Emergency Preparedness CSHCN 09.13.2013

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EMERGENCY

PREPAREDNESS:

CHILDREN WITH SPECIALHEALTH CARE NEEDS



Walking bridge collapsed

at an overnight camp for

children and adults with

physical and

developmental delays

10 foot fall

5 campers sent via EMS

to the nearest hospital

Health history provided

by 2 counselors with no

medical training

CASE

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=HLbVdvAJqFGQmM&tbnid=5a_jgk6Jg3bK0M:&ved=0CAUQjRw&url=http://es.easterseals.com/site/PhotoAlbumUser?view=UserPhotoDetail&PhotoID=1007738&position=1&AlbumID=136468&ei=VPsyUrelDszLigLqvICQBg&bvm=bv.52164340,d.cGE&psig=AFQjCNENCbkTVNn6HVn8kpDHHTQOWSHhzA&ust=1379158925343655



“Utah Report f romthe Nat ionalSurvey ofChi ldren’sHeal th . ” NSCH2011/2012. Chi ld

and AdolescentHeal thMeasurementIn i t iat ive , DataResource Centerfor Chi ld andAdolescent Heal thwebsi te .www.chi ldheal thdata .org .

THE

NUMBERS112,278

753,925

http://www.childhealthdata.org/






THE NUMBERS



THE NUMBERS

Data Graph



“Lack of access to all levels of care, with particular effects on

vulnerable populations, is a major difference between

emergency medical services for children in rural and suburban

areas” 10% of pre-hospital emergency responses and 37% of ED

visits are for patients < 24yo

41% of community hospitals are considered rural and are less

likely to have EMS/ED providers with pediatric training

- AAP Po l i c y S ta temen t : Ro l e o f t he Ped i a t r i c i an i n Rur a l Emerg enc y Med i c a l Se r v ic es fo r

Ch i l d ren , November 2012

EMERGENCIES



Multiple medications, medical devices, complex management

plans place them at increased risk of medical error

Difficult to access pertinent information

RECOMMENDATION: EIF = Emergency Information Form A concise, single sheet summary to provide essential information

needed for initial treatment and management

The responsibility of the primary medical provider in coordination

with specialists

Reviewed on a regular basis

Include disaster planning

- AA P Po li cy St ate me nt: Eme rgen cy Inf or mat io n Fo rms an d Em er gen cy Prep ared ness fo r Chi ld renwith Special Health Care Needs, April 2010

EXTRA CHALLENGES FOR CHILDREN

WITH SPECIAL HEALTH CARE NEEDS



Clinical Baseline:

- Physical exam

- Vitals

- Neurologic status

- Immunologic competency

- Medications - Antibiotic prophylaxsis

- Significant findings on baseline

labs/imaging

- Protheses, devices, life support

ED Management: - Common presenting problems and

suggested management

Disaster Planning

- AAP Policy Statement: Emergency Information Forms and Emergency

Preparedness for Children with Special Health Care Needs, April 2010



Previously known as The

Emergency Health

Information Registry for

Children with Special

Healthcare Needs

Purpose: to provide a way of

giving key emergency health

information to EMS

responding to a call on a

child with special healthcare

needs (CSHCN) in order to

improve the care of these

children.

IN UTAH: CHIRP



Who can be enrolled? Children with:

Frequent seizures

Tracheostomy

Ventilator dependency

CPAP / BIPAP

Congenital heart disease

Severe asthma with past admittance to ICU

Severe Autism

Complex respiratory and cardiology needs

Brittle Diabetes

Neurologically compromised How does it work?

Enroll online: www.health.utah.gov/ems/emsc

Info reviewed by EMSC Pediatric Clinical Consultant RN

Document vials, stickers, fridge magnet

Notification and information distributed to local EMS

CHIRP



Demographics (Demografia)

Name: (nombre)_____________________________________________________________________________________________________

Birthdate: (fecha de nacimiento)________________________ M F Age: (edad) ________________

Primary Language: (idioma preferido)_____________________________________

Parent/Guardian: (nombre de Padre/Tutor) ________________________________ Phone: __________________________________

Emergency Contact: (contacto de emergencia) ______________________ Phone:_________________________

Preferred Hospital for Transport: (hospital perferido) ______________________________________________

Baseline Status (Condicion normal)

Vital Signs: (los signos vitales) HR:____________ RR:____________ BP:__________ O2 Sat:___________%

Weight: (peso) _________lbs Height: (altura) __________ft/in Best IV site: (major IV sitio) __________________

Immunizations Current (vacunas al dia) Yes No

Neuro Status: (condicion neurologica del paciente)

_____________________________________________________________________________________ _____________________________________________________________________________________

Nonverbal (no puede hablar) Hearing Impaired (No puede oir) Visually Impaired (No puede ver)

Medical History (Historial medico)

Allergies/Reaction: (alergias/reaccion)

1._________________________________________________ 4. ___________________________________________________

2._________________________________________________ 5.____________________________________________________

3._________________________________________________ 6.____________________________________________________

Medical Conditions: (condiciones medicas)

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Hospitalizations/Surgeries: (hospitalizaciones/cirugias)

_____________________________________________________________________________________ _____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Medications: (medicinas) 1.________________________________________________ 6. ____________________________________________________

2.________________________________________________ 7. ____________________________________________________

3.________________________________________________ 8. ____________________________________________________

4.________________________________________________ 9. ____________________________________________________

5.________________________________________________ 10. ____________________________________________________

Special Needs/Equipment (Necesidades especiales/equipo)

Feeding pump (bomba de aleimentacion) Suction Machine (maquina de succion) Wheelchair (silla de ruedas)

Gastrostomy Tube (tubo gastronomico) Pulse Oximeter (oximetro) Oxygen (oxigeno)

Apnea Monitor (monitor de apnea) NG/NJ Tube (tubo nasogastrico)

Tracheostomy (traqueotomia) Size/type: (medida/marca) ___________________________________

Ventililator (ventilador) Type/mode (marca/moda) _________________________________________

Information Included:

- Demographics

- Baseline Status

- Medical History

- Special Needs/Equipment

- Care Providers



Encourage enrollment and maintenance of up to date

information

Participate in establishing care and practice guidelines as the

pediatric expert

Advocate for allocation of resources/funds

Consider additional community resources

OUR ROLE



Utah Department of Health Bureau of Emergency Medical

Services

AAP Policy Statements

Red Cross

Ready.gov/kids

CDC

Disability.gov

RESOURCES

Emergency Preparedness CSHCN 09.13.2013

Documents

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