Vermont EMSC Welcomes FAN Member Teri Hata (09/12/2014)
Vermont EMSC welcomes Teri Hata as its new Family Advisory Network (FAN) representative. Teri is a proud mother of an 8-year-old with Autism Spectrum Disorder. When she is not playing video games with her son, she works for the Vermont Health Department in the Division of Health Surveillance analyzing hospital data to ensure Vermonters have access to the best healthcare available.
Teri is passionate about ensuring EMS and hospital providers know how to work with families that have children with special healthcare needs. She is excited to learn more about the Vermont EMSC program and FAN. Welcome to the Vermont EMSC family!
Former Targeted Issue Grant Publishes on ED Recognition Program for Pediatrics (09/11/2014)
The former Targeted Issue grant based at North Carolina's Wake Forest University recently published a study in Pediatric Emergency Care that determined if a pediatric emergency care facility recognition (PECFR) program improved care processes for injured children less than 15 years of age. In a controlled pre-post study, investigators abstracted medical records from eight Delaware and 13 North Carolina hospitals in 2009. Investigators collected data again in 2013; one year post implementation of Delaware's PECFR program.
Medical record abstractions focused on key data points that represented a routine process of care for injured children in the emergency department (ED), including vital sign assessment, pain assessment, and management and diagnostic use of radiation. Children ages 14 and younger whom presented to the ED with an Injury Classification of Diseases, 9th Revision, Clinical Modification codes 800-959.9 were included in the study.
A total of 1,737 children were included in the study, 709 were from Delaware hospitals and 1,028 from North Carolina hospitals. Ninety-seven percent of children had an injury score of nine or lower. The Delaware and North Carolina cohorts both increased initial pain assessment documentation over time (P < 0001). Additionally, among children with extremity immobilization and a pain score of 5 or greater, Delaware hospitals had a significantly shorter interval between pain assessment and pain management (P < 0.01). Lastly, Delaware hospitals had a significant reduction in radiation use compared to North Carolina hospitals P< 0001).
Investigators concluded that improvements in care for children associated with the PECFR program was limited to the interval between pain assessments of 5 or greater and pain medication for children with extremity immobilization.
New Resources in CHaMP's Research Education Series (09/11/2014)
Developed and recorded by Brooke Lerner, PhD, at the Medical College of Wisconsin, these videos are the next installments of the Charlotte, Houston, and Milwaukee Prehospital (CHaMP) Research Node Center's EMS Research Education series. The series Selecting a Study Design examines the various types of study designs and the importance of selecting the best design as it relates to time, feasibility, ethics, and producing good results. Viewers learn how to develop a practical and feasible protocol and methods for assessing their project to determine the most viable study design.
The series Research in Prehospital Care examines how research in the EMS setting differs from hospital-based research. Viewers learn about the barriers to obtaining patient consent in the prehospital environment. The presentation also summarizes the differences between a cohort study and a clinical trial and how they may affect the interpretation of the findings.
Oregon EMSC to Host Webinar on Enhancing the EMS Educational Experience: On-Scene Real Patient Video Cases (08/29/2014)
Oregon EMSC will host the webinar "Enhancing the EMS Educational Experience: On-Scene Real Patient Video Cases" from 11:00 am to 11:30 am (Eastern) on Wednesday, September 3. Oregon EMSC, in conjunction with Portland-based health/tech start-up ReelDx, has launched the first online library of real-patient video case studies designed to train EMS providers.
The prehospital library provides EMS professionals with short videos of real patient encounters in the field and in the emergency department. Each case includes a video of about one minute in length along with patient medical history, dispatch information, and first responder interventions used. Many cases also include rich supplemental materials, such as still pictures of trauma scenes; caregiver interviews; EKG, and other test results.
This webinar will review patient video cases captured in the prehospital field and demonstrate how to use the ReelDx website, as well as answer audience questions
Louisiana EMSC Introduces the Arkansas EMSC "Exertional Heat Illness - Cool Down First" Video into Louisiana Department of Education (08/29/2014)
The Arkansas Departments of Education and Health, in partnership with the Arkansas EMSC Program, have released the "Exertional Heat Illness - Cool Down First" video. In August 2014, Louisiana EMSC introduced the video to the Louisiana Department of Education, and received approval to distribute it to all schools throughout Louisiana. Congratulations to all.
New Committee to Advise HHS on Children's Health in Disasters (08/28/2014)
A new federal advisory committee, the National Advisory Committee on Children and Disasters, has been established to provide advice and consultation to the Department of Health and Human Services (HHS) Secretary on comprehensive planning and policies to meet the unique health needs of children before, during, and after a disaster or other public health emergency. The committee was established under the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, and will include 15 federal and non-federal experts in pediatric disaster preparedness.
