EMSC Connects
July 2021; Vol.10, Issue 7
Pedi Points
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.
Your agency is not truly peds ready until they have a PECC
What is a PECC?
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 . . .
We have 65 designated EMS agency PECCs in Utah
One PECC can represent multiple agencies
Does your agency have a PECC? We are still looking for PECCs to represent EVERY agency in Utah.
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.
What's a peds readiness discussion without a look at disaster?
The Doc Spot
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.
Protocols in Practice—Pediatric Assessment
Pediatric Skills Refresher - Using the Pediatric Assessment Triangle
News from Utah EMSC
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)
The Latest on Covid-19 and kids
The 2021 National Pediatric Readiness Project for hospitals closes July 31st
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/
Ask Our Doc
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.
Have you met the PCH EMS Liaison?
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.
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 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.
Emergency Medical Services for Children, Utah Bureau of EMS and Preparedness
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.
