This document provides information about the Utah Emergency Medical Services for Children (EMSC) program and its efforts to develop pediatric protocol guidelines for EMS providers in Utah. It discusses the development of 41 pediatric protocols across various categories (medical, trauma, respiratory, etc.) by a team over 10 months. The protocols are meant to serve as guidelines for pre-hospital care of pediatric patients when online medical direction is unavailable. The document outlines a 4 stage plan to rollout and educate providers on the new offline protocols.
Hello guys, bringing to you the concept of golden hour of neonatology. As in trauma, the first hour of neonatal life is most precious and this ppt is an attempt to highlight a few key aspects of this resuscitative strategy in premature infants.
This gives a brief idea about the:
Techniques, Response To NIV, Clinical indications, Contraindications and Evidence Based Decisions on the use of noninvasive ventilation with neonates
The most challenging scenario you can ever face is resuscitation of pediatric population in your ED, high level of stress is involved, so going systematic will make your work easy. The new PALS guidelines by AHA is quoted d here.
Hello guys, bringing to you the concept of golden hour of neonatology. As in trauma, the first hour of neonatal life is most precious and this ppt is an attempt to highlight a few key aspects of this resuscitative strategy in premature infants.
This gives a brief idea about the:
Techniques, Response To NIV, Clinical indications, Contraindications and Evidence Based Decisions on the use of noninvasive ventilation with neonates
The most challenging scenario you can ever face is resuscitation of pediatric population in your ED, high level of stress is involved, so going systematic will make your work easy. The new PALS guidelines by AHA is quoted d here.
The eumusc.net project was a panEuropean project on musculoskeletal (MSK) health. It developed an atlas of MSK health and tools to vigil it, standards of care for rheumatoid arthritis (RA) and osteoarthritis, quality indicators for RA, and tips for implementing all them.
El proyecto eumusc.net fue un proyecto paneuropeo sobre salud musculoesquelética (ME). Se desarrolló un atlas de y herramientas de vigilancia de la salud ME, estándares de cuidado para la artritis reumatoide (AR) y la artrosis, indicadores de calidad para la AR, y consejos para la implementación de todos ellos.
Safety Event Analysis Teams (SEAT) comprised of believers & opinion builders. The team identified defects from the event reports. Implemented systems changes to reduce the probability of recurring. At least one defect was investigated each month.
The implications of SEAT were, staff came open and reported the incidents. It helped institute a Fair and Just Culture. Investigation examined the processes and not just people. Staff share their experiences with other CUSP units. SEAT helped turn these staff in to champions
Improving quality, safety and lives - the Patient Safety Collaborative Programme 2014-2019
Presentation from Chief Nursing Officer for England's Summit 2014
26 November 2014
Improving acute care for children and young people, pop up uni, 10am, 3 septe...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Dr Michael Sullivan
Associate Professor of Paediatric Oncology, University of Otago; Consultant Paediatric Haematologist/Oncologist in the Children’s Haematology Oncology Centre, Christchurch Hospital
Our vision for using patient insight and feedback in the nhs, 12.00, pop up u...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Competition or Collaboration - 2015 Policy Prescriptions® SymposiumCedric Dark
The symposium is designed for clinicians – physicians, nurses, nurse practitioners, physician assistants, and students – and healthcare executives interested in expanding their scope of knowledge about currently popular health policy topics.
This presentation on developing resources for heart failure was first given by CareSearch Director Jennifer Tieman at the Australasian Cardiovascular Nursing College 5th Annual Conference, 18-19 March 2011.
A talk to the South Australian branch of the Australian Cardiac Rehabilitation Association at their local meeting.
In particular the talk was about the cardiac rehabilitation DVD called 'what's wrong with my heart'.For more information go to www.whatswrongwithmyheart.com,and to read more visit www.dralistairbegg.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. What is EMSC ?
Every state in the USA has an EMSC program.
Federal grant jointly administered by:
• Health Resources and Services Administration’s (HRSA)
• Maternal and Child Health Bureau (MCHB)
• National Highway Traffic Safety Administration (NHTSA)
3. Kristin Lauria Gurley MS, MPH Kris Hansen RN Jolene Whitney MPA
Bureau of EMS Primary Children’s Medical Center Bureau of EMS
EMSC Program Manager Partnership Leadership Partnership Leadership
• Dr. Kathleen Adelgais MPH, EMSC Medical Director
• Gina Holley RN, EMSC Pediatric Clinical Consultant Nurse
• Susan Garcia RN, EMT-IA EMSC Pediatric Preparedness Nurse
• Andy Ostler PM, Lead EMSC Course Coordinator
• Shauna Hatton-Ward, EMSC Family Representative
• Stephen Brooks EMT-I, Assistant Lead EMSC Course Coordinator
• 40 EMSC Coordinators: Teach pediatric education to EMS Providers statewide.