NLM to Host Webinar on Health Resources on Children in Disaster and Emergencies (08/28/2014)
The National Library of Medicine (NLM), in collaboration with the EMSC Program and the Office of the Assistant Secretary for Preparedness and Response, will host the webinar "Not Just Small Adults: Health Resources on Children in Disasters and Emergencies" from 4:00 pm to 5:00 pm (Eastern) on Thursday, September 11. This webinar will feature the new comprehensive online guide developed through collaboration among multiple U.S. Department of Health and Human Services agencies and funded organizations. This guide will serve as a central repository for pediatric-related disaster and emergency health information.
Former TI Grantee's Publication Elected to 2014 EMS LLSA Reading List (08/14/2014)
The American Board of Emergency Medicine (ABEM) elected the publication "Root causes of errors in a simulated prehospital pediatric emergency," by former Michigan Targeted Issue Grantee Richard Lammers, MD, and State Partnership Coordinator Maria Willoughby-Byrwa, EMT-P, to the ABEM 2014 EMS Lifelong Learning and Self-Assessment (LLSA) Reading List.
The primary goal of LLSA is to promote continuous learning by diplomates. The EMS Examination Committee facilitates this learning by identifying a set of LLSA readings every other year to guide diplomates in self-study of recent EMS literature. The readings are designed as study tools and should be read critically. They are not intended to be all-inclusive and are not meant to define the standard of care for the practice of emergency medical services
Oregon EMSC and ReelDx Announce Partnership to Publish Medical Videos from 911 Responders (07/17/2014)
ReelDx, the leading provider of real-patient videos, has launched the first online library of real-pediatric patient video case studies designed to train emergency medical services (EMS) providers. Sponsored by Oregon EMSC, the new pediatric cases within the prehospital library provides EMS professionals with short videos of real patient encounters in the field and in emergency rooms, substantial case data and imagery, and peer-authored and reviewed write-ups of each case. Each case includes a video of about one minute in length along with patient medical history, dispatch information, and first responder interventions used. Many cases also include rich supplemental materials, such as still pictures of trauma scenes, caregiver interviews, EKG, and other test results.
Registration to view the video cases is free. For more information contact Philip Engle.
In addition, from 2:00 pm to 2:30 pm on July 21, Oregon EMSC will host the webinar "Real-patient Video Case Studies."
EMSC Legislative Update (07/17/2014)
For a federal program to exist, Congress must approve a program's authorization, which establishes a program in name and also delineates what a program is allowed to do and, sometimes, what it is not allowed to do. Federal programs are usually authorized for a finite amount of time, typically three to five years, at which time Congress must renew the program's authorization through the legislative process.
As you may know, the EMSC Program's current authorizing legislation will expire at the end of this fiscal year, October 30, 2014. As such, this week, the House Energy and Commerce Committee approved H.R. 4290, the Wakefield Act, to reauthorize the Program for five years, or through fiscal year 2019. Before this bill can become law, however, the House will have to vote on it, and the Senate will have to take up its version of the measure, S. 2154.
Alabama EMSC to Host Webcast on Children and Disasters (07/03/2014)
From 11:00 am - 12:30 pm (Eastern) on Tuesday, July 29, Alabama EMSC will host the webcast "EMS Grand Rounds: Children and Disasters." During this webcast, faculty will present information learned from real life events in Alabama to highlight persona, hospital, state, and regional-level coordination efforts on behalf of children.
New Resource from CHaMP on Presenting and Publishing Your Research Results (07/03/2014)
Developed and recorded by Brooke Lerner, PhD, at the Medical College of Wisconsin, this video is the third installment of the Charlotte, Houston and Milwaukee Prehospital (CHaMP) Research Node Center's EMS Research Education series. The series aims to assist healthcare professionals in designing EMS-based research and engaging with the CHaMP network. Dr. Lerner examines why dissemination of findings is important, and describes ways to circulate research results. Viewers learn where to submit their work and explore key elements of a scientific presentation or publication.
PECARN Publishes on Cervical Spine Injury Patterns in Children (06/20/2014)
A recent study published in Pediatrics described a large cohort of children with cervical spine injuries (CSIs) to explain specific injury patterns relative to age and mechanisms of injury, and to review treatments and outcomes by injury patterns. This retrospective study included children ages 0-16 with blunt trauma-related CSI. Study participants were treated at one of 17 emergency departments (ED) within the Pediatric Emergency Care Applied Research Network (PECARN) from 2000 to 2004. A total of 540 had sufficient information in their medical charts to be included in the study.
For children less than 2 years of age and children ages 2 to 7 years of age, motor vehicle crash (MVC) was the most common injury mechanism (56% and 37%, respectively). Furthermore, children less than 2 and children ages 2 to 7 most commonly experienced injuries to the axial region (occiput-C2) (74% and 78%, respectively).
For children ages 8 to 15 years of age, sport injuries accounted for as many injuries as MVCs. More than half of these injuries were subaxial (C3-7). Moreover, in the 8 to 15 age group, CSIs often needed surgical interventions (axial, 39%; subaxial 30%), resulted in neurologic deficits (21%), and death (7%).
