Pedi-U

Love Shouldn’t Hurt: Pediatric Non-Accidental Trauma, Episode 18

Podcast: Play in new window | Download (Duration: 1:03:24 — 45.4MB)

What is child abuse? What picture comes to mind? Is it the same as to what your co-worker pictured? Now picture the abuser and again ask your co-worker. Are they the same? What about neglect and should these people go to jail?

Join Dr. Lou Romig, Kyle David Bates, Julie Bacon as they discuss not only typical injuries and those conditions that mimc abuse, but dispel the common picture that is associated with typical abuser, and discuss reasons beyond criminal prosecution why child abuse and neglect should always be reported.

AAP report on Abusive Head Trauma

LEARNING OBJECTIVES

At the completion of the podcast, the listener will be able to:

1. Define “Non-Accidental Trauma”;
2. Identify a child who may have been or is currently being abused;
3. Discuss the profile of an abuser;
4. Discuss the purpose of reporting child abuse and neglect.

Tags: abuse, ambulance, assessment, child, concussion, crime scene, EMS, EMT, head injury, injury prevention, kids, legal, neglect, non-accidental trauma, Paramedic, pediatric, TBI, trauma
Category Abuse and Neglect, Assessment, Psychological, Trauma |

The Cost of Education, Episode 17

Podcast: Play in new window | Download (Duration: 1:05:59 — 49.2MB)

Recently, the NAEMT EPC Course was offered at EMS Today 2012 in Baltimore, Maryland. Afterwords I sat down with the faculty to discuss EMS and pediatric education.

Join Kyle David Bates, Chad McIntyre, Dave Aber, and Chris Cebollero as they discuss the financial costs of education, methods of delivery, whether EMS providers have the knowledge to care for pediatric patients, and instructor professionalism. 

Tags: ambulance, child, education, EMS, EMT, Paramedic, pediatric, pediatrics, philosophy
Category Education |

Children with Special Healthcare Needs: Special in Other Ways, Episode 16

Podcast: Play in new window | Download (Duration: 1:02:16 — 45.8MB)

This episode we continue our discussion on Children with Special Healthcare Needs from episode 15.

Join Dr. Patricia Cantwell, Linda Bell, Kyle David Bates, and Dr. Lou Romig as they explore patient assessment, caregiver interaction, and specialty equipment in patients of this special population.

Learning Objectives

At the completion of the podcast, the listener will be able to:

1. Discuss the differences in assessment of the CSHCN
2. Identify the importance of the caregiver;
3. Communicate effectively with the caregiver;
4. Describe common equipment that they may encounter.
5. Identify common problems they may encounter with equipment.

Tags: ambulance, assessment, child, Children with Special Healthcare Needs, CSHCN, EMS, EMT, Family centered care, kids, Paramedic, pediatric
Category Assessment, Children with Special Healthcare Needs, Communication, Management |

To AIR is Human: Assessing and Managing Tracheostomies, Episode 15

Podcast: Play in new window | Download (Duration: 1:11:18 — 52.6MB)

You receive a call for a 2-year-old girl with difficulty breathing. No problem, right? Upon your arrival you find that the 2-year-old girl has a tracheostomy and is on a ventilator. She appears listless and has retractions as well as a dusky appearance. Would you know what to do?

Join Kyle David Bates, Dr. Cantwell, and Dr. Romig as they walk through this case, discussing the assessment and management of a special healthcare needs child who has a tracheostomy.

Objectives

At the conclusion of the podcast, the listener will be able to:

1. Identify the different types of tracheostomy tubes;
2. Identify patients that may have a tracheostomy;
3. Assess and manage a child with a tracheostomy having dyspnea and on a ventilator;
4. Discuss transport considerations of a child with special healthcare needs. 

Tags: ambulance, assessment, child, EMS, EMT, Family centered care, kids, lower airway, Paramedic, pediatric, pulmonary, respiratory, Tracheostomy, upper airway, wheezing
Category Assessment, Children with Special Healthcare Needs, Respiratory |

Death of a Child Part III: Notification

Podcast: Play in new window | Download (Duration: 1:14:49 — 54.7MB)

In the third and final installment of Death of a Child we discuss how our focus of care shifts from the child to the family.

