"MS 154 respond to a child unconscious, non-responsive, unknown cause."
You arrive at the address and are met by the patient's mother. She tells you that her daughter is in bed and can't be awaken, as she's been sick for a few days. As you assess the scene and find it safe to continue your response, you are led to a bedroom where you hear moaning. From the doorway, you begin utilizing the Pediatric Assessment Triangle (PAT). General appearance is poor as the young girl is not responding to her father's voice. She is moaning and her lips appear dry. You continue towards her, introduce yourself, and notice her breathing is accelerated.
Two major "red flags" from the PAT exist; your initial thoughts have confirmed that this child is probably significantly sick and in need of a quick, yet safe transport to definitive care. Now at the patient's side, you feel her skin and find it cool to the touch, showing signs of dehydration, and mottled about the abdomen and thighs. Her capillary refill is slowed to four seconds distally, which is consistent with the weak distal pulses felt.
As you gather formal vital signs, the parents tell you that Kathy, an otherwise healthy nine-year-old girl, has had flu-like symptoms, nausea, and vomiting for about four days and they are worried that she's contracted the swine flu. Her vital signs are: Pulse = 142 beats per minute and weak distally, Respirations = 34 breaths per minute, BP = 88/40, Pulse Ox = 98 percent on room air. Because of her "cool to the touch" status, a tympanic temperature is taken and recorded to be 92.50 F (33.50 C). Her capillary refill is greater than three seconds and she is only responding to painful stimuli.