This study concludes that CSI level is associated with both age and mechanism of injury. Additionally, there is a high degree of variability in CSI patterns, treatments, and outcomes in children.
Announcing Leadership Transitions at the EMSC NRC (06/19/2014)
Angela Mickalide, PhD, MCHES, and Kathleen Brown, MD, will assume the principal investigator and medical/scientific director roles, respectively, at the EMSC National Resource Center (NRC). Dr. Mickalide has served as executive director at the EMSC NRC since 2013 after a long career as a prevention expert with Safe Kids. Dr. Brown is a senior faculty member in the Division of Emergency Medicine and a recognized expert in prehospital pediatrics.
Additionally, Joseph Wright, MD, MPH, will be transitioning to a new leadership position at the Howard University College of Medicine effective July 1. Congratulations to Drs. Wright, Mickalide, and Brown on their new leadership roles.
Inaugural Meeting of the Pediatric Disaster Planning and Preparedness Community of Practice (06/19/2014)
The EMSC National Resource Center will host the first web conference meeting of the EMSC Pediatric Disaster Planning and Preparedness Community of Practice from 4:00 pm to 5:00 pm (Eastern) on Tuesday, June 24, 2014. During this meeting, led by New Jersey EMSC Program Manager Eric Hicken, CPM, EMT-P, members will begin to build the framework for community-based learning, resource sharing, and collaborative exploration of novel solutions and existing best practices in pediatric disaster preparedness. The featured speaker will be Steve Krug, MD, professor of pediatric emergency medicine at Northwestern University's Feinberg School of Medicine in Chicago, IL.
To register for this event, go to: https://emscnrc.adobeconnect.com/cop1/event/registration.html?campaign-id=CoP1.
All are invited to attend this inaugural meeting. However, future meetings may be restricted to members and invited guest, so if you missed the May 31 deadline to apply for the EMSC Pediatric Disaster Planning and Preparedness Community of Practice and would still like to participate, here is your chance. Go online now through June 27 to submit your application.
ACS Releases Joint Policy Statement: Equipment for Ground Ambulances (06/09/2014)
The American College of Surgeons' Committee on Trauma (ACS-COT), in collaboration with the American Academy of Pediatrics, the American College of Emergency Physicians, the EMSC Program, the Emergency Nurses Association, the National Association of EMS Physicians, and the National Association of State EMS Officials, published the Joint Policy Statement: Equipment for Ground Ambulances in Prehospital Emergency Care. This revision statement includes updated pediatric recommendations developed by the federal EMSC Program and endorsed by the American Academy of Pediatrics. EMSC performance measure 73 evaluates the availability of essential pediatric equipment and supplies for basic life support (BLS) and advanced life support (ALS) patient care units. This document is used as the standard for this performance measure.
EMSC and IHS Publish on Pediatric Care Capabilities of IHS EMS Agencies Serving American Indians/Alaska Natives in Rural and Frontier Areas (06/06/2014)
The EMSC Program, in collaboration with the Indian Health Service (IHS), published a study in the Journal of Rural and Remote Health whose purpose was to understand the infrastructure of the IHS Emergency Medical Services (EMS) agencies to care for children.
A consensus process involving stakeholders was used to identify topic areas for a survey to assess the pediatric capabilities of IHS EMS. The survey was sent to 75 of 88 IHS EMS agency contacts. Sixty-one agencies responded.
Results indicated that nine agencies did not have a medical director. Agencies without a medical director were less likely to report the availability of online or offline pediatric medication direction. Fifty-one percent of the agencies had a mass casualties plan; 29% reported that they had responded to a mass casualty incident involving a large number of pediatric patients that overwhelmed their service. Most agencies were well integrated with their state EMS system with almost all (95%) collecting EMS patient care data and 47% using national standard data elements.
The study concluded that in some areas IHS EMS agencies did not have the infrastructure to treat pediatric patients during day-to-day operations, as well as during disasters. Similar to operational challenges faced by rural EMS agencies, the IHS agencies lacked a medical director, were unable to provide pediatric continuing education, and were overwhelmed during mass casualty incidents. Moreover, the overall ratio of IHS EMS to service population is almost double that for other EMS agencies. In other areas, agencies were well integrated with their state EMS system. One possible solution to increase capabilities to care for pediatric patients is to combine and share common resources, including medical directors with their state EMS systems and authorities.
EMSC and IHS Announce New Continuing Education Credits for Pediatric Disaster Triage Product (06/05/2014)
The Emergency Medical Services for Children (EMSC) Program, in collaboration with the Indian Health Service (IHS) Clinical Support Center, is pleased to announce that the 2010 Connecticut EMSC Targeted Issue Grantee Mark Cicero, MD product Pediatric Disaster Triage: Doing the Most Good for the Most Patients in the Least Time is now available with continuing education (CE) credits. Targeting prehospital providers, this course contains five narrated modules addressing the following: Recognizing a Disaster; Disaster Triage Rationale; Pediatric Triage Considerations; Triage Methodologies (JumpSTART, SMART, SALT, and clinical decision making); and Special Triage Decisions.
