North Carolina Emergency Medical Services for Children Enhancement Grant Office Preparedness for...
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Transcript of North Carolina Emergency Medical Services for Children Enhancement Grant Office Preparedness for...
North Carolina Emergency Medical Services for Children
Enhancement Grant“Office Preparedness for Pediatric
Emergencies”
OFFICE PREPAREDNESSOFFICE PREPAREDNESSforfor
PEDIATRIC EMERGENCIESPEDIATRIC EMERGENCIES
Objectives...Objectives...1. Recognize an emergency1. Recognize an emergency
2. Ensure staff preparation2. Ensure staff preparation
3. Choose approp. equipment3. Choose approp. equipment
4. Update provider skills4. Update provider skills
5. Maintain readiness5. Maintain readiness
6. Recognize EMS: member of 6. Recognize EMS: member of the teamthe 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 Recognizing an EmergencyEmergency
• Train your secretary or Train your secretary or receptionist how to receptionist how to recognize a pediatric recognize a pediatric emergency.emergency.
• Develop office Develop office protocols, including protocols, including accessing EMSaccessing EMS
What is a true What is a true emergencyemergency??
• labored labored breathingbreathing
• cyanosiscyanosis
• stridor or stridor or audible audible wheezingwheezing
• stupor or coma stupor or coma
• seizuresseizures
• vomiting after a vomiting after a head injuryhead injury
• uncontrollable uncontrollable bleedingbleeding
Response to a Pediatric Response to a Pediatric EmergencyEmergency
• Establish and post office protocols Establish and post office protocols regarding:regarding:
a. accessing EMSa. accessing EMS
b. notification of b. notification of
provider or nurse.provider or nurse.• Have contingency plans for staff if Have contingency plans for staff if
no physician or PCP is in the officeno physician or PCP is in the office• Have office nurse periodically check Have office nurse periodically check
the waiting areathe waiting area
Pre-assign roles of Pre-assign roles of “resuscitation team“resuscitation team””
STAFF STAFF PREPARATIONSPREPARATIONS
•Train receptionist to identify Train receptionist to identify infants and children in infants and children in distressdistress
•Determine skill level and Determine skill level and knowledge of newly employed knowledge of newly employed medical personnelmedical personnel
Teach Staff Teach Staff About:About:
• respiratory respiratory distress distress (stridor and (stridor and wheezing)wheezing)
• shockshock• anaphylaxisanaphylaxis• seizures seizures
EMS EMS
Equipment & Equipment & MedicationsMedications
Location of Location of EquipmentEquipment
• Resuscitation Resuscitation RoomRoom
• Code BoxCode Box
Specialized Specialized OrganizersOrganizers•Bag systemsBag systems
•Cart systemsCart systems
•Other itemsOther items
EQUIPMENT LISTEQUIPMENT LIST• Oxygen sourceOxygen source• Oxygen masksOxygen masks• Self-inflating Self-inflating
bag-valve bag-valve resuscitatorsresuscitators
• Nasal cannulaNasal cannula• Nebulizer for Nebulizer for
inhalation inhalation treatmentstreatments
• Suction Suction apparatusapparatus
• Suction cathetersSuction catheters• Oral airwaysOral airways• FluidsFluids• IV Access IV Access
catheterscatheters• Intraosseous Intraosseous
needlesneedles
Miscellaneous EquipmentMiscellaneous Equipment
• Blood Blood pressure cuffspressure cuffs
• Nasogastric Nasogastric tubestubes
• Feeding tubesFeeding tubes• MonitorMonitor
• Wt. Based Wt. Based tapetape
• Pediatric Pediatric backboardbackboard
• Foley urine Foley urine catheterscatheters
• Pulse Pulse oxymeteroxymeter
MedicationsMedications• LorazepamLorazepam
• Sterile WaterSterile Water
• NalaxoneNalaxone
• CetfriaxoneCetfriaxone
• DiphehydramineDiphehydramine
• AlbuterolAlbuterol
• EpinephrineEpinephrine
• Sodium bicarbonateSodium bicarbonate
• D50D50
• AtropineAtropine
• CorticosteroidCorticosteroid
Maintaining Resuscitation Skills and Knowledge
Continuing Education
PALS
ENPC
APLS
CME
Maintaining “Readiness” for a Maintaining “Readiness” for a Pediatric EmergencyPediatric Emergency
Mock CodesMock Codes
Scavenger HuntsScavenger Hunts
DocumentationDocumentation
Maintaining ReadinessMaintaining Readiness
Mock CodesMock Codes
Scavenger HuntsScavenger HuntsDocumentationDocumentation
Maintaining ReadinessMaintaining Readiness
Mock CodesMock CodesScavenger HuntsScavenger Hunts
DocumentationDocumentation
EMS: EMS: Members of the health care Members of the health care
teamteam
EMS LevelsEMS Levels
Pediatric Training and Pediatric Training and ExperienceExperience
Call 911Call 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 EmergencyRecognize an Emergency
SummarySummary
• Recognize an emergencyRecognize an emergency• Staff preparationStaff preparation
• EquipmentEquipment• Provider SkillsProvider Skills
• Maintain ReadinessMaintain Readiness• EMS: member of the health care EMS: member of the health care
teamteam