Join Dr. Patricia Cantwell, Scott Kier, Daniel McGuire, and Kyle David Bates as they discuss how to approach the family, possible reactions that you may encounter, and the concept of “Leave no Trace” when dealing with an out-of-hospital death of a child.

Learning Objectives

At the completion of the podcast, the learner will be able to:

1. Perform a self-check regarding how they feel about death.
2. Discuss death notification techniques.
3. Discuss possible reactions by the survivors.

References

Under Standing Grief and Mourning

Grief and Loss

ATSM grieving

CISM Death Notify card

A special thank you goes to Dan for these references. If you have more questions about death notification or CISM please contact Dan.

Tags: ambulance, assessment, cardiac, child, crime scene, death, dying, EMS, EMT, ethics, Family centered care, field resuscitation, field termination, kids, legal, Paramedic, pediatric, philosophy, SIDS
Category Assessment, Death and Dying, Family Centered, Management, Psychological |

Death of a Child, Part II: Calling the Code

Podcast: Play in new window | Download (Duration: 1:06:17 — 43.6MB)

Last episode we talked about the philosophical, ethical, and emotional components that play a part when a child dies. This week we discuss medical futility.

We address the question of when it is appropriate to say “NO” or “STOP” in regards to a pediatric cardiac arrest. We also discuss if EMS should even be considering this in the first place.

Join Dr. Laurie Romig, Dr. BJ Coopes, Dr. Patricia Cantwell, Wilma Vinton, and Kyle David Bates as they once again delve into part II of this 3-part series.

Learning Objectives

The listener will be able to:

1. Identify circumstances when resuscitation may be futile in the pediatric patient.
2. Discuss pros and cons of in-field termination.

Tags: ambulance, assessment, cardiac, child, crime scene, death, dying, EMS, EMT, field resuscitation, field termination, kids, legal, Paramedic, pediatric, police, SIDS
Category Assessment, Death and Dying, Management |

Death of a Child, Part I: Is it About Emotions? Episode 12

Podcast: Play in new window | Download (Duration: 1:18:12 — 49.6MB)

Adults die. Children die. People do die and we may be the ones that determine death, viability, and ultimately be the final ones present as they complete their journey.

Nowhere does this concept seem to be more troublesome as when death comes to a child. Decisions are often based upon emotions, religion, personal philosophy and beliefs while putting aside medically sound judgement. Why is this?

Join Dr. Lou Romig, Dr. Laurie Romig, Scott Kier, Daniel McGuire, Dr. Todd Bindig, and Kyle David Bates as they only start to dissect this complicated topic in part 1 of 3 in the series entitled Death of a Child.

Join us over on our Facebook page to discuss this topic in-depth. 

You can download Dan MacGuire’s Death Notification Card for your PERSONAL USE only as it is copyrighted and may not be distributed. If you would like more copies, or information on CISM you can contact Dan through his website. 

Learning Objectives

At the completion of the podcast the listener will be able to:

1. Discuss how medical, legal, ethical, and emotional issues play a role in decision making when a child dies;
2. Discuss how and why people may view the death of a child differently.

References

Tags: ambulance, assessment, cardiac, child, death, dying, EMS, EMT, ethics, field resuscitation, field termination, kids, legal, Paramedic, pediatrics, philosophy, SIDS
Category Assessment, Death and Dying, Psychological |

Pediatric Chest Pain: Not Your Father’s Chest Pain – Episode 11

Podcast: Play in new window | Download (Duration: 1:18:32 — 58.6MB)

Kids having chest pain? Really?! Should we be breaking out the aspirin, nitroglycerin, and 12-leads? Well that depends upon what the cause of that chest pain is.

As a great compliment to our syncope episode, pediatric chest pain is an infrequent complaint that may be the result of any number of things from trauma, to infection, to cardiac-related causes.  Join Russell Stine, Arnold Facklam, and Kyle David Bates as they talk to Dr. Lou Romig about this perplexing complaint that kids may actually present with.

**I  apologize about the audio quality. We had some issues with the microphones and technology but found it still to be a fascinating episode!

Pediatric Chest Pain outline

The Listener will be able to:

1. Identify and discuss the various etiologies of pediatric chest pain.
2. Obtain and interpret pertinent history of a pediatric patient having chest pain.
3. Perform and interpret an assessment of a pediatric patient having chest pain.
4. Discuss appropriate treatment of a pediatric patient having chest pain.

