Office Preparedness For Pediatric Emergencies

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  • 1. North Carolina Emergency Medical Servicesfor Children Enhancement Grant Office Preparedness for Pediatric Emergencies

2. OFFICEPREPAREDNESS 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 3. 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 dayThe infant has retractions; she then becomes cyanotic and begins gasping.

4. 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 call911 or your local emergency number?What level of pediatric care is provided by your local EMS system?

5. Recognizing an Emergency

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

6. What is a trueemergency ?

  • labored breathing
  • cyanosis
  • stridor or audible wheezing
  • stupor or coma
  • seizures
  • vomiting after a head injury
  • uncontrollable bleeding

7. Response to a Pediatric Emergency

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

8. Pre-assign roles ofresuscitation team 9. STAFF PREPARATIONS

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

10. Teach Staff About:

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

11. EMS 12. Equipment & Medications 13. Location of Equipment

  • Resuscitation Room
  • Code Box

14. Specialized Organizers

  • Bag systems
  • Cart systems
  • Other items

15. 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

16. MiscellaneousEquipment

  • Blood pressure cuffs
  • Nasogastric tubes
  • Feeding tubes
  • Monitor
  • Wt. Based tape
  • Pediatric backboard
  • Foley urine catheters
  • Pulse oxymeter

17. Medications

  • Lorazepam
  • Sterile Water
  • Nalaxone
  • Cetfriaxone
  • Diphehydramine
  • Albuterol
  • Epinephrine
  • Sodium bicarbonate
  • D50
  • Atropine
  • Corticosteroid

18. Maintaining Resuscitation Skills and Knowledge 19. Continuing Education

  • PALS
  • ENPC
  • APLS
  • CME

20. Maintaining Readiness for a Pediatric Emergency

  • Mock Codes
  • Scavenger Hunts
  • Documentation

21. Maintaining Readiness

  • Mock Codes
  • Scavenger Hunts
  • Documentation

22. Maintaining Readiness Mock Codes Scavenger Hunts Documentation 23. EMS:Members of the health care team 24. EMS Levels 25. Pediatric Training and Experience 26. Call 911 27. 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 dayThe infant has retractions; she then becomes cyanotic and begins gasping.

28. Recognize an Emergency 29. Summary

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