ASPR Blog Features EMSC (05/27/2014)
The Assistant Secretary for Preparedness and Response's (ASPR) Blog featured a post about EMSC and the Program's efforts to better serve children in disasters. The post discusses the importance of working together to improve the quality of pediatric emergency care before and during hospitalization. It also asked readers to take part in EMS for Children Day, held May 21, 2014.
PECARN Publishes on Comparison of PECARN, CATCH, and CHALICE Rules (05/23/2014)
The Pediatric Emergency Care Applied Research Network's (PECARN) Traumatic Brain Injury (TBI) prediction rules were tested for diagnostic accuracy in the March 2014 issue of Annals of Emergency Medicine. This study aimed to evaluate the diagnostic accuracy of clinical decision rules and physician judgment in identifying clinically important traumatic brain injuries in children with minor head injuries.
Study subjects included children who presented to the emergency department (ED) within 24 hours of a minor blunt head trauma and had a Glasgow Coma Scale score of 13 to 15.
A total of 1,009 children presenting to the ED were enrolled in the study. Two percent (21) of study participants had clinically important TBIs. The PECARN TBI prediction rules and physician practice were the only of the five modalities to identify all clinically important TBIs. Physician estimates, Canadian Assessment of Tomography for Childhood Head Injury (CATCH), and Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE) accuracy was 95%, 91%, and 84%, respectively. This study concluded that the PECARN TBI prediction rules accurately identified all children for clinically significant TBI.
Tennessee EMSC Releases Updated Pediatric Disaster Preparedness Toolbox (05/22/2014)
Tennessee EMSC recently updated its Pediatric Disaster Preparedness Toolbox designed to help improve disaster response in the state of Tennessee. The courses are for families, healthcare providers, and other professionals who may be expected to respond in the event of large-scale disasters.
Each course has a pediatric focus in keeping with the mission of EMSC, however much of the information applies equally well in non-pediatric situations. For more information about the Tennessee EMSC State Partnership program, visit its website.
EMSC NRC Seeks Applicants for Pediatric Disaster Preparedness CoP Pilot (05/22/2014)
The Emergency Medical Services for Children (EMSC) National Resource Center (NRC) is proud to announce the launch of the EMSC Pediatric Disaster Preparedness Community of Practice. The vision of this pilot project is to advance individual knowledge and practice to improve emergency care for children. The overarching goal is to provide a forum for EMSC grantees to engage in community based learning and resource sharing, and promote the collective exploration of new ideas and best practices.
During the next year, the EMSC NRC will develop a sustained CoP model that provides EMSC grantees a forum through which members will:
Innovate and create breakthrough ideas to improve practice
Help each other resolve challenges to pediatric disaster preparedness and EMSC performance measures that directly impact everyday readiness for disaster
Develop and disseminate best practices
Organize, manage and steward a body of knowledge in the development of the pediatric emergency systems of care
To participate, submit your application by May 31 and be sure to register for the online community forum. The registration is a two-step process: (1) sign up for phconnect.org account and (2) request access to the CoP located at the link above.
Note that the dates for the community meetings are set. Mark your calendars for 4:00pm (Eastern) on June 24; 4:00pm (Eastern) on July 22; and then for 4:00pm (Eastern) for the fourth Tuesday of each month thereafter. An in-person CoP meeting also will occur at 5:00pm on July 30, during the EMSC Program Meeting in Arlington, VA.
For more information, contact Tony Gilchrest at firstname.lastname@example.org.
EMSC Seeks Pictures for 2014 EMSC Program Meeting (05/12/2014)
Help the EMSC Program celebrate its 30-year anniversary by submitting photos for display at this year's 2014 EMSC Program Meeting. Photos should represent staff at work, events, partnerships, EMS or any key EMSC-related accomplishments between 1984 to present day. Please email photos in "jpeg" format to Suzanne Sellman of the EMSC National Resource Center by June 30.
PECARN Publishes on Lorazepam versus Diazepam for Pediatric Status Epilepticus (05/09/2014)
The Pediatric Emergency Care Applied Research Network (PECARN) published a study in the April 2014 issue of the Journal of the American Medical Association aimed to test the hypothesis that lorazepam is better than diazepam in efficacy and safety for treating pediatric status epilepticus patients.
Children ages 3 months to less than 18 years that presented to one of 11 pediatric emergency departments (ED) with convulsive status epilepticus were included in this double-blind randomized clinical trial. A total of 310 pediatric patients presented to the ED. Of these, 273 patients were enrolled in the study with 140 patients being treated with diazepam and 133 being treated with lorazepam. Patients enrolled in the study received either a 0.2 mg/kg dose of diazepam or 0.1 mg/kg dose of lorazepam intravenously. If symptoms persisted after five minutes, the patient received half of the original dose. If symptoms continued after 12 minutes, the patient received fosphenytoin.
