Data from the AHA and the Pediatric Advanced Life Support (PALS) guidelines consistently report neurologic intact survival from pediatric cardiac arrest to be 3% for infants and 10% for children. This pediatric survival data has remained unchanged for decades without a clear vision or path to improved survival statistics. Change is needed and we recommend focusing on the following three pillars in order to achieve success in pediatric cardiac arrest.
Are there things you do every day because it’s how you’ve always done them? Author Seth Godin beautifully illustrates this point in a podcast where he describes why some changes take decades to become widespread. He starts with a story dating back to 1847 when a Hungarian physician named Ignaz Semmelweis proposed the practice of hand washing when delivering babies in the clinic. The amazing part of this story is that it took more than 20 years for the scientific community to prove this theory to be correct and for other doctors to accept it as standard practice.
A 2-year-old boy has been pulled out of the pool limp and lifeless after a 6-minute submersion. 911 is called and EMS professionals are 7 minutes away. They hear the tones go off at the station and are dispatched to a “2-year-old in cardiac arrest.”
It’s an exciting time in medicine, specifically pre-hospital care and resuscitative care. As we patiently await the release of the AHA 2015 guidelines, many EMS thought leaders will have already implemented practices and protocols that will differ from AHA recommendations.
Ketamine is being used successfully to treat pain in children and adults yet there are some important things to know before using this drug clinically. Dr. Antevy discusses the best options for Ketamine administration when being used for pain in the ED or the field.
In this Handtevy Minute with Dr. Peter Antevy watch how to use Epinephrine 1:1,000 (1 mg/mL) for both Croup and Asthma.
We are in the thick of summer, which means families everywhere are no doubt soaking up the sun and relishing time in the water. Kids are in the pool, sometimes up until dinner, coming out with prune-like features and giant smiles.
We talk about CPR a lot. In the field, at conferences, with industry peers and even on social media. If you follow our social media accounts (and we hope you do, cough cough), you will often see stories about the benefits of CPR. One of the biggest topics we call out, is the importance of CPR administered in pre-hospital situations, since it greatly impacts the chances of a more positive outcome.
The 3-way stop cock should be in every emergency provider’s toolbox. This valuable device has many uses when providing care to critical pediatric patients. Let us know how you use a 3-way in your day to day practice.
Denver Health is hosting the 43rd annual Rocky Mountain Trauma and Emergency Medicine Conference and I am honored to be delivering the opening keynote on June 16th focusing on Pediatric Resuscitation Psychology. It turns out that the behavioral economics of pediatric resuscitation and the quality of the team skills are more important than any one particular individual involved in the resuscitation (doctors I’m looking at you).
Eight years ago, in a gated South Florida community on a summer afternoon, Jonathan Robbins found himself racing to his first serious pediatric call. He and his crew knew they were responding to an unresponsive 2-year-old drowning victim. This was Robbins’ first month on duty as a paramedic; he’d recently completed paramedic school and the required probationary period at the Coral Springs Fire Department. His adrenaline was surging as he mentally prepared for what was to come.
Sudden cardiac arrest (SCA) has garnered significant attention lately. And for good reason – according to SuddenCardiacArrest.org, it’s a leading cause of death in the U.S., claiming nearly 300,000 deaths each year. Yet, in Michigan high schools there is a major disparity regarding Automated External Defibrillators (AEDs), which can be the difference between life and death in SCA scenarios.
It is well known that adenosine is rarely given in the field, especially to pediatric patients. The reason why has to do with not only the dosing (calculations) but also the logistics of administration. In this short video, Dr. Peter Antevy shows an easy way to rapidly administer Adenosine using a 3-way stopcock.
Watch how to make Epinephrine 1:100,000 (0.01 mg/mL) for severe anaphylaxis. Your patient will have received 3 doses of Epi 1:1,000 IM yet clinically is still deteriorating. Your next move is to start an Epi infusion yet this may take time. Here’s the “poor man’s epi drip” which can be done in just a few seconds.
I’ll admit that I am one of those people whose mind is always working. My wheels are constantly spinning. The content in those wheels fluctuates between my family, work, new ideas, etc. So last week as I was en route to the NAEMSP national conference in San Diego and the plane reached the 30,000 foot cruising altitude, there I was…left with my thoughts, Wifi…and two active infants in the row in front of me (thank you Southwest Airlines!)
The New Year is the time for resolutions, so let’s resolve to improve pediatric arrest outcomes in 2016! Check out the latest Handtevy Minute with three actionable steps to make this a reality!
Therapeutic Hypothermia has been a hot topic for both adult and pediatrics, but there is something about the pediatric guidelines that we should look deeper into.
Learn how to dose Epinephrine 1:10,000 and Amiodarone for Pediatric Arrest during this installment of the Handtevy Minute.
Epi 1:1,000 can be used differently yet if used incorrectly it can be harmful.
Pre-hospital pain control is moving at a rapid pace; it’s time to buckle up for an interesting ride. While Morphine is being laid to rest by many EMS agencies due to its side effect profile, time to peak effect and the inability to be administered intranasally, other medications are moving to the forefront of care.
If you are an EMS provider and want to ruffle some feathers simply tell your local easy going pediatric specialist “kids are just little adults,” and then sit back and watch them boil up with anger. For years I was that guy. Having trained at 2 large academic children’s hospitals it was ingrained in me that kids are kids, and absolutely NOT just little adults.
Pediatric Emergency Standards Inc. does not make clinical or medical decisions. The Handtevy System is intended to be utilized as a guide only. Provider's experience and training should be the final determinant of clinical treatment decisions.
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