Tia Dickson, RN, BSN

Primary Children's Hospital

Did you know, at the bottom of every newsletter there is a PDF attachment that allows you to print out that issue? They make a great "bathroom read" in agencies and breakrooms.

Trauma is trauma, even when the patient is pediatric

Lindy Kartchner RN, BSN

Trauma outreach coordinator, Primary Children's Hospital Trauma Services

Excerpts from October 10th PETOS

For EMS, pediatric patients usually fall into your high acuity, low frequency category. You don't see many patient younger than 18 (about 8% of all calls in 2021). From recent stats your top 5 pediatric complaints for all pediatric calls are:

1. Trauma
2. Seizure
3. Respiratory distress
4. Behavioral health
5. Pain

In 2021 there were 28,217 pediatric calls but only about 1.000 were classified as critical ill or injured. Besides the scarcity of these calls, a research study found universal reasons that peds calls affect us more than adult calls.

• There is a special social value for children
• Caregivers (parents) become secondary patients
  
• We identify with patient and family
• There are clinical difficulties (difference in anatomy, physiology and development)

• Pediatric calls make up about 8% or your calls; of those, only 3% are critical
• Add the themes that came out of that research study
• And the differences in anatomy and physiology

You can see why your heart may start to beat a bit faster when dispatch relays a pediatric call. What is important to remember is that when it comes to trauma, trauma is trauma even for the pediatric patient.

• Trauma time out: Occurs before you arrive. The team leader will identify roles, lay out the information received from your called in report, and make a plan of care with all those present.
• Transfer to gurney
• Primary survey and resuscitation: the ABCDE of our systematic approach. The PAR process will pause here if the child needs any life-saving intervention (intubation, epi drips, access, etc.)
• EMS report: Follows the MIST mneumonic
• Secondary survey: A head-to-toe evaluation, collection of history, and obtaining additional diagnostic tests.
• Trauma huddle: This is a brief team discussion about anything that needs to be completed before leaving the bay.

Lindy Kartchner does in-depth follow up on any trauma cases

Tia Dickson does in-depth follow up on any medical case

Annette Newman MS, RN, CCRN

Disaster preparedness consultant

Utah Hospital Association

On behalf of the pediatric surge team, thank you all so much for the amazing care you give to children during this early season pediatric respiratory surge. We appreciate all of you who have reached out for extra education and resources on caring for young children with bronchiolitis and other respiratory illnesses.

Currently, Utah is seeing an increase of COVID-19, RSV, parainfluenza, and influenza cases. DHHS continues to monitor hospital capacity statewide, specifically Primary Children's Hospital.

There are many excellent resources available in the quick links below and attached as PDF files (at the end of this newsletter).

• ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE) page on Pediatric Surge Resources launched to help respond to the current pediatric surge in viral respiratory illnesses
• Version 1 of the WRAP-EM JIT Basic Clinical Guidance for Pediatric Respiratory illness. It is intended to be distributed to hospitals and providers particularly in rural areas. Updates will be available at the WRAP-EM website, https://wrap-em.org/ (also attached)
• EIIC surge page which includes resources from PPN, WRAP-EM, Region 5 for kids and others. It also contains excellent EMS/prehospital resources (attached) https://emscimprovement.center/domains/preparedness/active/surge/
• PCH Clinical guidance for respiratory care of children including High-Flow Nasal Cannula (HFNC) Protocols (attached in addition to being located in the ASPR TRACIE resource link).

Remember when you took the 2022 EMS for children survey? Did you get your results?

NEDARC sent this report to the approximately 16,000 respondent and non-respondent EMS agencies across the country by personalized emails. The primary intent of the report is to serve as a thank you to those who completed the survey. You can download each national report below:

2020 National EMS for Children Survey Report for EMS Agencies

2021 National EMS for Children Survey Report for EMS Agencies

2022 National EMS for Children Survey Report for EMS Agencies

Check out the attached PDFs at the end of this newsletter to help deal with the pediatric respiratory surge.

The EMSC Data Center has created a new fact sheet which describes the link between pediatric readiness facility recognition on NPRP assessment scores. We continue to see that emergency departments who participate in a Pediatric Readiness Recognition Program score, on average, more than 20 points higher on the NPRP assessment than those who do not.

HRSA Highlight—CYSHCN Blueprint for Change

If you work to improve care for children and youth with special health care needs (CYSHCN), we hope you will take a look at a new report from the National Academies of Sciences, Engineering, and Medicine. They conducted a 2-day workshop to examine the impact of the COVID-19 pandemic on children with who have disabilities and their families. The report, Supporting Children with Disabilities: Lessons from the Pandemic, can help inform the work in the CYSHCN Blueprint for Change. Let's create a nation where all children enjoy a full life and thrive in their communities from childhood through adulthood.

Utahns who are eligible to receive a bivalent booster dose right now include:

• Individuals 6 years of age and older are eligible for the updated Moderna booster if it has been at least 2 months since they completed their primary vaccination series or received a booster dose.
• Individuals 5 years of age and older are eligible for the updated Pfizer-BioNTech booster if it has been at least 2 months since they completed their primary vaccination series or received a booster dose.

A list of vaccine providers is available on the state’s coronavirus webpage or vaccines.gov.

Get your COVID-19 booster

The pandemic lead to many missed well-child checks and some children missed childhood vaccinations. Check to see if you’re up-to-date on all immunizations, whether for yourself or your children, as well as health screenings and well-child checks:

Up2Date.Utah.gov

Pediatric education for the prehospital provider

Register online at www.peppsite.com. Look up classes in Utah and find the 1 that works for you. Once you find the class, go to jblearning.com, and look up pepp als in the search tool. Purchase the number ($21.95). Return to peppsite.org to register for the class and follow the prompts.

If you have any questions, please email Erik Andersen at erikandersen@utah.gov or text/call 435-597-7098. Continue to watch the website for additional classes.

The Emergency Medical Services for Children (EMSC) Program aims to ensure emergency medical care for the ill and injured child or adolescent is well integrated into an emergency medical service system. We work to ensure the system is backed by optimal resources and that the entire spectrum of emergency services (prevention, acute care, and rehabilitation) is provided to children and adolescents, regardless of where they live, attend school, or travel.

Email: tdickson@utah.gov
Website: https://bemsp.utah.gov/
Phone: 801-707-3763
Facebook: facebook.com/Chirp-UtahDepartmentofHealth