Mike’s Training Moment
I offer greetings to all EMS providers in the great State
of
Pediatrics can be a challenge. As a father of two boys and one girl, who has actively participated in raising them from infancy, I do not look forward to dealing with children when they get injured. Whenever any of my children have been injured, I do not call 911 for the ambulance, but usually call their mother at work. She gives me the standard answer, “Why are you calling me, you are the EMT.” So last time I hung up the phone and called our doctor’s office. I have had to learn the hard way how to stop bleeding, apply bandages, stop the crying, get ice, and still clean up the house afterward.
The only way to become comfortable with children is to spend time with them. I must admit I would not touch a baby until my wife and I had ours. After that, I realized that children will not break when they are picked up. If you do not have children of your own, spend some time working with Cub Scouts, the church, or volunteer at the local school. The schools are always looking for someone to read to the little kids. Interacting with children will quickly show that they are very different from adults. (Please note that you may have to take a training course under FERPA, the Family Educational Rights and Privacy Act, if you want to volunteer at a school. The Boy Scouts of America requires a class called Youth Protection, which can be taken online, prior to working with scouts.)
All training exercises need to be practical, realistic and interesting, and this includes pediatric training exercises. Check with your squad members to see which ones have children who would be willing to participate. My children like riding in the fire trucks, so we have a trade off: if they let me practice on them, I let them ride in the fire trucks. Over the years, I have practiced blood pressures and pulse checks on my kids. My oldest son has a heart murmur that can be heard across the room. Lung sounds can be interesting when the kids have colds. I am not as good as their mother, but I can generally tell when children are sick by looking at their eyes. Also the fact that they stop running around and want to sit with mom is another indication.
Here is a potential outline and some other ideas you can use when trying to teach pediatrics to your rescue squad:
1) Review the American Heart Association age guidelines for infants and children.
2) Review CPR standards for infants and children.
3) Review appropriate vital signs for children of different ages.
4) Review Maine EMS protocols for infants and children.
a) This is the pink section.
b) Review ALS protocols if you have EMT-Is and EMT-Ps.
5) Review some of the issues facing children today. These issues can be researched by looking online. Below are a few ideas:
a) ADD
b) ADHD
c) Autism
d) Cerebral Palsy
e) Epilepsy
f) Emotional, physical, and sexual abuse
i) Review Maine EMS policy, including when to call the Department of Health and Human Services (pages 12 and 13 in the grey section of the protocol book).
6) Know the location of the pediatric equipment.
a) This is where I have the most difficulty.
b) Know how to use all the pediatric equipment you have.
7) Check to make sure your equipment is in good working order.
a) We do not use it enough.
b) It gets outdated.
c) It gets abused bouncing around the truck.
8) For one class you might ask a school nurse, a nurse who teaches children, or one who works on the pediatric floor at the local hospital to come speak to your ambulance or rescue service.
a) They know more than I ever will.
b) They deal with children on a daily basis.
c) And if they have a sense of humor, you are golden.
9) For another class you might invite a guidance counselor or a person who works with troubled children to come speak to the group. In my scout troop I have a child who reacts to loud noises, and he will shy away from the noise. Raising my voice is detrimental to our conversation. I have learned how to communicate with him over the past several years. A guidance counselor might be able to provide insight into dealing with children with problems like this.
10) A complete review of obstetrics and delivering children would be a good evening review.
a) This would be a good field trip to the local hospital.
b) Nurses and doctors may be willing to teach this for you.
i) How about a midwife???
11) Check
with the
a) Please note: I prefer to use our own equipment.
12) This is a good chance to look at next year’s budget and start purchasing more up to date pediatric supplies. There are different car seats, back boards and other gadgets you can use. Speak to sales representatives at conferences to get ideas, or look in medical supply catalogues.
13) Label your equipment so you can easily tell the difference between adult and pediatric supplies.
a) I find that plastic sandwich bags with construction paper in them make it easier to tell pediatric from adult equipment. This works really well on oxygen masks: blue paper for children, pink paper for infants.
14) A school size backpack makes an inexpensive pediatric trauma bag.
An example of a practical station would be to extricate a child from the back seat of a car. Place a collar on the child, and remove him or her to a backboard. Complete an assessment. Take a complete set of vital signs. Move the child to the ambulance. Remember to talk to the child and the parents so they both know what is going on. Don’t forget about the parents or siblings, especially if they are in the automobile.
Lastly, I would like to mention a former ambulance member in my town, Elaine Hill. Elaine likes to make quilts. She makes them yearly so that if we have a pediatric ambulance call, we can leave a quilt with the patient. I find that sometimes these work better than stuffed animals. If you have a member who likes to sew, this can be a neat advertising tool for the squad, too.
If you have stuffed animals, make sure they are in a sealed bag so they stay clean. If your stuffed animals are in a compartment and they get covered with dust and you give them to a child with asthma, you may cause further issues. Also what germs are you giving to the child? Seal the stuffed animals in large plastic bags or use freezer-type sealable bags.
And remember that every child you treat is a future potential squad member.
Until next time, THANK YOU for the people you train and the lives that are saved as a result.
© 2009 by Jacqueline B. Vaniotis