Intraosseous infusion & Feeding a sick child

      • Intraosseous infusion
        • Temporary route of administration for use in an emergent situation in which venous access cannot be obtained
        • Use an intraosseous or large bore needle that is inserted into the tibia.
        • Monitor site for infection, leakage of fluid
        • Monitor distal pulses, temperature of leg, and color frequently
        • Risk for compartment syndrome
    • Feeding a sick child
      • Take a dietary history and use information to make eating time as similar to eating at home as possible.
      • Encourage parents or other family members to feed child or to be present at mealtimes.
      • Make mealtimes pleasant; avoid any procedures immediately before or after eating; make certain child is rested and pain free.
      • Serve small, frequent meals rather than three large meals, or serve three meals and nutritious between-meal snacks.
      • Provide finger foods for young children.
      • Involve children in food selection and preparation whenever possible.
      • Serve small portions, and serve each course separately, such as soup first followed by meat, potatoes, and vegetables and ending with dessert. With young children, camouflage size of food by cutting meat thicker so less appears on plate or by folding a cheese slice in half. Offer second helpings.
      • Ensure a variety of foods, textures, and colors.
      • Provide food selections that are favorites of most children, such as peanut butter and jelly sandwiches, hot dogs, hamburgers, macaroni and cheese, pizza, spaghetti, tacos, fried chicken, corn, and fruit yogurt.
      • Avoid foods that are highly seasoned, have strong odors, or are all mixed together unless typical of cultural practices.
      • Provide fluid selections that are favorites of most children, such as fruit punch, cola, ginger ale, sweetened tea, flavored ice pops, sherbet, ice cream, milk, milkshakes, pudding, gelatin, clear broth, or creamed soups.
      • Offer nutritious snacks, such as frozen yogurt or pudding, ice cream, oatmeal or peanut butter cookies, hot cocoa, cheese slices, pieces of raw vegetable or fruit, and dried fruit or cereal.
      • Make food attractive and different, for example:
        • Serve a “picnic lunch” in a paper bag.
        • Pack food in a Chinese take-out container; decorate container.
        • Put a “face” or a “flower” on a hamburger or sandwich with pieces of vegetable.
        • Use a cookie cutter to shape a sandwich.
        • Serve pudding, yogurt, or juice frozen as an ice pop.
        • Make Slurpies or snow cones by pouring flavored syrup on crushed ice.
        • Add food coloring to water or milk.
        • Serve fluids through brightly colored or unusually shaped straws.
        • 3Make “bowtie” sandwiches by cutting them in triangles and placing two points together.
        • Slice sandwiches into “fingers.”
        • Grate mounds of cheese.
        • Cut apples horizontally to make circles.
        • Put a banana on a hot dog bun and spread with peanut butter.
        • Break uncooked spaghetti into toothpick lengths, and skewer cheese, cold meat, vegetables, or fruit chunks.
      • Praise children for what they do eat
      • Do not punish children for not eating by removing their dessert or putting them to bed


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