The results of the study were as follows: termination of status epilepticus for at least 10 minutes without recurrence for 30 minutes occurred in 72.1% (101 of 140) of diazepam patients and 72.9% (97 of 133) lorazepam patients, absolute efficacy difference of 0.8% (95% CI, -11.4% to 9.8%). Additionally, 26 patients in each group required assisted ventilation (16.0% and 17.6%, risk difference 1.6% for diazepam and lorazepam respectively). Study results also showed there was no statistically significant difference in secondary outcome measures except that lorazepam patients were more likely to be sedated (66.9% vs. 50%, respectively, absolute risk difference, 16.9%).
In conclusion, the study found that there was no improved efficacy or safety in the use of lorazepam compared to diazepam for the treatment of pediatric status epilepticus patients despite the preferential use of lorazepam
EMSC NRC Now Accepting Submissions for Grantee Spotlight at 2014 EMSC Program Meeting (05/08/2014)
The EMSC Program is hosting a Grantee Spotlight session during this year's EMSC Program Meeting, to be held July 29 through August 1, in Arlington, VA. The Grantee Spotlight, which willl take place on Thursday, July 31 from 5:30 pm to 7:00 pm, is an opportunity for all grantees, family representatives, and cultural liaisons to exhibit and share their resources, priorities, successes, and knowledge with their colleagues, including fellow grantees as well as federal and national organization partners.
If you would like to exhibit at this year's EMSC Program Meeting, please complete the submission form and return via email to Rinal Patel of the EMSC National Resource Center (NRC) or fax to 301-244-6301 by June 2, 2014
Don't Forget...Update Your Peds Ready State Page! (04/25/2014)
The EMSC National Resource Center continues to collect updates from states and territories regarding their Peds Ready activities. These updates are posted to the National Pediatric Readiness Project website under the section "State Results." Please send updates in Word format to Suzanne Sellman at email@example.com.
Not sure what to post? Go to www.PediatricReadiness.org and click on "State Results" to see examples of what others are posting. Currently, every state and territory has its Peds Ready data sheet posted, showing a breakdown of state and comparative scores.
Former TI Grantee Publishes on Collaborative Care Intervention Targeting Patterns of Risk Behaviors and Symptoms of Adolescents With and Without TBI (04/24/2014)
Former Targeted Issue (TI) Grantee Doug Zatzick, MD, published a study in the April 2014 issue of JAMA Pediatrics that aimed to test the effectiveness of a collaborative care intervention targeting the pattern of risk behaviors and symptoms of adolescents with and without traumatic brain injury (TBI).
In this randomized clinical trial, 120 adolescents ages 12 to 18 were assessed; with 59 participants in the control group and 61 in the intervention group. All study participants received an evaluation of violence and injury risk behaviors, alcohol and drug use, post-traumatic stress disorder, and depressive symptoms. Study participants were evaluated at baseline within an average of 10 days of the initial injury by a series of questions related to the year prior to the injury event.
Results of the study found that compared to all other adolescents admitted to the trauma center, these 120 participants were less likely to be intentionally injured and have a positive blood alcohol concentration (4.2% vs. 12.0% and 2.5% vs. 9.8%, respectively). In addition, among the 120 study participants, the highest prevalence risk behavior at baseline was carrying a weapon with 32.8% of study participants reporting this behavior. Additionally, 10.9% of adolescents reported alcohol consumption or use consistent with an abuse or alcohol dependence diagnosis.
An average time of 13.1 hours was spent with each of the 61 participants who received the intervention. Nearly two-thirds or 39 of intervention study participants received one or more motivational interviews aimed at substance abuse or risk behaviors. When comparing the control versus intervention groups at 12 months post injury, 7.3% of intervention vs. 21.3% of control patients reported carrying a weapon. Similarly, 18% of adolescents in the control group began new weapon carrying behaviors vs. 3.4% of intervention patients following injury hospitalization.
In this patient population, collaborative care intervention reduced the risk of weapon carrying among adolescents. More research needs to be done to replicate this study's findings.
Arkansas EMSC Releases Exertional Heat Illness Project (04/11/2014)
Arkansas EMSC and the Arkansas Department of Health partnered with the Kory Stringer Institute at the University of Connecticut, Life Touch Media Productions, the Arkansas Department of Education, and many other key stakeholders to create Cool Down First as part of the Exertional Heat Illness Project.
Exertional heat illness is 100% preventable with the proper preparation and care of those that may suffer from it. The goal of the project is to be a resource to parents, schools, coaches, emergency medical personnel, and any others who may face this issue. Every public, private, and charter school in Arkansas will receive informational packets and Cool Down First DVDs. Additionally, every EMS agency in Arkansas will receive the same materials.
