Peter Antevy introduces the blink assessment, a rapid pediatric evaluation done in seconds when first approaching a child. Clinicians observe appearance, breathing, and circulation to spot critical problems before touching the patient, using the pediatric assessment triangle as a guide.
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Okay, now I want to talk about pediatric assessment. The most important part of your interaction with the child. This type of assessment, we're going to call it the blink assessment. Why blink? Because it's the assessment you make as you're walking up to the family, as you're walking up to the child. And there's three components of that. You know of this, you've heard of this, called the pediatric assessment triangle. I want to back up a little bit because the blink assessment can only happen if you're in the right frame of mind. And so let's kind of back up to the 6 to 8 minute ride until you get to this family's house. Very, very important for you to be in the right frame of mind. You have to know the age of the child. And oftentimes you'll know that. If you know the age of the child, what are we going to find out? You'll find out the epidose, the airway size, let's say using an eye gel or a king tube, you'll have that size, and the joules for cardiac arrest. We're going to be going over all of this today in the class. That's important because when you get to the scene, if you're calm and you're relaxed, then you can look at the mother in the eyes, you can look at the child in the eyes, and then you'll actually be able to make this blink assessment appropriately. So you're probably thinking, why do I have to be stress free? It turns out that if you think about autistic children, it's very interesting that children with autism.
Have the ability to detect those nonverbal cues. You'll notice that their eye contact is not that good. So if your eye contact is good, your brain subconsciously is understanding facial features, facial movements, and when you're looking at a mom in the face, when you're looking at a child in the face, it turns out that you're able to view what's going on almost inside of them without even knowing that you're doing it. And so if your stress level is too high, let's say your heart rate's up, let's say your heart's going at 180 and you're sweating. It turns out that the stress provider acts like an autistic child, meaning that you lose those nonverbal cues. You don't have the ability to come and just relax, look at mom in the face, look, look at the child, and then make that blank assessment. So let's now move into the blank Assessment, it's essentially you're doing this as you're walking up. So if I show you these kids right here on the screen, your brain is automatically picking up what this child is sick or not sick, picking up what this child is sick or not sick. And then how about this third child? That child's sick as well. And you're doing that in the blink of an eye. You're doing that in an instant. And so that type of assessment can only be made if your stress levels are correct and your stress levels get down to normal. If you're coming in prepared, having known that child's age, okay, now that your stress levels are normal, now that you have the ability to walk in, the three parts of the blink assessment, which again, will mirror the pediatric assessment triangle, just want you to think of it differently. The three parts are the appearance, the breathing, and the circulation. So what does that mean? It means when you walk in, who's the first person you're going to look at? Is the parent. Because you want that parent to kind of connect with you. You want to look at them and kind of get the sense, are they relaxed, are they nervous, are they stressed out, are they screaming, are they at the curb wanting you to run in and they're going to give you their kid. That's assessment number one. You want to engage with that family, you want to tell them who you are, and then you want to turn your attention to the child. When you're looking at the child, you need to look right at their face, you need to look at their neck, you look at their torso, and you're looking at their skin. And essentially what you're doing is you're looking at how they're appearing. If a child, let's say, who's a year of age, is not tracking you as you're walking into the room, that's a problem, right? So those kids at that age, they know exactly who you are or where you are, and they know that you're a stranger. And so they should have some fear in them. So if you're walking up to a child who's not really looking at you, maybe the eyes, the eyelids are a little closed and they're not looking. Right. The appearance, that first part is abnormal. Your brain will detect that. Next thing you're going to do is look at the breathing. Again, this is just a look. You're going to look at their face. Are they using any accessory muscles, like are they flaring in their nose, look at their mouth, how are they sitting when they're breathing. You can look at their chest very easily. You can see if there's any distress, any retractions. Again, this is all being done from across the room. And then the third thing is circulation. In this particular case, you're looking at the color. You can walk right up to them. You can see, are they pale, are they ashen? Of course. Are they cyanotic? These are all very, very important things. And infants are being modeled as an example. That entire assessment takes less. I would say maybe even less than a second. It takes seconds. Don't think about this too hard. The most important part of this whole segment is that you have to be mentally in the right place to make that blank assessment. That's the key. Thank you.
