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Encourage others to sign up for the PEDReady newsbrief, the PE2ARL, by sharing this link: http://bit.ly/flpearl
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Florida EMSC and PEDReady Updates and Announcements
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Last month we announced the appointment of new Florida EMSC Advisory Committee members and a monthly newsletter format. Our team is excited to welcome new committee liaisons and looks forward to our November 19th committee meeting. Please encourage others to sign up for the FL PEDReady newsletter at: https://airtable.com/shrov0Ha3DCVzXBSw. Send announcements, resources and requests for topics to [email protected].
Thank you EMLRC for hosting the PEDReady website and newsletter!
Sincerely,
Phyllis Hendry, MD, FAAP, FACEP
Florida EMS-C Medical Director and Editor
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1. Announcements and Updates |
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A. Announcing New PECC (Pediatric Emergency Care Coordinator/Champion) Liasions To Florida’s EMSC Advisory Committee
Captain Jeremiah Rabish, PMD
EMS Operations Captain and PECC for Sarasota County Fire Department
Ernest (Sonny) Weishaupt, EMT-P
EMS Liaison/PECC for Arnold Palmer Hospital for Children
Lieutenant Sarah Weed
Alachua County Fire Rescue
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B. Florida EMS Advisory Council & Committee Fall meetings
The Florida EMS Advisory Council & Committee Fall meetings will be held online November 16-20, 2020. Constituency group meetings are being scheduled separately. For the overall schedule click here. The Florida EMS for Children Advisory Committee will meet on Thursday at 11am. Most meetings are limited to one hour. Please email [email protected] if you have topics for discussion.
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Thursday, November 19, 2020
11:00 a.m.- 12:00 p.m.
EMS for Children Committee
Join Zoom Meeting
Password: 224161
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C. English/Haitian Creole and English/Spanish Communication Cards are now in stock!
The cards are ideal for communicating with non-English speakers, non-verbal patients, children and can be used as a distraction device. Each card set is made of durable material that can be easily sanitized between uses and is attached to a ring clip,
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2. PEDReady Champions of the Month |
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Thanks to new EMS and ED FL PEDReady PECC liaison, Ernest (Sonny) Weishaupt, EMT-P, for sharing this great mock trauma scenario with pediatric and adult patients. Great job St. Cloud Fire Department & Orlando Health! See video and pics below.
How is your agency or ED preparing for pediatric readiness? Share your stories and ideas be emailing [email protected]
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3. New 2020 AHA Pediatric and Neonatal Guidelines |
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New American Heart Association Guidelines were recently published in Circulation and Pediatrics journals. Click here for a summary of adult, pediatric and neonatal highlights and changes.
NRP: Neonatal resuscitation concepts reaffirmed include:
Pediatric Basic and Advanced Life Support guidelines
Algorithms and visual aids were revised to incorporate the best science and improve clarity for PBLS and PALS resuscitation providers.
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Based on newly available data from pediatric resuscitations, the recommended assisted ventilation rate has been increased to 1 breath every 2 to 3 seconds (20-30 breaths per minute) for all pediatric resuscitation scenarios.
- Cuffed ETTs are suggested to reduce air leak and the need for tube exchanges for patients of any age who require intubation.
- The routine use of cricoid pressure during intubation is no longer recommended.
- To maximize the chance of good resuscitation outcomes, epinephrine should be administered as early as possible, ideally within 5 minutes of the start of cardiac arrest from a nonshockable rhythm (asystole and pulseless electrical activity).
- After ROSC, patients should be evaluated for seizures; status epilepticus and any convulsive seizures should be treated.
- Because recovery from cardiac arrest continues long after the initial hospitalization, patients should have formal assessment and support for their physical, cognitive, and psychosocial needs.
- A titrated approach to fluid management, with epinephrine or norepinephrine infusions if vasopressors are needed, is appropriate in resuscitation from septic shock.
- On the basis largely of extrapolation from adult data, balanced blood component resuscitation is reasonable for infants and children with hemorrhagic shock.
- Opioid overdose management includes CPR and the timely administration of naloxone by either lay rescuers or trained rescuers.