Texas EMSC to Host Webinar on Next Steps in Pediatric Readiness (04/11/2014)
Texas EMSC will host the webinar "Next Steps in Pediatric Readiness: Is It Time for Pediatric Facility Categorization in Texas?" at 9:00 am (Eastern) on Thursday, April 17 and again at 12 noon (Eastern) on Monday, April 28. Join the webinar to learn:
how Texas data from the National Pediatric Readiness Project supports the development of a pediatric facility categorization program;
what pediatric facility categorization is and how it can ensure quality emergency care for children in Texas; and
how pediatric facility categorization is currently being implemented in other states and regions and how those models can be used to develop a similar program in Texas.
To register, please email Sam Vance, Texas EMSC program manager, and include your first and last name, email address, job title, company, and date of webinar you choose to attend. Participants will receive a confirmation email two to three days prior to the webinar with login information.
Targeted Issue Grantee Publishes on Termination of Resuscitation in the Pediatric Out-of-Hospital Setting (04/10/2014)
EMSC Targeted Issue (TI) Grantee Mary Fallat, MD, at the University of Louisville Research Foundation published findings from her TI project "Compassionate Options for Pediatric Emergency Medical Services (COPE)" in the April issue of Pediatrics.
The aim of this study was to determine if the current protocols for out-of-hospital termination of resuscitation in adults with cardiopulmonary arrest are appropriate for pediatric victims. Despite growing acceptance of the termination of resuscitation when there is no expectation of a good outcome, pediatric patients are not considered in these out-of-hospital protocols.
In a systematic literature review utilizing PubMed and Medline, the study researchers determined 27 articles were appropriate for this study. Of the 1,114 patients who suffered a traumatic cardiopulmonary arrest out-of-hospital, 5.4% (60 patients) survived to hospital discharge. Of these 60 patients, outcome data was available for 51. The outcome data indicated that 29 suffered neurologic devastation and were severely disabled or in a vegetative state, three had moderate disability, and 19 had "good" or full neurologic recovery.
Researchers concluded that resuscitation should be initiated and continued until the patient arrives to the appropriate care facility. If the patient has arrested, resuscitation has exceeded 30 minutes, and the nearest facility is greater than 30 minutes away, parents and caregivers should be involved in the decision making process of determining whether to discontinue resuscitation.
March 2014 Issue of Clinical Pediatric Emergency Medicine Focuses on EMSC (04/01/2014)
The March 2014 issue of Clinical Pediatric Emergency Medicine focuses on Emergency Medical Services for Children (EMSC). The issue features 15 publications written by EMSC champions, including Program grantees and State Partnership advisory committee members.
Congratulations to all authors and the EMSC Program on this outstanding achievement!
EMSC Presents at John Templeton Jr. Pediatric Trauma Conference (03/28/2014)
EMSC Grantees Nathan Kuppermann, MD, MPH, and Randall Burd, MD, PhD, and the EMSC National Resource Center's Diana Fendya, MSN (R), RN, presented at the 14th Annual John Templeton Jr. Pediatric Trauma Conference held March 7 and 8, in Philadelphia, PA. This educational conference is a collaborative venture of Children's Hospital of Pittsburgh, St. Christopher's Hospital for Children, and the Children's Hospital of Philadelphia.
"Development of an Evidence-based Abdominal Imaging Algorithm" and "Indications for Head CT in the Pediatric Trauma Patient" (Kuppermann)
"Assessing and Improving Team Performance During Pediatric Trauma Resuscitation" and " Challenging Cases in Pediatric Trauma" (Burd
"Trauma Care Begins with the ABCDE, but Don't Forget the Ws': Who, What, Where and When to Transfer" (Fendya)
Comparison of Decision Rules Highlights Results of Former PECARN Study (03/27/2014)
A recent publication in Annals of Emergency Medicine compared two clinical decision rules and clinician practice to the Pediatric Emergency Care Applied Research Network (PECARN) Traumatic Brain Injury (TBI) prediction rules (published in Lancet 2009) to evaluate diagnostic accuracy for identifying clinically important traumatic brain injuries in children with minor head trauma presenting to the emergency department. This study concluded that only physician practice and the PECARN TBI prediction rules identified all clinically important TBIs.
Alabama EMSC to Host EMS Pediatric Respiratory Emergencies Webcast (03/13/2014)
The Alabama EMSC program along with the Alabama Department of Public Health will host the webcast EMS Pediatric Respiratory Emergencies from 11:00 am – 12:30 pm (Eastern) on March 25, 2014. This webcast will provide education and awareness on pediatric respiratory difficulties as well as provide an overview of pediatric respiratory anatomy and physiology, emphasize airway support and management, demonstrate some of the most common airway problems, and use clinical experience to explain how common pediatric respiratory issues can be better assessed.
