Feburary 2020; Volume 9, Issue 2
Expert Input - CDC - Vital Signs
Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood. ACEs can include violence, abuse, and growing up in a family with mental health or substance use problems. Toxic stress from ACEs can change brain development and affect how the body responds to stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. However, ACEs can be prevented.
Preventing ACEs can help children and adults thrive and potentially:
- Lower risk for conditions such as depression, asthma, cancer, and diabetes in adulthood.
- Reduce risky behaviors like smoking and heavy drinking.
- Improve education and employment potential.
- Stop ACEs from being passed from one generation to the next.
3 Types of Aces
Pedi Points - Tia Dickson, RN, BSN, Primary Children's Hospital
Why should ACEs matter to EMS providers?
The ACE Study has completely changed the way many pediatricians are treating kids. First responders should also know about the study and this topic is a follow up to our child abuse issue in December 2019. One EMT in NY uses an ACE survey as "emotional first aide" on calls.
"Many of the people I help on EMT calls overdose, attempt suicide, are injured in fights, and suffer from chronic diseases, mostly because of their childhood trauma. Maybe if they knew about their ACEs, it would help them understand their lives, give them hope that they weren’t born bad, that what happened to them when they were kids wasn’t their fault, that they coped appropriately by smoking or drinking or overeating because that’s all that was offered or available to them, and, most important, with help, they could change."
-Peter Chiavetta EMT
The ACE Study measured five types of abuse and neglect: physical, verbal, and sexual abuse; physical and emotional neglect. And five types of family dysfunction: a family member with mental illness, a family member who has been incarcerated, a family member who is abusing alcohol or other drugs; witnessing a mother being abused; losing a parent to divorce or separation. (Of course, there are other types of childhood trauma, and subsequent ACE surveys include other types of trauma.)
The higher a person’s ACE score, the greater the risk for chronic disease and mental illness.
Compared with someone who has an ACE score of zero, a person with an ACE score of four is:
- Twelve times more likely to attempt suicide
- Seven times more likely to become an alcoholic
- Twice as likely to have heart disease.
People with a score of 6 or higher have shorter lifespans – 20 years shorter.
It is important to remember the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences. The study does make the point that ACE scores don't tally the positive experiences in early life that can help build resilience and protect a child from the effects of trauma. Having a grandparent who loves you, a teacher who understands and believes in you, or a trusted friend you can confide in may mitigate the long-term effects of early trauma.
What is my ACE score?
How can I help my family, my community, my patients?
Protocols in Practice - Family Centered Care
Expert Input - Novel Coronavirus, what do you need to know?
Intermountain Healthcare recently updated their employees. EMSC is passing on this information to their partners in the EMS community.
“There’s no reason for immediate alarm, but we’re prepared to support our caregivers and communities should the situation worsen,” says Kristin Dascomb, MD, PhD, Intermountain’s Medical Director of Infection Prevention and Employee Health.
What’s a coronavirus? Coronaviruses are a large family of viruses common throughout the world that can cause respiratory illness in people and animals. Several known coronaviruses that infect people usually only cause mild respiratory disease, such as the common cold. However, at least two previously identified coronaviruses have caused severe illness — severe acute respiratory syndrome (SARS) coronavirus and Middle East respiratory syndrome (MERS) coronavirus. The 2019-nCoV is a new strain of coronavirus not previously identified in humans. The key features of 2019-nCoV are respiratory symptoms with a fever and cough.
How is the coronavirus transmitted? Human coronaviruses are often spread through person-to-person contact. Similar to cold and flu, a person becomes sick through close contact with an infected person. The virus is spread through respiratory droplets produced by an infected person through coughing and sneezing or by touching surfaces with the virus on them.
What are the signs and symptoms of the 2019 novel coronavirus? Symptoms include fever, cough, and shortness of breath and the severity ranges from mild to severe. If you haven’t traveled to China or been in close contact with someone known to have the virus, your risk of contracting coronavirus is very low.
How can I protect myself and our patients from coronaviruses? The best way to protect yourself and patients from contracting coronaviruses is by using the same six daily habits that help prevent the spread of many viruses, including the common cold and the flu:
- Avoid close contact with people who are sick.
