Tia Dickson, RN, BSN

Primary Children's Hospital

Pediatric readiness isn't just disaster prep! We usually talk about pediatric preparedness during September because it pairs so nicely with National Preparedness Month but being ready for a pediatric call within your agency is more than emergency prep. It's having the knowledge and skills training to care for a child. It's having protocols in place and knowing how and when to use them. It's having the right equipment on hand. It's also knowing how to access the resources available to you. Disaster prep is also important but if you're ready for a day-to-day peds call, you will be ready for the catastrophe.

A Pediatric Emergency Care Coordinator (PECC)--sometimes referred to as a pediatric champion or pediatric liaison--is a term the EMSC program uses to refer to any individual who has a particular interest in or responsibilities related to pediatric emergency care. In Utah, the PECC role is a designated (in Imagetrend) position within an EMS agency or hospital. Sometimes this individual is dedicated solely to this role. However, depending on the pediatric volume of the EMS agency or hospital, this person may take on the PECC duties in addition to other responsibilities (e.g., EMS instructor, educator, trauma coordinator, etc.).

• The IOM report in 2007 entitled "Emergency Care for Children: Growing Pains," recommends EMS agencies and emergency departments (EDs) appoint a Pediatric Emergency Care Coordinator (PECC) to advocate and provide pediatric leadership for the organization.
• In 2018, Utah made the requirement of having a PECC in every hospital and EMS agency an EMSC Performance Measure.

EMSC began with hospitals and tried out the PECC role in nine states. A study found that hospitals with a PECC . . .

If you're a pediatric advocate within your agency, we need you. Please contact our program manager, Mark Herrera (markherrera@utah.gov), to find out how you can help. Join BEFORE our first annual PECC Conference on September 30th (see below). We have designated PECCs from 47 agencies already registered for the conference.

Pediatrics in Disasters: Assessing our Readiness

Jonathan Eisenberg, MD

A disaster is an event that most often occurs suddenly and unexpectedly, causing trauma to people and/or severe damage to the environment and exceeds or overwhelms the response capacity of the affected community. These are rare, but devastating events, that require planning, practice, and response. During a disaster scenario, the care of patients is altered as a result of the limited resources and availability of providers. These changes of care and scope of practice fall under the crisis standards of care guidelines which essentially dictate weighing the greatest good for the greatest number of patients. This is achieved by delaying, degrading, and denying care; actions that can be very uncomfortable for a provider.

The response to a disaster is multifaceted and complex. There is the scene response, coordinated by an incident commander where the initial triage is performed. There are multiple accepted forms of mass casualty/disaster triage. The START triage, and JUMPSTART for pediatric patients, are simple tools to objectively assess large groups of patients quickly and effectively. It uses a color-coded system (green, yellow, red, and black) along with targeted exam findings to delineate severity of disease. The pediatric version gives slightly more latitude toward an attempt at resuscitation with rescue breaths prior to ceasing all efforts. A secondary triage can be performed at the receiving facility to determine change in status.

Regarding pediatric disaster victims, there are significant differences that make the pediatric patient more susceptible to disaster pathology. There are anatomical and physiological differences (similar to a pediatric trauma victim) that predispose children to worse outcomes. Short stature makes them susceptible to aerosolized chemicals in a terrorist attack or projectiles from an explosive device. Large head size leads to an increased rate of brain injury. They also have faster metabolism and respiratory rate, along with a less mature immune system. Developmental issues also make them more difficult to evaluate and reunify with family.

There are ongoing efforts to increase pediatric readiness in emergency departments (National Pediatric Readiness Project) which in turn, will allow for greater preparation to deal with pediatric disaster victims. But, individual hospitals, clinics, fire departments, and EMS systems should take stock of their disaster plans and ensure pediatric involvement. In the state of Utah, 29% of the population is younger than 18 yrs of age. Neglecting their medical importance in preparation and mitigation strategies will, at some point, lead to catastrophic outcomes in the event of a large scale disaster event.

The EIIC has launched a new Prehospital Pediatric Readiness Toolkit

The Prehospital Pediatric Readiness Toolkit content is organized by the seven domains of prehospital pediatric readiness as outlined in the checklist. The tools and resources align with the Joint Policy Statement and will help prehospital emergency care providers better understand and achieve the components of pediatric readiness in the prehospital environment. The resources in this toolkit have been curated by a comprehensive team of stakeholders and will be useful to all who are dedicated to delivering high-quality pediatric prehospital care.

Here is link to page:

https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-readiness/pprp-toolkit/

And in this link, you will find some great videos for education and skills:

https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-readiness/pprp-toolkit/education-competencies-providers/

Recruiting Participants for Pediatric Emergency Care Champions (PECC) Development Collaborative

September 1, 2021—June 30, 2022

Purpose

This collaborative will develop individuals who are interested in improving the quality of pediatric care at your EMS agency, ED/hospital, or within your region. We will provide resources, example practices, and networking opportunities at no cost to help push forward any effort for pediatric improvement.

