Transcript Slide 1
10 Tips For Preparing For Pediatric Office Emergencies #1. The Office Self Assessment • What type of emergencies do you see? How often? • Location, setting, resources? • Staffing, training? • Equipment, supplies, meds on hand? http://pediatrics.aappublications.org/cgi/reprint/120/1/200 #2. Essential equipment and supplies Equipment • Oxygen-delivery system • Bag-valve mask • Suction • Nebulizer • Oropharyngeal airways • Pulse oximeter Supplies • Cardiac arrest board • Sphygmomanometer with cuffs • Splints, sterile dressings Strongly Suggested • Vascular access and fluid management supplies #3. Keep a card, chart or tape handy • Color-coded tape or preprinted drug doses • Recognition works better than memory #4. Essential Medications Essential 1. Oxygen 2. Albuterol for inhalation 3. Epi 1:1000 Strongly recommended • *Activated charcoal • *Antibiotics • Anticonvulsants - benzos • Atropine • Corticosteroids • D5 0.45 NS • *Dextrose 25% • Diphenhydramine • Epi 1:10,000 • Naloxone • *Normal saline or Lactated Ringer’s • Sodium bicarbonate 4.2% #5. Maintain your resuscitation skills • In the setting of a pediatric emergency, primary care pediatric providers must be able to provide basic airway management and initiate treatment of shock • PALS and APLS are two excellent courses to develop and renew knowledge and skills #6. Train your staff with CPR Anytime® CPR Anytime® for children and adults #7. Recognize emergencies early Every person in the office should be trained to recognize a potential emergency • Extremely labored breathing • Blue or pale color • Noisy breathing • Altered mental status • Seizure • Agitation (in the parent) • Vomiting after a head injury • Uncontrolled bleeding #8. Have a plan to call for help • Have a plan for arranging transport – How – Where • The person arranging transport is responsible for the safety of the patient • Call ahead and talk to a doctor #9. Translate research into practice • Always use two person bag mask resuscitation Davidovic et al. Annals Emerg Med. 2005;46:37-42 • Early recognition, resuscitation and reversal of septic shock in children makes a difference – it improves outcome Han YY, Carcillo JA, Dragotta M et al. Pediatrics. 2003;112;793-799 • Therapy for shock should be initiated from the time of diagnosis not transport #10. Teach your patients about emergencies • Encourage first aid training and CPR training for parents and caregivers • Provide access numbers for after-hours advice, emergency response system and poison control • Teach your families about the symptoms and situations where they should seek immediate help Summary • • • • • Perform an office self-assessment Have essential equipment, supplies and meds on hand Refresh and renew your skills Use two person bag mask technique Treat shock early, it improves outcome For questions or comments e-mail me at [email protected]