- Children with acute myocarditis who have arrhythmias, heart block, ST-segment changes, or low cardiac output are at high risk of cardiac arrest. Early transfer to an intensive care unit is important, and some patients may require mechanical circulatory support or extracorporeal life support (ECLS).
- Infants and children with congenital heart disease and single ventricle physiology who are in the process of staged reconstruction require special considerations in PALS management.
- Management of pulmonary hypertension may include the use of inhaled nitric oxide, prostacyclin, analgesia, sedation, neuromuscular blockade, the induction of alkalosis, or rescue therapy with ECLS.
Algorithms and Visual Aids
- A sixth link, Recovery, was added to the pediatric OHCA Chain of Survival and is included in the new pediatric IHCA Chain of Survival. The Recovery link acknowledges that resuscitation does not end with return of spontaneous circulation. It brings more attention to the needs of cardiac arrest survivors after discharge, such as physical, cognitive and emotional challenges that will require ongoing therapy and interventions.
- The Pediatric Cardiac Arrest Algorithm and the Pediatric Bradycardia With a Pulse Algorithm have been updated.
- The single Pediatric Tachycardia With a Pulse Algorithm now covers both narrow- and wide-complex tachycardias in pediatric patients.
- Two new Opioid-Associated Emergency Algorithms have been added for lay rescuers and trained rescuers. In addition to standard basic life support care, naloxone is recommended for all pediatric patients with respiratory arrest due to suspected opioid overdose.
- A new checklist is provided for pediatric post–cardiac arrest.
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A. EMS World On Demand Webinar
Improving Pediatric Emergency Readiness: How to Reduce Skills Decay in The New Era of Virtual Learning with Dr. Jen Anders, Associate State Medical Director Pediatrics Maryland Institute for EMS Systems and Cole Sandau, Health Scholars.
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2. Two national websites you don’t want to miss!
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C. Is your ED ready for children?
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This checklist is based on the American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), and Emergency Nurses Association (ENA) 2018 joint policy statement “Pediatric Readiness in the Emergency Department”. |
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D. First Aid for Severe Trauma: Empowering High Schoolers to Respond to Traumatic Injuries
In 2018, the National Center for Disaster Medicine and Public Health received a $2.3 million grant to develop a trauma training course geared toward high school students. In partnership with the American Red Cross, the National Center is creating a curriculum focusing on applying pressure to stop bleeding, communication in emergencies, situational awareness, and body positioning.
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E. Pediatric Resuscitation Training
Help test new online resources designed to help all emergency departments increase their pediatric resuscitation readiness. Click here to learn more and get started. The SAVE-PEDS project is a collaborative effort between the Children’s Hospital of Philadelphia and Yale-New Haven Children’s Hospital to assist and equip all hospitals for self-directed quality improvement in pediatric resuscitation. As part of this EMSC-funded project, we are evaluating several new web-based training courses in pediatric resuscitation topics. The courses offer FREE pediatric training for health professionals.
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F. ACEP Sim Box and Tele Sim Box- Free online remote learning including pediatric cases
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G. Open Access to 6th International Pediatric Emergency Medicine Conference Content through December 2020.
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H. EMLRC Educational Webinars |
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Webinar: Pediatric Toxicology: Just One Pill Can Kill
Available until November 28, 2020
1.0 CME available | hosted by EMLRC
Pediatric patients comprise a large percentage of toxic exposure calls to US Poison Centers. Most of the exposures involve children under the age of 6 years of age. Although many of these are minor ingestions, there are at least seven different classes of substances that can lead to severe toxicity or even death with even small ingestions in children.
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Webinar: Hit that Dab: From High Potency THC to CBD Use
November 23, 2020 at 1:00pm
1.0 CME available | hosted by EMLRC
During this presentation there will be an in-depth discussion on the various non-traditional means of using Tetrahydrocannabinol (THC). In addition, a review on the uses of Cannabidiol (CBD) in today’s patient population and how emergency medicine professionals can recognize the differences.
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Stay Safe, Pediatric Champions! |
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The Florida PEDReady Program
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