• Jenny Allred, Support Services
Utah Emergency Medical Services
for Children Staff
4. National Performance Measures:
Utah’s Status
Pediatric Representation on EMS Board: Met
Pediatric CME Requirements for BLS & ALS Providers : Met
Hospitals Recognized for Pediatric Emergencies: Met
Advisory Committee: Met
State Funded Full time FTE: Met
Pediatric Transfer Agreement and Guidelines: Met
Pediatric equipment on ambulances: In Process
Integrated into EMS statutes and regulations: In Process
On-line & Off-line Medical Direction: In Process
5. 5
Performance Measures Progress:
Pediatric On-Line Medical Direction
Performance Measures Progress:
Pediatric On-Line Medical Direction
Utah is one of only 3 states in the country that did not
meet the ALS 2007 goal for this measure
6. 6
Performance Measures Progress:
Pediatric On-Line Medical Direction
Performance Measures Progress:
Pediatric On-Line Medical Direction
• 53% of BLS services feel they have on-line
pediatric medical direction at the scene of an
emergency
• 36% of ALS services feel they have on-line
pediatric medical direction at the scene of an
emergency
7. 7
Performance Measures Progress:
Pediatric On-Line Medical Direction
Performance Measures Progress:
Pediatric On-Line Medical Direction
2011 Goal
90% of EMS agencies will have on-line
pediatric medical direction at the scene of an
emergency for ALS and BLS providers.
8. 8
“I don’t think they (ED staff) have an idea of what we can do in the field.
When I call them for a chest pain and ask for things they flat out refuse
me. They won’t actually let us do what we are capable of doing and treat
the patient.”
“We just don’t go to a house and here
is the problem right away- we have to
figure out their problem- sometimes we
have to get them out of the mud onto a
backboard. They don’t understand the
pre pre medical care…There is a lot of
stuff we have to do before we can even
serve our patients.”
9. 9
EMS & ED Integration PlanEMS & ED Integration Plan
• Disseminate test, training, and booklet to every ED in the
state
• Educate EMS Agencies about resources and training
being provided to the ED
• Educate ED staff providing on-line medical direction on
the EMSC off-line pediatric protocols: Protocol of the
week webcasts
• EMSC Pediatric RN will establish contacts with every ED
in the state to serve as pediatric quality improvement
liaison
10. • 42% of BLS services report they have off-line
medical direction at the scene of an emergency
• 67% of ALS services report they have off-line
medical direction at the scene of an emergency
Performance Measures Progress:
Pediatric Off-Line Medical Direction
Performance Measures Progress:
Pediatric Off-Line Medical Direction
11. Performance Measures Progress:
Pediatric Off-Line Medical Direction
Performance Measures Progress:
Pediatric Off-Line Medical Direction
2011 Goal
90% of EMS agencies will have off-line
pediatric medical direction at the scene of an
emergency for ALS and BLS providers.
12. EMSC Off-line
Pediatric Protocol Guidelines
EMSC Advisory Committee Recommendation
EMS Providers (EMS & ED Integration Project):
“Protocol driven is quality assurance, quality
improvement system.”
“With having a protocol you don’t have that
connection (to on-line). If you have the protocol
you can treat it instead of having to wait.”
