Managing Specific Medical Emergencies in Primary Care

An emergency medical situation requires the use of emergency, albeit proficient management that is based on prior evidence. Specifically, according to Geyman (1998), evidence-based clinical approaches are important in ensuring that the benefits of the approach outweighs the harm that is likely to arise. In this regard, a quick and rigorous periodic reassessment of evidence should be conducted before a clinical decision is made. Further, the decisions of the clinicians should be integrated with the best available, but rather relevant evidence on that particular medical emergency. The importance of the evidence-based approach in primary healthcare setting needs to be underscored. The mere experience of the clinician is not enough; there is a need to consult an external source so that an informed decision can be made on the best approach to be used in a particular medical emergency (Geyman, 1998). Most importantly, evidence-based approach ensures that the approach that is going to be used is the best in the circumstances compared to the others that could be used.

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In an emergency, there is a very short period for the clinician to consult. However, with a computer around, it will be very easy to access the approaches and decide which one is best in the circumstances. Indeed, the approach is important in informing the clinician of the method that offers more benefits than harm. According to Greenhalgh (2014), Evidence-based plan of care is informative in nature. As such, a clinician who uses this method can never be wrong, as the final decision will be made based on the review of a variety of approaches (Toback, 2016). In the present case, a child under the age of one year requires very quick but proficient medical approaches that will get him/her out of the pain. The approach that will be applied in this case would be based on the extent and the depth of the Burns/Chemical Exposure. Additionally, there is need for a multidisciplinary team of medical personnel. This team should be composed of doctors, nurses, therapists, etc. These would ensure that the physical, psychological and social needs of the child are well-taken care (Burns et al., 2012).

In this emergency of a childs Burns/Chemical Exposure, there is some piece of objective and objective information that may be found. Objective information is that which is collected with an aim of aiding in the treatment of the child. As such, it is objective in nature as it involves the standard questions that are asked in hospital. However, the subjective information is personal in nature as it touches on the family of the child. In this regard, the exact age of the child will be one of the objective information. Further, the psychosocial status of the family would contribute to the subjective information. However, the extent and severity of the burn, the presence of infection, and the health status of the child would all form subjective information. Further, in this emergency, all information whether subjective or objective will be important in ensuring that proficient decisions are made on the best way that the child can be treated without much pain and harm.

According to Simons, Kimble (2010), the first step in diagnosing the child would be to assess the severity of the burn/chemical exposure. This will involve the taking of the history and physical examination by a medical officer. Since the child is unable to speak due to age, this information will be obtained from the parents/relatives of the child. The history of the burn will help in determining the requirements of the surgery. Due to the age of the child, the second step would be to do an intubation to the child since the burn must have compromised the airwaves (Toback, 2016). After ascertaining the surface area affected as well as the depth of the burn/chemical exposure, the injury would be classified. In the present case, a full thickness burn will require skin grafting. However, if the burn were either superficial, superficial partial thickness or deep dermal partial thickness would not necessarily require skin grafting. Afterwards, a burn/chemical exposure assessment would be done by a competent surgeon. At this stage, a laser Doppler scanner would be used to determine the depth of the injury. However, this process requires that the child be sedated to prevent her from the pain.

Pain management is another step of this care that cannot be left behind. In this regard, nurses should assess the pain and record the observation charts on an hourly basis. According to Toback (2016), the assessment tool necessary for this case is the Faces, Legs, Activity, Cry and Consolability (FLACC). Being an infant below one year of age, an intravenous medication should be injected to reduce the pain that the child is experiencing. Notably, the discomfort of the child during therapy would negate the efficiency of the therapy. At this stage, various strategies for distraction can be employed. In this regard, the child can be tickled so that he/she is distracted from the pain and anxiety of the moment (Toback, 2016). The wound is then dressed via the Antimicrobial activity which is known to decrease infections that are related to wounds. The dressing should be performed under aseptic conditions to prevent more pain to the child.

Evidence-based, management plan would involve the consultation of prior measures/approaches that have been used to treat severe burns and chemical exposures. from that evidence, the medical practitioner will combine that with his/her experience and make rational judgment on the best method that can be used in the treatment of burns for a child below the age of one year. As such, all the specialists would be consulted to ensure that the approach that is used has more benefits than harm. In the above paragraphs, it has been shown that the approach used is the one that considers the age of the child, the severity and depth of the burn as well as the probability of infection.

In conclusion, evidence-based management plan is very important as it provides the most proficient way of handling an emergency. In this regard, it enables a medical officer to apply an approach that is more beneficial and that causes less or no harm. In the present case, a physical examination should first be done to establish the severity and depth of the burn. In the performance of all that, the medical practitioner must take into account that the child is below one year of age and that he requires emergency medical attention. This is done after the child has been sedated. Notably, the child must be given an intubation incase the burn blocked the airway. After the examination, a surgery is performed to ensure that the burnt skin is removed. Afterwards, they wound is dressed to ensure that it is not infected. Finally, burn rehabilitation is done to ensure that the burn heals without any complications.

References

Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2012). Pediatric primary care. Elsevier Health Sciences.

Caep.ca,. (2016). Implementation Guidelines | CAEP. Retrieved 24 January 2016, from http://caep.ca/resources/ctas/implementation-guidelines

Geyman, J. P. (1998). Evidence-based medicine in primary care: an overview. The Journal of the American Board of Family Practice, 11(1), 46-56.

Greenhalgh, T. (2014). How to read a paper: The basics of evidence-based medicine. John Wiley & Sons.

Reynolds, S. (2008). Evidence-based practice: a critical appraisal. L. Trinder (Ed.). John Wiley & Sons.

Simons MA, Kimble RM. 2010. Pediatric Burns. In: JH Stone, M Blouin, editors. International Encyclopedia of Rehabilitation. Available online: http://cirrie.buffalo.edu/encyclopedia/en/article/119/

Toback, S. (2016). Medical Emergency Preparedness in Office Practice - American Family Physician. Aafp.org. Retrieved 24 January 2016, from http://www.aafp.org/afp/2007/0601/p1679.html