View Recruitment Video https://youtu.be/Nn8M5DCqeF4

For details go to: https://emscimprovement.center/collaboratives/pwdc/

In The News

• “2021 Special Report: National Pediatric Readiness Project” podcast - Emergency Medicine Reviews and Perspectives (EM:RAP), May 2021
• “EMS for Children Program offers pediatrics resources for EMS Week 2021” article - EMS1, May 6
• “National Pediatric Readiness Project” article - Pediatric EM Morsels, March 26
• May 19 & 20 Pediatric Readiness webinar recordings

Last Call for Handtevy!

As you may know, Utah EMSC has purchased the Handtevy App for ALL EMS Agencies in the State. Want access to yours? It has already been purchased for you!

We still have a number of agencies who have not signed up/been in contact with the Handtevy administration.

Here is a list of the agencies who have taken advantage of the Handtevy purchase. These agencies have an active Handtevy account:

• American Fork Fire
  Brigham City Fire
  Cedar Mountain Fire Protection District
  Classic Air Medical
  Davis County Sheriff's Office
  Draper City Fire Department
  East Carbon Ambulance
  Emery County Ambulance
  Enterprise Fire and EMS
  Garfield County Ambulance
  Grand County EMS
  Juab County EMS
  Lehi Fire Dept
  Logan City Fire Department
  Lone Peak Fire Department
  Mendon Fire and Rescue
  Millard County Ambulance Service
  Morgan County Fire Department
  Mountain West Ambulance
  Murray City Fire Department
  North Fork Fire
  North Sanpete Ambulance
  North Summit Fire District
  Ogden City Fire Department
  Orem Fire Department
  Piute County Ambulance
  Plymouth Fire Department
  Rich County Ambulance
  Rocky Ridge EMS
  Roy City Fire & Rescue
  Salt Lake City Fire Department
  Salt Lake Community College
  San Juan County EMS
  Santa Clara - Ivins Fire Rescue
  Santaquin Fire & EMS
  Saratoga Springs Fire & Rescue
  Scipio Ambulance
  Sevier County EMS
  South Ogden Fire UT
  Spanish Fork EMS
  Uintah Basin Medical Center EMS
  University of Utah Health AirMed
  Utah County Sheriff Search and Rescue
  Utah Navajo Health System
  Ute Tribe Ambulance
  Wasatch Fire District
  Weber County Sheriff's Office
  West Jordan Fire Department
  West Valley City Fire Department
  Zion National Park EMS
  

If you are interested in Handtevy and would like to take advantage of this great opportunity, encourage agency leadership to fill out the survey attached below.

Survey: https://forms.gle/GNsQi2sPYm7iSHHE8

Please do not hesitate to contact me if you have any questions or concerns.

Thank you,

Mark Herrera, NRP, FP-C

EMSC Program Manager

Bureau of EMS and Preparedness

Utah Department of Health

markherrera@utah.gov

801-232-9138 (c)

• With temperatures soaring, Primary Children’s safety experts remind you about dangers of hot cars
• What parents need to know about preventing heat-related illnesses
• Drowning is the second leading cause of death for children younger than 14 in Utah: Here are seven tips to keep your kids safe around water

Talk to your community about the Covid-19 vaccine

Intermountain has developed conversation guidance addressing vaccine hesitancy and scripting examples in “Tips for talking about the COVID-19 vaccine with your patients.” It was developed with support from physician and APP leaders, epidemiologists, and vaccine experts, and informed by conversations many providers have already had.

Covid-19 Trackers

Johns Hopkins Global tracker (desktop)

Johns Hopkins Global tracker (mobile)

Utah Department of Health

WE HAVE A 71.4% RESPONSE RATE. The survey closes July 31.

What is the National Pediatric Readiness Project (NPRP)?

The National Pediatric Readiness Project is a multi-phase quality improvement initiative to ensure all U.S. emergency departments have the essential guidelines and resources in place to provide effective emergency care to children.

What is the 2021 NPRP Assessment?

The NPRP Assessment is a national assessment of America’s EDs to determine progress in pediatric readiness, identify existing gaps, promote quality improvement (QI) efforts in hospital EDs around the country, develop national collaboratives to address common and critical gaps, and identify best practices.

Why is participation in the 2021 NPRP assessment important for ED managers?

The NPRP assessment helps ED personnel better prepare to provide quality care for patients of all ages by evaluating the QI process of EDs over time.

• Hospitals with high ED readiness scores demonstrate a 4-fold lower rate of mortality for children with critical illness than those with lower readiness scores; thus, improving pediatric readiness improves outcomes for children and their families.

ED nurse managers, we need you!

https://emscimprovement.center/domains/pediatric-readiness-project/

Do you have a question for our EMSC Medical Director, Hilary Hewes, MD, PCH, ER Attending Physician about this newsletter topic or anything related to pediatrics? Shoot an email to the following address tdickson@utah.gov.

You have the right to close the loop on care you provided. For follow up on patients brought to Primary Children's Hospital, contact the PCH EMS Liaison, Lynsey Cooper at Lynsey.Cooper@imail.org.

Pediatric Education for the Prehospital Provider

Register online at www.peppsite.com. Look up classes in Utah and find the one 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 ($18.95). 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 that emergency medical care for the ill and injured child or adolescent is well integrated into an emergency medical service system. We work to ensure that 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, no matter 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