References
A pediatric chest pain slide presentation

Chest Pain in Children and Adolescents

From Dr. Lou:

Here’s a brand new article (Management of Pediatric Chest Pain Using a Standardized Assessment and Management Plan, Pediatrics, Vol 128, No 2, Aug 2011) that looked at 406 children from 7-21 yrs of age presenting during 2009 for  outpatient evaluation for pediatric chest pain at Children’s Hospital Boston. Of the 406 pts, only 5 had a cardiac etiology – 2 had pericarditis, 2 had SVT and 1 had nonsustained episodes of V-tach (? etiology). The pericarditis patients had abnormal EKGs and classic complaints and physical findings. All arrhythmia patients complained of palpitations as well as chest pain. 8 patients were found to have previously undiagnosed incidental cardiac diagnoses not related to the chest pain (1 WPW pt and 7 structural cardiac abnormalities). 99% of the patients referred for cardiology evaluation for chest pain were determined to have noncardiac sources for their pain. Keep in mind that this is 99% of the children referred to a specialist for their chest pain. There are undoubtedly many more who were not referred. This reinforces two of the main points in our chest pain session: 1) the overwhelming majority of kids with chest pain are not having an acute cardiac event and 2) the small number of patients that are having a cardiac event have positive histories, physical exams and/or EKG

There’s also a concise review article on causes of pediatric sudden cardiac death (Recognize the Warning Signs of Sudden Pediatric Cardiac Death, R. Slaven, BS, NREMTP) in the August 2011 issue of JEMS. The article’s title is just a touch misleading because it’s not assessment-based but the review of some of the causes of sudden cardiac death in children and young adults should peak your curiosity and give you a place to start if you’re interesting in further researching the topic.

Tags: ALTE, ambulance, Apparent Life-Threatening Event, assessment, cardiac, chest pain, child, dysrhythmia, EMS, EMT, fever, infection, kids, medication administration, pain management, Paramedic, pediatrics, Prolonged QT syndrome, pulmonary, respiratory, Syncope, trauma
Category Assessment, Cardiovascular, Management |

Done Fell Out! Pediatric Syncope Episode 10

Podcast: Play in new window | Download (Duration: 58:58 — 26.3MB)

Kids pass out? Really? Yes they do! Join Kyle David Bates as he talks with Dr. Peter Antevy and Dr. Lou Romig as they discuss pediatric syncope and how it may be more common then we think!

ERCAST / Pediatric Syncope

Pediatric Syncope: Cases from the Emergency Department

Electrocardiogram Sine Wave in Hyperkalemia

Wolff-Parkinson-White Syndrome

Long Qt Syndrome

1. The listener will be able to define pediatric syncope.
2. The listener will be able to compare and contrast syncope and seizure.
3. The listener will be able to identify potential causes of pediatric syncope.
4. The listener will be able to identify patients suffering from a potential syncopal event.
5. The listener will be able to obtain a relevant history of a pediatric patient with possible syncope.
6. The listener will identify and perform a pertinent assessment of a patient with syncope.

Tags: ALTE, ambulance, Apparent Life-Threatening Event, assessment, child, dysrhythmia, EMS, EMT, kids, Paramedic, pediatric, pediatrics, Prolonged QT syndrome, Seizure, Syncope
Category Assessment, Cardiovascular |

Summertime Fun! Episode 9

Podcast: Play in new window | Download (Duration: 1:12:42 — 32.9MB)

Summer is here, but so are its related injuries and illnesses. Join Dr. Romig, Dr. Antevy, Chris Cebollero, Russell Stine, Tim Noonan, and Kyle David Bates as they discuss heat and water related emergencies. We also reference an interesting website as well in regards to heat-related injuries to children.

1. The listener will be able to discuss common causes of heat-related injuries in the pediatric population.
2. The listener will be able to identify and manage a pediatric patient suffering from a  heat-related injury.
3. The listener will be able to discuss pediatric drownings.
4. The listener will be able to assess and manage a pediatric patient who has drowned.
5. The listener will be able to discuss proper airway and ventilatory management of a pediatric patient who has drowned.

Category Uncategorized |