New York EMSC and NYSDOH Revise Pediatric Hospital Regulations (02/28/2014)
The New York State Department of Health (NYSDOH) and its EMSC program have revised the minimum operating standards for all hospitals in regards to the pediatric patient. The hospital codes and regulations were revised to include quality improvement activities, staffing qualifications/competencies, appropriately-sized equipment and building infrastructure, and policies and procedures all centered around the pediatric patient; the obvious goal being to ensure hospitals are treating the patients they are qualified and prepared to treat, and if not, to transfer the patient(s) to an appropriate facility.
The sections of the New York code that were revised include: Admission and Discharge, Quality Assurance, Surgical, Outpatient, Anesthesia, Respiratory, Radiology, Pharmaceutical, and Emergency Services. A new section on Pediatric Intensive Care Units was also added.
California EMSC to Host Educational Forum at CFEDWest 2014 Conference and Expo (02/28/2014)
On Monday, May 19, California EMSC is partnering for the second year with the California Fire EMS and Disaster West (CFEDWest) to host the pre-conference educational forum "Get Ready with Kids" at the 2014 CFEDWest Conference and Expo in Palm Springs, CA. This forum will explore current issues and practices in providing emergency care to children.
EMSC Grantees Publish on Program Manager Survey on Education of Prehospital Providers (02/27/2014)
EMSC Grantees Manish Shah, MD, and Karen Belli recently published a study in Prehospital Emergency Care aimed to examine the content and number of hours of pediatric-specific education that prehospital providers receive during initial certification and recertification. The study also aimed to identify barriers to implementing specific requirements for pediatric education of prehospital providers.
Electronic surveys were sent to 55 EMSC State Partnership grant program managers to inquire about the certification and recertification processes of prehospital providers and barriers to receiving pediatric training in each jurisdiction. Based on a 91% response rate, results indicate that specified pediatric education hours exist in more states and territories for recertification than initial certification. Barriers to enhancing pediatric education include: limitations in funding, time, instructors, and accessibility. The study suggests modifying statewide policies on prehospital education and increasing hands-on training to help overcome identified barriers.
EMSC EMS Performance Measure Reassessment Response Rate Exceeds 82% Nationwide (02/27/2014)
On June 1, 2013, the Maternal and Child Health Bureau began conducting a reassessment of Emergency Medical Services for Children (EMSC) performance measures 71, 72, and 73. Each state is required to participate in the re-assessment and has a three-month window to collect the data. That three-month window was determined by each State Partnership grantee as long as it fell between June 1, 2013, and February 28, 2014. The current response rate is 82.3% nationwide! Congratulations!
New Mexico SPROC Releases Module on Emergency Management of DKA in Children (02/14/2014)
New Mexico's EMSC State Partnership Regionalization of Care (SPROC) project released a new module on emergency management of diabetic ketoacidosis (DKA). In the module scenario, Chelsea, a 16-year-old known Type 1 diabetic, presents to the pediatric emergency department in diabetic ketoacidosis. This emergency scenario, filmed at the University of New Mexico Health Sciences Center Medical Training Center, visually instructs medical personnel in the emergency treatment of a pediatric patient in diabetic ketoacidosis. The module also includes an interview with a pediatric endocrinologist who discusses key points and treatment highlights of pediatric diabetic ketoacidosis.
Former TI Grantee Publishes on Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis (02/14/2014)
Former Targeted Issue (TI) Grantee Richard Lammers, MD, published "Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis" in the January/March 2014 issue of Prehospital Emergency Care. This article aimed to identify underlying causes of prehospital medication errors that were observed during a simulated pediatric anaphylaxis reaction.
A standardized scenario and child mannequin were used in a mobile simulation lab to identify common and clinically significant medication errors and underlying causes of those errors during the treatment of a five-year old patient with anaphylaxis by prehospital providers. Study subjects included licensed emergency medicine technicians, specialists, and paramedics who worked as either a two- or four-person EMS crew.
Subjects participated in a 20-minute simulation using their own equipment and medication. The investigators utilized a checklist-based scoring protocol to identify errors.
A total of 142 providers participated in 62 simulation sessions. Ninety-five percent of crews gave epinephrine; 46% delivered the correct dose with the appropriate concentration. Twenty percent gave a dose that was more than five times the correct dose and 14% bolused epinephrine intravenously. Among the 55 crews who administered diphenhydramine, four delivered the correct dose.
The eight underlying causes of errors were as follows: faulty reasoning, faulty recall of medication dosages, weight estimation errors, problematic references, calculation errors, dose estimation, communication errors, and medication delivery errors.
PECARN Publishes on Validation of TBI Prediction Rules (02/13/2014)
Pediatric Emergency Care Applied Research Network (PECARN) Principal Investigator Lise Nigrovic, MD, and colleagues published "Pediatric Emergency Care Applied Research Network Head Injury Clinical Prediction Rules Are Reliable in Practice" in the January 2014 issue of Archives of Disease in Childhood. This cross-sectional study aimed to evaluate the performance of the PECARN Traumatic Brain Injury (TBI) prediction rules in an external patient population.