EMSC National Performance Measure / Grant requirement
13. Protocol DevelopmentProtocol Development
• Process initiated in November 2007
- Reviewed examples of EMS protocols
• National Association of EMS Physicians (NAEMSP)
• Kentucky
• Maryland
• Washington DC
- Discussed groupings of routine protocols and
addition of innovative protocols
• List of protocols generated
• Process initiated in November 2007
- Reviewed examples of EMS protocols
• National Association of EMS Physicians (NAEMSP)
• Kentucky
• Maryland
• Washington DC
- Discussed groupings of routine protocols and
addition of innovative protocols
• List of protocols generated
14. •Jan 2008: Presented to EMSC Advisory
Committee
•Team of pediatric physicians, pediatric nurses,
EMS providers recruited to develop protocols
•Resources:
- Examples from other states
- EMS Scope of Practice booklet
•Feb 2008-Nov 2008: Biweekly meetings to develop
protocols
•Jan 2008: Presented to EMSC Advisory
Committee
•Team of pediatric physicians, pediatric nurses,
EMS providers recruited to develop protocols
•Resources:
- Examples from other states
- EMS Scope of Practice booklet
•Feb 2008-Nov 2008: Biweekly meetings to develop
protocols
Protocol DevelopmentProtocol Development
16. Guidelines on Protocol
Development
Guidelines on Protocol
Development
• KISS principle
• Utah EMS provider scope of practice
• Keep in accordance with NAEMSP Model Pediatric
Protocols
• Be evidence-based (when possible)
• Be innovative
- Use of nebulized epinephrine
- Use of intranasal medications
• KISS principle
• Utah EMS provider scope of practice
• Keep in accordance with NAEMSP Model Pediatric
Protocols
• Be evidence-based (when possible)
• Be innovative
- Use of nebulized epinephrine
- Use of intranasal medications
17. 17
Summary of ProtocolsSummary of Protocols
7 major categories
Medical (10)
Trauma (6)
Children with Special Health Care Needs (5)
Special Care (8)
Respiratory (4)
Cardiac (4)
Preparedness protocols (4)
7 major categories
Medical (10)
Trauma (6)
Children with Special Health Care Needs (5)
Special Care (8)
Respiratory (4)
Cardiac (4)
Preparedness protocols (4)
19. Pain TreatmentPain Treatment
•Pain is common and often under-treated
- In Utah, 6% of pediatric patients receive pain
medications
•Barriers include lack of pain assessment tools, lack
of offline medical direction, need for IV placement
•Guideline is meant to be flexible based on the
resources available to the agency
- Intranasal, intravenous,
- intramuscular,
- doses possible
•Pain is common and often under-treated
- In Utah, 6% of pediatric patients receive pain
medications
•Barriers include lack of pain assessment tools, lack
of offline medical direction, need for IV placement
•Guideline is meant to be flexible based on the
resources available to the agency
- Intranasal, intravenous,
- intramuscular,
- doses possible
20. Apparent Life-Threatening EventApparent Life-Threatening Event
• ALTE specific to children
• Common reason for EMS calls (up to 10%)
- Idea of ALTE is new to most EMS providers
- Cause of ALTE is varied (abuse, seizures,
respiratory disorders, gastroesophageal reflux)
- Presentation can be vague
- Identified as an area for education and
improvement within our EMS
- system
• ALTE specific to children
• Common reason for EMS calls (up to 10%)
- Idea of ALTE is new to most EMS providers
- Cause of ALTE is varied (abuse, seizures,
respiratory disorders, gastroesophageal reflux)
- Presentation can be vague
- Identified as an area for education and
improvement within our EMS
- system
21. Non-Traumatic Shock
and Sepsis
Non-Traumatic Shock
and Sepsis
• PCMC has initiated a hospital-wide program to
improve recognition and treatment
• Protocol developed with similar guidelines in place
- Vital sign criteria for shock and sepsis based on
national standards
- Rapid initiation of IV/IO and fluid administration
• Goal: To improve recognition and
treatment of hypotension from
sepsis in pre-hospital setting
• PCMC has initiated a hospital-wide program to
improve recognition and treatment
• Protocol developed with similar guidelines in place
- Vital sign criteria for shock and sepsis based on
national standards
- Rapid initiation of IV/IO and fluid administration
• Goal: To improve recognition and
treatment of hypotension from
sepsis in pre-hospital setting
22. TraumaTrauma
• Blunt Trauma
• Burn
• Penetrating Trauma
• Spinal Immobilization
• Submersion Victim
• Moderate to Severe Closed Head Injury
(TBI)
• Blunt Trauma
• Burn
• Penetrating Trauma
• Spinal Immobilization
• Submersion Victim
• Moderate to Severe Closed Head Injury
(TBI)
23. Traumatic Brain Injury (TBI)Traumatic Brain Injury (TBI)
• Leading cause of morbidity and mortality
among pediatric trauma patients
• Pre-hospital care significantly
