EMSC Connects

January 2022; Vol.11, Issue 1

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Pedi Points

Tia Dickson, RN, BSN

Primary Children's Hospital

You respond to a motor vehicle crash, multiple cars, multiple victims. Several crews are working the scene. A 6 year-old is handed off to you. The report, including "One dead, mom is critical," is overheard by the child. What do you think that child is thinking?

"Is my dad dead?"

"What does critical mean?"

"That was a lot blood."

"Was that crash my fault?"

"Where's mom and dad?"

One in four children experience a traumatic event by the time they are 18 years old. EMS is often on the scene after these events occur. While ABCs are your priority, your words will impact the child's experience in the moment and what they go through could impact their lives long term. Do you know what to say and do to ease their experience?

Children will process traumatic experiences in many ways and it will be influenced by their age. Understanding child development will guide the ways you can help.

The Littles

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Older children

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Provide information about others in the accident.
  • Some families want to have these conversations together especially those involving a death.
  • Even if you assume the child knows about a death, confirming the hard-to-hear information is best done by someone they know and who will help them feel safe.
Use big or ambiguous words.
  • A child may mentally create a definition of the word that isn't correct.
  • They may assume a big word means something bad or scary.


Be mindful of your report.
  • Who is within earshot?
  • When possible step outside of earshot when reporting new or sensitive information ("Mom died en route" or "sister's leg was amputated").
  • Even unconscious patients will report memories of conversations held in the trauma bay.
It is typically appropriate to discuss the child's condition in from of them.
Assure the child of their physical safety.
  • Remind the child that EMS and those at the hospital are there to help them and keep them safe.
Use Child Life when available to explain information to the child.
Be aware that various cultures may handle traumatic situations and/or death differently.


Know the Signs of Post-traumatic Stress Disorder (PTSD)

One half of the children who survive traumatic events will show signs of PTSD. Every child's symptoms are different. In general, your child may have:

  • Intense fear
  • Feelings of helplessness
  • Feelings of being agitated and disorganized
  • Trouble sleeping
  • Trouble focusing
  • Loss of appetite
  • Changes in their interactions with others, including more aggressive or more withdrawn

Your child may also go back to behaviors they had outgrown:

  • Bedwetting
  • Clinging
  • Sucking their thumb
  • Emotionally-numb, anxious, or depressed
  • Separation anxiety

Your Child Needs Your Support

Let your child know they are safe and you are in control.

  • Recognize your child is taking cues from you on how to react to the traumatic event. It is OK for you to be sad or hurt.
  • Your child needs to know that you are in control and are protecting them.

Let your child know you are there for them.

  • Return to a daily routine as soon as you can. Create a schedule for when to eat, sleep, school, and play. Daily routines help kids know what to expect and make them feel safe.
  • Talk to your child. Let them know what you are doing to keep them safe. Answer their questions in a way they can understand.
  • Stay close to your child. Let them sit near you or hold your hand.
  • Accept and work with your child on regressed behavior.

Monitor information your child is getting about an event. Turn off the TV news and limit your conversations about events in front of young children.

Let teachers know about traumatic events in your child's life. Keep open communication about changes in your child's behavior.

Get Your Child Help

Expect your child will return to their normal routine over time. If your child still has trouble recovering after one month, get professional help. Your child will learn how to:

  • Talk about what happened. They will tell their stories with words, pictures, or play. This helps them see the reaction to the trauma is normal.
  • Develop coping strategies to help with fear and anxiety.

Protocols in Practice

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Pediatric Skills Refresher— PTSD in children: a study summary

The PTSD brains of children & soldiers - BBC News

News from Utah EMSC

The 2022 EMS For Children Survey will go live January–March 2022. It will only take six minutes to complete. Among other questions they will ask . . . Does your agency have a PECC?

The answer is YES!

PECC Planning

PECCs, you will receive an email this month with a link to the EMS for Children's Survey. It's a short assessment of your agency's peds capabilities. Below is a link to help you and your agency better understand the things the survey will assess.


Performance Measure EMSC 02 - Pediatric Emergency Care Coordinator (6/9/2017)

News from National EMSC

Despite the added pressures and obstacles, the pediatric emergency community rallied to make tremendous strides in improvements to care in 2021. A quick highlight of some of EMSC’s work in 2021 includes:

And so much more.

EMSC Newsletter

Looking for follow up or case review on your patients taken to Primary Children's Hospital?

The Latest On Covid-19 and Kids

COVID-19 hospitalization surge among U.S. children spurs new Omicron concerns
Within weeks, the Omicron variant fueled thousands of new COVID-19 hospitalizations among U.S. children, which raises new concerns about how the many unvaccinated Americans younger than age 18 will fare in the new surge.

Read in Reuters: https://apple.news/AXlZQxhYQQmea5Y1sqBtPZA

Caseloads and vaccination rates among Utah's school-aged children


Covid-19 Trackers

Johns Hopkins Global tracker (desktop)

Johns Hopkins Global tracker (mobile)

Utah Department of Health

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.

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.

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

Wednesday, Feb. 9th, 2pm

This is an online event.

Virtual-Zoom Meeting Meeting

ID: 938 0162 7994 Passcode: 561313

Pediatric Education and Trauma Outreach Series (Petos)

Monday, Feb. 14th, 2-4pm

This is an online event.

Utah EMS for Children (EMSC), Primary Children's Hospital (PCH) and Utah Telehealth Network (UTN) have partnered to offer the Pediatric Emergency and Trauma Outreach Series (PETOS) to EMS providers.

This course provides one free CME from the Utah Department of Health Bureau of EMS and Preparedness 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 2nd Monday at 02:00 PM Mountain Time (US and Canada)

Join Zoom Meeting

Meeting ID: 981 9375 7707

Password: EmscPCH

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 and once the quiz is returned, certificates are e-mailed out.

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

30th Annual Issues in Pediatric Care Conference—Save the Date

Thursday, May 19th, 8am to Friday, May 20th, 4pm

This is an online event.

This conference originally planned for October 7th has been postponed to May 2022 due to the current Covid surge.

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.