Rethinking Pediatrics [JEMS]

Cynthia Kincaid — If you met Peter Antevy, MD, at a party and asked him what he did for a living, chances are he would say, “I’m a pediatric emergency room doctor.” This answer is the equivalent of calling the Grand Canyon a “deep crater” or Niagara Falls a “waterfall.”

Board certified in pediatric emergency medicine, and medical director for multiple EMS agencies, two paramedic schools and a private ambulance company, Antevy has spent much of his professional life working for innovation and change in pediatric healthcare. He’s worked as a pediatric emergency physician at the Joe DiMaggio Children’s Hospital in Hollywood, Fla., since 2005, following six years of training at two top children’s hospitals, but still felt unprepared for his first resuscitation as a new attending physician.

“I felt inadequate because what we had been taught about resuscitation in my residency and fellowship didn’t work,” he said. Antevy, and others in the ED, struggled with how to administer the correct dosages of medication for children. The more resuscitations he performed, the more stressed he became. “Every resuscitation that came was worse for me,” he said.

He forged ahead, trying to calculate the correct dosage of epinephrine or dextrose for children in the midst of a medical crisis. One morning, Antevy sat down with eight common drugs in mind and created a spreadsheet. He calculated those doses for children and listed them as volumes.

“I figured out a system that was age-based and easily understandable to my brain,” he said. After he recognized the pattern of those drug calculations and could easily recall them under duress, he felt present and confident at every resuscitation.

For years Antevy used his system, never telling anyone what he was doing, until a pediatric nurse asked him one day after a resuscitation how he did it. How did he know all the drug dosages by heart?

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