EMSC Connects

December 2022; Vol.11, Issue 12

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Pedi Points

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.

Expert Input

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)
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So to recap . . .
  • 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.

Everyone starts in the same place—a systematic approach

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What to expect at Primary Children's Hospital

When you call in a report, the charge nurse fills out this form. The yellow items are required to generate the form so that's the bare minimum. More information is always better.
When you arrive to the trauma bay at Primary Children's, you are ushered into a very crowded room. A trauma activation (in response to your called in report) brings all the resources to this room.
We follow a PAR evaluation process which means we do the same steps in the same order for every trauma activation. Note: when in this process our MDs are looking for EMS report.

  • 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.
You can find the PAR poster on the wall in the trauma bay beside bed #1.
The MIST mneumonic is preferred for EMS report throughout the Intermountain system and can be found posted on the wall near trauma bay 1 at Primary Children's.
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You should direct your report to the the provider who is standing at the foot the the bed. This is where the team leader will stand as part of the PAR process. We have another provider (MD or NP) at the bedside doing the hands on assessment, but the team lead oversees everything.

How do you close the loop? Get follow Up

Lynsey Cooper is your contact for basic follow up on all patients brought to the emergency department.

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

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

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Skill refresher—traumatic brain injury

Handtevy Minute: Severe Traumatic Brain Injury (TBI)

Other Resources

Protocols in practice—General trauma management

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Current Events in Pediatrics

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).

Seasonal subjects

Let's Talk About Bronchiolitis

News from Utah EMSC

Confused that EMSC, UPTN, and PPN all seem to be talking pediatrics? These are 3 distinct programs with shared goals. Check us out!
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EMS Surveys

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

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PECC Development

Hospital PECCs

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.

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HRSA HighlightCYSHCN 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.

EMSC monthly office hours

Tuesday, Jan. 3rd 2023 at 9-11am

This is an online event.

EMSC offers monthly, virtual open office hours on the 1st Tuesday of each month. Our team will jump on zoom and go live. Anyone with questions, concerns, ideas, or needs is invited to join and discuss with our team. While this offering is focused on EMS and hospital PECCs, anyone with pediatric concerns or a desire to learn more about EMSC is welcome.

Zoom link

BEMSP is inviting you to a scheduled Zoom meeting.

Join Zoom meeting

Meeting ID: 870 0564 5259

Monthly from 9 a.m. to 10 a.m. on the first Tuesday from Tuesday, November 1 to Tuesday, February 7, 2023 (Mountain Time—Denver)

Virtual quarterly PECC meeting—save the date

Tuesday, Feb. 21st 2023 at 10am-12pm

This is an online event.

You will receive an invitation with the link through email. If you are a PECC and don't receive this invitation contact our program manager, Jared Wright


Kids and COVID-19

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:


Ask our doc

Do you have a question for our EMSC medical director, Sarah Becker, MD, PCH, ER attending physician about this newsletter topic or anything related to pediatrics? Email tdickson@utah.gov.

Pediatric education from Utah EMSC

Pediatric education and trauma outreach series (Petos)

Monday, Dec. 12th, 2-4pm

This is an online event.

Utah EMS for Children (EMSC), Primary Children's Hospital (PCH), and Utah Telehealth Network (UTN) offer the pediatric emergency and trauma outreach series (PETOS) to EMS providers.

This course provides one free CME from the Utah Department of Health and Human Services Office of Emergency Medical Services for EMTs and paramedics. The lectures are presented by physicians and pediatric experts from Primary Children’s Hospital. The format is informal; inviting questions and discussion.

Join us on Zoom each second Monday at 02:00 PM Mountain Time (US and Canada) Click the pic below!

Archived presentations can be viewed and also qualify for CME. Access at https://intermountainhealthcare.org/primary-childrens/classes-events/petos

To obtain a completion certificate

  • For "live" (virtual) participants: To receive a certificate of completion for attendance be sure to include your email address when the host requests it in the chat during the live presentation. Certificates are e-mailed out after verification of attendance and processing.
  • For archived viewing: After viewing archived presentations (link above) e-mail utah.petos@gmail.com with the date and title of presentation viewed. You will receive a three question quiz to verify participation. Once the quiz is returned, certificates are e-mailed out.

We try to have certificates out within a week but will occasionally have delays.

Looking for a PEPP class?

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.

Other pediatric education

University of Utah injury prevention learning series

Tuesday, Dec. 20th, 11:30am-1:30pm

This is an online event.

Register here

To view previous sessions for all our series visit this link

45th Annual current concepts in neonatal and pediatric transport conference

Tuesday, Feb. 21st 2023 at 8am to Friday, Feb. 24th 2023 at 5pm

215 West South Temple

Salt Lake City, UT

Target audience: This conference is designed for advance practice providers, nurses, paramedics, physicians, and respiratory therapists, who have training in the transport of neonatal and pediatric patients to tertiary care centers.

Register Here

EMS Focused Education

University of Utah's EMS Grand Rounds (Offered every 2nd Wednesday of even months)

Wednesday, Dec. 14th, 2pm

This is an online event.

Click here to join

Virtual-Zoom Meeting Meeting

ID: 938 0162 7994 Passcode: 561313

Hospital Focused Education

Primary Children's Pediatric Grand Rounds (offered every Thursday, Sept-May)

Thursday, Dec. 22nd, 8am

This is an online event.

Offering both RN and MD CME

The Pediatric Grand Rounds weekly lecture series covers cutting-edge research and practical clinical applications, for hospital and community-based pediatricians, registered nurses, and other physicians and practitioners who care for children of any age.

The series is held every Thursday, 8 a.m. to 9 a.m. from September through May in the 3rd Floor Auditorium at Primary Children's Hospital. The lectures are also broadcast live to locations throughout Utah and nationwide.

Connect Live

Click here for the PGR PCH YouTube Channel to find the live broadcast. Archives (without continuing education credit) will be posted here within 1 week of the broadcast.

Emergency Medical Services for Children, Utah Bureau of EMS and Preparedness

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.