impacts outcome of patients
with TBI
• Utah TBI guidelines are
evidence-based
• Leading cause of morbidity and mortality
among pediatric trauma patients
• Pre-hospital care significantly
impacts outcome of patients
with TBI
• Utah TBI guidelines are
evidence-based
24. Traumatic Brain Injury (TBI)Traumatic Brain Injury (TBI)
• Goal: To improve recognition and treatment of
hypotention and hypoxia in these patients
• Research
- Identify barriers to following the
protocol
- Evaluate impact of protocol
on TBI outcomes
• Goal: To improve recognition and treatment of
hypotention and hypoxia in these patients
• Research
- Identify barriers to following the
protocol
- Evaluate impact of protocol
on TBI outcomes
25. CSHCNCSHCN
• Child With Special Health Care Needs
General Assessment
• Feeding Tube
• Internal Pacemaker and Defibrillator
• Tracheostomy
• Ventilator/BIPAP
• Child With Special Health Care Needs
General Assessment
• Feeding Tube
• Internal Pacemaker and Defibrillator
• Tracheostomy
• Ventilator/BIPAP
26. 26
Respiratory and CardiacRespiratory and Cardiac
• Anaphylaxis
• Bronchospasm
• Respiratory Failure
& Impending Failure
• Upper Airway
Obstruction
• Anaphylaxis
• Bronchospasm
• Respiratory Failure
& Impending Failure
• Upper Airway
Obstruction
• Asystole & PEA
• Bradycardia
• Tachyarrythmia
with Pulse
• VF and Pulseless
VT
• Asystole & PEA
• Bradycardia
• Tachyarrythmia
with Pulse
• VF and Pulseless
VT
27. Special Care ProtocolsSpecial Care Protocols
• Assessment and Transport of the Neonate
• Behavioral Emergencies
• Do Not Resuscitate
• Family Centered Care
• Immunocompromised Children
• Non-Accidental Trauma
• Safe Infants Act
• Sudden Infant Death Syndrome (SIDS)
• Assessment and Transport of the Neonate
• Behavioral Emergencies
• Do Not Resuscitate
• Family Centered Care
• Immunocompromised Children
• Non-Accidental Trauma
• Safe Infants Act
• Sudden Infant Death Syndrome (SIDS)
28. Preparedness ProtocolsPreparedness Protocols
• Developed by Susan Garcia, RN EMT-IA
- Mass Casualty Incident
- Nerve Agents
- Radioactive Agents
- Vesicants Chemical Exposure
• Will be essential in guiding the Utah Pediatric
Strike Team
• First pediatric-specific statewide guidelines for
these areas ever developed
• Developed by Susan Garcia, RN EMT-IA
- Mass Casualty Incident
- Nerve Agents
- Radioactive Agents
- Vesicants Chemical Exposure
• Will be essential in guiding the Utah Pediatric
Strike Team
• First pediatric-specific statewide guidelines for
these areas ever developed
29. 29
IconsIcons
• Several icons created to visually remind
providers key points
• Several icons created to visually remind
providers key points
30. 30
- Ask additional questions
- Obtain blood pressure
- Contact Medical Control
- Provide detailed documentation
31. 31
- Be mindful of Family Centered Care
- Give medications
- Follow Biohazard protocols
- Wear protective gloves and mask
32. 32
- Arrange for rotor or fixed wing transport
- Provide warming measures
- Contact Poison Control
- Provide medications via nebulizer
34. 34
EMS Medical DirectorsEMS Medical Directors
• Designed to assist agency Medical Directors
with medic training and protocol development
• Will be updated by EMSC regularly and
updates distributed out to agency Medical
Directors
• Designed to assist agency Medical Directors
with medic training and protocol development
• Will be updated by EMSC regularly and
updates distributed out to agency Medical
Directors
35. 35
EMS Medical DirectorsEMS Medical Directors
• Protocols are Guidelines, not requirements
• They may be utilized as is, or modified to
meet a specific agencies needs
• Protocols are Guidelines, not requirements
• They may be utilized as is, or modified to
meet a specific agencies needs
36. 36
EMS Medical DirectorsEMS Medical Directors
• Feedback welcome!
• Please let EMSC know how these guidelines
work for your agency or how they can be
improved
• Feedback welcome!
• Please let EMSC know how these guidelines
work for your agency or how they can be
improved
37. 37
Off-Line Protocols Rollout
Stage 1: Gain support from EMS Committee, EMS
Agency Medical Directors, and ED Directors.
Distribute EMS scope of practice booklets to EDs
statewide. (January / February)
Stage 2: Post final protocols on EMSC website for
download. Protocols are final and should be used.
Print and distribute protocols to EMS agencies and
EDs. Provide EMS agency recognition for protocol
support. (March / April)
38. 38
Off-Line Protocols Rollout
Stage 3: Educate protocol users on science behind
each protocol using Protocol of the Week Web
broadcasts. Audience EMS providers and ED staff
providing on-line medical direction. (July).
Stage 4: Educate EMS providers on protocols
using case studies. EMSC Coordinators conduct
case study sessions statewide (September)