Final answer:
The approach to a pediatric case where a child has fallen requires immediate assessment, diagnostic tests such as x-rays or CT scans, and therapy based on findings. The child's care location depends on severity, and further actions may include involvement of child protective services amidst concerns of non-accidental injury.
Step-by-step explanation:
Approach to a Pediatric Fall Case
In the provided case scenario of a 4-year-old male brought to the Emergency Department (ED) after a fall with complaints of chest pain and a withdrawn demeanor, the following steps need to be taken:
- Emergency Orders: An immediate assessment must be done to rule out life-threatening conditions, ensure airway, breathing, and circulation are stable.
- Physical Exam: A thorough examination should include assessing for signs of trauma, bruising, or broken bones, especially in the chest area where the patient complains of pain.
- Diagnostic Tests: Request for imaging, such as x-rays or CT scans of the chest, to identity possible fractures or internal injuries.
- Therapy: Depending on findings, may include pain management, stabilization of any fractures, and appropriate wound care.
- Location: Patient should be kept in the ED or transferred to pediatric unit depending on severity.
- Final Order: After stabilization and assessment, follow-up steps involving potentially child protective services if abuse is suspected due to the circumstances.
- Diagnosis (Dx): Pending test results and findings but could range from simple contusions to more severe injuries like fractures or internal trauma.
Since the clinical presentation might vary and suspicion of non-accidental injury might be raised due to the babysitter's involvement and the child's demeanor, it is important to consider all possibilities and involve social services if necessary.