- Wash your hands with soap and water frequently. Use soap and warm water for 20 seconds. If soap and water aren’t available, use an alcohol-based hand sanitizer.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Stay home when you’re sick (and keep sick children home from school).
- Cough or sneeze into your upper sleeve or elbow, never your hands. Or cover your cough or sneeze with a tissue, then throw the tissue in the trash and wash your hands.
- Clean and disinfect frequently touched objects and surfaces.
What should I do if a patient arrives with coronavirus symptoms? If you encounter a patient who’s been to China in the past month and they’ve developed a fever, cough, or is having difficulty breathing, please ask them to put on a mask. IDEALLY THESE PATIENTS SHOULD NOT BE TRANSPORTED IN AN AMBULANCE UNLESS THEY ARE CRITICAL. Providers should encourage patients to contact their physician. If transport is warranted be sure to call ahead and give the receiving hospital warning. Follow appropriate Airborne/Contact isolation practices to decrease your risk of exposure. PPE is extremely important.
Dr. Dascomb adds that although 2019-nCoV is a concern, influenza poses a much greater risk in Utah and she encourages everyone to take steps to guard against its spread. Influenza has already sickened at least 13 million Americans this winter — hospitalizing 120,000 and killing 6,600, according to the CDC — and flu season hasn’t peaked yet. In a bad year, the flu can kill up to 61,000 Americans.
Ask Our Doc
From Our Medical Director Hilary Hewes
Help improve your agency and emergency department’s readiness to take care of pediatric patients and participate in a national quality improvement project!
The national EMS for Children program, with the help of the National EMSC Data Analysis Research Center (NEDARC), will be launching two national surveys in 2020.
The 2020 EMS Annual Data Collection started on January 7, 2020. The survey for your state is now open for respondents at emscsurveys.org. This survey asks basic demographic information about each agency including number of staff, level of certification, annual number of calls, number of pediatric calls, as well as critical information about whether your agency has a Pediatric Champion or Pediatric Emergency Care Coordinator (PECC). It will also ask what kind and how often agencies do skills checking on pediatric equipment. Please ensure someone in your agency completes this survey. It is important for us to see how Utah agencies are doing in general and how we compare with similar agencies across the country.
The data collection will run through March 31, 2020.
On June 1, 2020, the National Pediatric Readiness Project will launch the 2020 Assessment. This assessment will be sent to nurse managers and medical directors of all emergency departments across the country to evaluate structural processes and policies in place to be ready for pediatric patients. Those who take the assessment will get immediate feedback with a gap report comparing your score with previous scores (if taken in the past) and comparing you with similar emergency departments across the country. These scores have been linked to outcomes such as mortality from critical illness, and participation in the project is very important for the Utah Department of Health to better understand the state of pediatric preparedness in Utah.
News from National EMSC
Our Juab County Coordinator Jackie Schugk has recently loss her son.
We want them both to know they are in our thoughts! Our Coordinators are at the heart of everything we do at EMSC.
Are you interested in joining our EMSC team?
Pediatric Education and Trauma Outreach Series (Petos)
Monday, March 9th, 2-3pm
475 300 East
Salt Lake City, UT
Pediatric lectures for EMS. Face time with PCH attending physicians. These lectures occur on the 2nd Monday of each month from 2-3 p.m. You may attend in person or watch the webinar. It will qualify for pediatric CME from the Utah Department of Health Bureau of EMS and Preparedness. Access at https://intermountainhealthcare.org/locations/primary-childrens-hospital/classes-events/petos/
RSVPs are enabled for this event.
2020 Zero Fatalities Safety Summit March 31-Apr 2nd
Tuesday, March 31st, 8am to Thursday, April 2nd, 4:30pm
1651 North 700 West
There is a fantastic EMS track at this conference, lots of swag, and registration is open now.
2020 EMSC Coordinators Workshop
Thursday, June 25th, 8am to Saturday, June 27th, 12pm
1731 South Convention Center Drive
St. George, UT
Looking for a PEPP Class?
EMSC Pediatric Education for Prehospital Providers
Register online at peppsite.org. 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 firstname.lastname@example.org 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.