Transcript Enhancement Grant for North Carolina Emergency Medical Services Children

North Carolina Emergency Medical Services
for Children
Enhancement Grant
“Office Preparedness for Pediatric Emergencies”
OFFICE PREPAREDNESS
for
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
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 didn’t think baby
could wait until her
appointment later that day
The infant has retractions;
she then becomes cyanotic
and begins gasping.
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?
Recognizing an Emergency
• Train your secretary or
receptionist how to
recognize a pediatric
emergency.
• Develop office
protocols, including
accessing EMS
What is a true
emergency?
• labored
breathing
• cyanosis
• stridor or
audible
wheezing
• stupor or coma
• seizures
• vomiting after a
head injury
• uncontrollable
bleeding
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
Pre-assign roles of
“resuscitation team”
STAFF PREPARATIONS
• Train receptionist to identify
infants and children in distress
• Determine skill level and
knowledge of newly employed
medical personnel
Teach Staff About:
• respiratory distress
(stridor and
wheezing)
• shock
• anaphylaxis
• seizures
EMS
Equipment &
Medications
Location of Equipment
• Resuscitation
Room
• Code Box
Specialized Organizers
• Bag systems
• Cart systems
• Other items
EQUIPMENT LIST
• Oxygen source
• Oxygen masks
• Self-inflating bagvalve resuscitators
• Nasal cannula
• Nebulizer for
inhalation
treatments
•
•
•
•
•
•
Suction apparatus
Suction catheters
Oral airways
Fluids
IV Access catheters
Intraosseous needles
Miscellaneous Equipment
• Blood pressure
cuffs
• Nasogastric
tubes
• Feeding tubes
• Monitor
• Wt. Based tape
• Pediatric
backboard
• Foley urine
catheters
• Pulse oxymeter
Medications
•
•
•
•
•
•
Albuterol
Epinephrine
Sodium bicarbonate
D50
Atropine
Corticosteroid
•
•
•
•
•
Lorazepam
Sterile Water
Nalaxone
Cetfriaxone
Diphehydramine
Maintaining Resuscitation
Skills and Knowledge
Continuing Education
PALS
ENPC
APLS
CME
Maintaining “Readiness” for a
Pediatric Emergency
Mock Codes
Scavenger Hunts
Documentation
Maintaining Readiness
Mock Codes
Scavenger Hunts
Documentation
Maintaining Readiness
Mock Codes
Scavenger Hunts
Documentation
EMS:
Members of the health care team
EMS Levels
Pediatric Training and
Experience
Call 911
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 didn’t think baby
could wait until her
appointment later that day
The infant has retractions;
she then becomes cyanotic
and begins gasping.
Recognize an Emergency
Summary
• Recognize an emergency
• Staff preparation
• Equipment
• Provider Skills
• Maintain Readiness
• EMS: member of the health care team