Study subjects included children who presented to one of two pediatric emergency departments (ED) in Boston, MA, and Padua, Italy, within 24 hours of a minor blunt head trauma and had a Glasgow Coma Scale equal to or greater than 14. Pediatric emergency and general pediatric attendings, pediatric emergency medicine fellows, and senior residents completed all study forms in the prospective cohorts, and a senior researcher conducted a standard medical chart review and chart abstraction for the retrospective cohort.
A total of 2,750 children presented to the EDs with 2,439 being enrolled in the study. Fifteen percent (373) of study participants had a computed tomography (CT) performed, 3% (69) had traumatic findings on the CT, and 0.8% (19) had a clinically important TBI. None of the children with a clinically important TBI were classified as very low risk by the PECARN TBI prediction rules. This study concluded that the PECARN TBI prediction rules accurately identified children at very low risk for clinically significant TBI.
Preliminary Agenda Now Available for 2014 EMSC Program Meeting (02/13/2014)
The preliminary agenda and logistics fact sheet are now available for the 2014 Emergency Medical Services for Children Program being held Tuesday, July 29 through Friday, August 1, 2014, at the Renaissance Arlington Capital View Hotel in Arlington, Virginia. The theme for this year's meeting is: "Emergency Medical Services for Children: Then, Now, Imagine; Honoring the Past, Experiencing the Present, Visualizing the Future."
Online registration will open on March 3, 2014. Attendees will be responsible for making their own hotel reservation by contacting the hotel directly or by using the hotel's online reservation system. Attendees should not call the Renaissance Arlington Capital View Hotel until they receive an identification code that is specific to this year's meeting. That code will be released when registration opens on March 3. Additional details about the meeting will be forthcoming.
HHS Seeks Nominations for New National Advisory Committee on Children and Disasters (02/07/2014)
The needs of children in disasters will be the focus of a new advisory committee of the U.S. Department of Health and Human Services (HHS). The National Advisory Committee on Children and Disasters (NACCD) will provide expert advice and consultation to the HHS Secretary on comprehensive planning and policies to meet the needs of children before, during, and after a disaster or public health emergency. Nominations are being accepted from non-federal health care professionals and representatives from state, tribal, territorial, or local health departments with expertise in pediatric disaster planning, preparedness, response, or recovery. The submission deadline for nominations is February 14, 2014. For more information and instructions on how to apply, visit www.phe.gov/naccd.
Texas EMSC is Accepting Nominations for EMSC Crew of the Year Award (01/31/2014)
In honor of EMSC Day 2014 and the 30th Anniversary of the EMSC Program, the Texas EMSC State Partnership program is now accepting nominations for the Sixth Annual EMSC Crew of the Year Award. This award is granted to an EMS crew or station who has displayed outstanding care for a child in an emergency medical or trauma event, demonstrated exceptional effort in the development of pediatric training or quality improvement programs, or was instrumental in planning and conducting creative injury prevention programs.
To submit a nomination for the EMSC Crew of the Year, please send the following information to EMSC Program Manager Sam Vance by February 7, 2014 at Samuel.Vance@bcm.edu
Names and titles of crew members
Agency or organization with contact information
A brief (500 words or less) description of the event or program and why you feel this crew deserves special honor and recognition
Your contact information (will not be disclosed without your permission)
Arkansas EMSC Holds Successful Simulation Event (01/31/2014)
Arkansas EMSC held a simulation event on Wednesday, January 22, which took place in an elementary school. Simulation dolls were utilized to help prepare emergency medical personnel in the community for child emergencies.
Charlotte, Houston and Milwaukee Prehospital (CHaMP) Research Node Center (RNC) Releases a New Research Lecture (01/30/2014)
The 2013 Targeted Issue Grantee CHaMP Research Node Center released its second research lecture titled "Developing a Research Question." Produced by E. Brooke Lerner, PhD, at the Medical College of Wisconsin, this video is the second installment of the CHaMP node's EMS Research Education video series. The series aims to assist healthcare professionals in designing EMS-based research and engaging with the CHaMP network. The presentation examines the origin of research ideas and provides a step-by-step tutorial on developing a high-quality research question. Topics covered include: what makes a good research question, identifying a suitable research question's key components, and the construction of a research question using the PICO method.
Alaska EMSC Welcomes New Program Manage (01/18/2014)
Alaska EMSC welcomes its new program manager, Marna Lee Schwartz , MD, FAAP. Dr. Schwartz is a Board-certified primary care pediatrician with additional training in evaluation of child abuse and neglect, neurodevelopmental delays/autism, and fetal alcohol syndrome. She has spent the last six years doing full-time clinical work at a large primary care clinic in Juneau working with general and special needs pediatric patients. Dr. Schwartz also provides pediatric coverage for the emergency department, labor and delivery, and inpatient care (general and pediatric intensive care unit) at Bartlett Regional Hospital. The EMSC family would like to congratulate Dr. Schwartz on her new role!