Circulation 22,72
Circulation and external hemorrhage control 31
CNS conditions 115
Common injuries and their management 98
Components of PAT 21
Compressed gas cylinders 104
Continue to evaluate the baby 48
Core communication skills 142
Criteria 100,134
transfer 100
tube removal 134
D
Defibrillation/cardioversion 136
Developmental considerations 5
Diabetes ketoacidosis 115
Disability or neurological status 26
Disordered of control of breathing 91, 93
Distribution of water in the human body 109
E
Electrolyte deficit in hypotonic dehydration 111
Endocrinal considerations 9
Equipments for neonatal resuscitation 55
Establish vascular access 59
Evaluation of cervical spine injury 96
Examination of extremities 33
Exposure 27
Exposure/environment 31
F
Flail chest 99
Fluid adjustment in special situations 115
Fluid and electrolytes considerations 10
Fluid refractory hypotension 61
Fluid requirements in neonates 114
Fluid resuscitation 59, 61
Fluid schedule 113
Focused history 27
Foley's catheter insertion 139
Foreign body aspiration 87
Formulation of calcium 119
Formulations 117, 119
Free water deficit in hypernatremia 112
G
Gastrointestinal considerations 9
General differences between children and adults 3
H
Head and face 32
Head injury 101
Hemothorax 99
Hepatic encephalopathy 115
High flow oxygen delivery devices 107
History and physical examination 97
Holiday-Segar method 110
Hyperkalemia 117
Hypocalcemia 119
Hypokalemia 116
Hypomagnesemia 118
Hypoxic or asphyxial arrest 64
I
Identification of cardiopulmonary failure 65
Immunological considerations 10
Initial steps in stabilization 46
Insensible water loss adjustment 114
Intraosseous needle insertion 128
Issues during air transport 125
L
Log rolling 136
Low flow devices 104, 106
Lower airway obstruction 88,92
Lung tissue disease 91
M
Metabolic considerations 9
Minimal requirement of equipments 14
Monitoring devices 14
Monitoring child on intravenous fluid therapy 120
Musculoskeletal injury 100
Myocardial contusion 100
N
Nasogastric/orogastric tube placement 135
Needle thoracostomy 131
Neurological considerations 8
Normal daily fluid requirement 110
Normal ECF and ICF composition 110
O
Objectives of course 1
Open pneumothorax (sucking chest wound) 98
Optimizing oxygen delivery 59
Oxygen concentrators 103
Oxygen delivery 58
Oxygen delivery devices 104
Pxygen delivery sources 103
P
Pediatric airway management 72
Pediatric cardiac arrest 64
Percent of dehydration from ECF and ICF 111
Peripheral venous catheter 127
Physiologic response to injury or acute illness 17
Positioning 59
Positive pressure ventilation 49
Pre/perioperative deficit 116
Preoperative fasting 116
Prerequisite for PPV 52
Primary assessment 22
Primary survey 30,94
Principles of effective communications 142
Problems during transport 122
Pulmonary contusion 100
Pulseless electrical activity 65
Pulseless ventricular tachycardia 66
R
Recognize decreased mental status and perfusion 61
Recognizing children at risk 18
Recognizing different types of shock 58
Renal considerations 10
Respiratory considerations 5
Respiratory distress 71
Respiratory failure 71
Resuscitation 94
S
Secondary assessment 27
Secondary survey 32,97
Shock 57
signs 59
Specific management of septic shock 61
Stabilization of airway 72
Stabilization phase 124
Stroke volume 58
Sudden cardiac arrest 65
T
Target of good transport 123
Tension pneumothorax 98
Tertiary assessment 27
Tertiary survey and definitive care 33
Therapeutic end points after one hour 62
Third space losses 116
Thoracic injuries 98
Thorough physical examination 27
Transfer the child to higher center 59
Transport phase 124
Transport team's responsibility 124
Trauma consideration 12
Treatment beyond first hour 62,87
Tube thoracostomy 132
U
Upper airway obstruction 85,92
Use of automated external defibrillato 41
V
Vascular devices 15
Ventricular fibrillation 66
W
When to stop PPV 53
Work of breathing 21
×
Chapter Notes

Save Clear


ObjectiveChapter 1

Most of the Indian population live in rural areas where health facilities are still not adequate or present to meet the demand. A great number of sick children are attended by primary health care providers specially working at primary health centers and community health centers. We have no data to say that how many sick children die due to lack of basic facilities in the emergency department. Approximately 23% neonates die due to asphyxia. Though our country has good transport system but it is not well equipped to transport the sick patients. It has also been seen that good number of patients die on their way. “Scoop and run” situation which is common practice at most of places, lead to increase morbidity and mortality. Identification, assessment stabilization, and transport (IAST) course for acutely ill children has been designed for doctors and nurses working at peripheral centres where no specialist or advanced health care facilities are available (Fig. 1.1). This is an Indian adaptation with modification of PEARS course from American Heart Association.
 
 
Objectives of the Course
  1. Identification and stabilization the critically ill or injured child using simple assessment
  2. Mastering cardiopulmonary resuscitation skills
  3. Neonatal resuscitation
  4. Use of laryngeal mask airway and oxygen delivery devices
  5. Emergency procedures
  6. Transport of critically ill or injured child
  7. Developing effective communication skills between doctor and patient.
    2
zoom view
Fig. 1.1: Approach by primary response team