North Carolina Emergency Medical Services for Children Enhancement Grant Office Preparedness for Ped

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North Carolina Emergency Medical Services for
ChildrenEnhancement GrantOffice Preparedness
for Pediatric Emergencies
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OFFICE PREPAREDNESSfor PEDIATRIC EMERGENCIES

• Objectives...
• 1. Recognize an emergency
• 2. Ensure staff preparation
• 3. Choose approp. equipment
• 4. Update provider skills
• 5. Maintain readiness
• 6. Recognize EMS member of the team

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Scenario

• A six-month old infant is brought into your
  office during the lunch hour with severe
  wheezing. The mother tells a receptionist that
  she didnt think baby could wait until her
  appointment later that day The infant has
  retractions she then becomes cyanotic and begins
  gasping.

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Questions

• 1. Are your non-medically trained office
  personnel prepared to respond to this or other
  emergency situations?
• 2. Do you have the necessary equipment and
  medicines needed to manage this infant? Are they
  readily available?
• 3. Who will call 911 or your local emergency
  number? What level of pediatric care is provided
  by your local EMS system?

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Recognizing an Emergency

• Train your secretary or receptionist how to
  recognize a pediatric emergency.
• Develop office protocols, including accessing EMS

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What is a true emergency?

• labored breathing
• cyanosis
• stridor or audible wheezing

• stupor or coma
• seizures
• vomiting after a head injury
• uncontrollable bleeding

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Response to a Pediatric Emergency

• Establish and post office protocols regarding
• a. accessing EMS
• b. notification of
• provider or nurse.
• Have contingency plans for staff if no
  physician or PCP is in the office
• Have office nurse periodically check the waiting
  area

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Pre-assign roles of resuscitation team
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STAFF PREPARATIONS

• Train receptionist to identify infants and
  children in distress
• Determine skill level and knowledge of newly
  employed medical personnel

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Teach Staff About

• respiratory distress (stridor and wheezing)
• shock
• anaphylaxis
• seizures

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EMS
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Equipment Medications
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Location of Equipment

• Resuscitation Room
• Code Box

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Specialized Organizers

• Bag systems
• Cart systems
• Other items

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EQUIPMENT LIST

• Oxygen source
• Oxygen masks
• Self-inflating bag-valve resuscitators
• Nasal cannula
• Nebulizer for inhalation treatments

• Suction apparatus
• Suction catheters
• Oral airways
• Fluids
• IV Access catheters
• Intraosseous needles

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Miscellaneous Equipment

• Blood pressure cuffs
• Nasogastric tubes
• Feeding tubes
• Monitor

• Wt. Based tape
• Pediatric backboard
• Foley urine catheters
• Pulse oxymeter

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Medications

• Lorazepam
• Sterile Water
• Nalaxone
• Cetfriaxone
• Diphehydramine

• Albuterol
• Epinephrine
• Sodium bicarbonate
• D50
• Atropine
• Corticosteroid

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Maintaining Resuscitation Skills and Knowledge

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Continuing Education

• PALS
• ENPC
• APLS
• CME

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Maintaining Readiness for a Pediatric Emergency

• Mock Codes
• Scavenger Hunts
• Documentation

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Maintaining Readiness

• Mock Codes
• Scavenger Hunts
• Documentation

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Maintaining Readiness
Mock Codes Scavenger Hunts Documentation
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EMS Members of the health care team
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EMS Levels
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Pediatric Training and Experience
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Call 911
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Scenario

• A six-month old infant is brought into your
  office during the lunch hour with severe
  wheezing. The mother tells a receptionist that
  she didnt think baby could wait until her
  appointment later that day The infant has
  retractions she then becomes cyanotic and begins
  gasping.

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Recognize an Emergency

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Summary

• Recognize an emergency
• Staff preparation
• Equipment
• Provider Skills
• Maintain Readiness
• EMS member of the health care team