Comparison of Four Methods of Paramedic Continuing Education in the Management of Pediatric Emergencies

Abstract

Ventilation Circulation Assessment Circulation Management -Check for responsiveness. -Check for spontaneous respirations. (not present) -Perform head tilt/chin lift airway maneuver. -Look in mouth for oral secretions or vomitus. (not present) -Select correct size mask. ("infant/child" size) -Select correct bag size. ("infant/child" size) -Attach tubing to bag* and deliver high-flow oxygen (6-15 L/min). -Select correct size oropharyngeal airway. (50 mm) -Prepare suction device.* -Insert oropharyngeal airway. -Insert oropharyngeal airway correctly. -Use correct hand position on mask. -Perform bag-valve-mask ventilation.* -Begin ventilations within 60 seconds. -Check for chest rise with ventilations. -Auscultate lungs.* (normal) -Deliver ventilations at rate of 20-30/min. -Deliver ventilations at an appropriate tidal volume. (approx. 40-75 cc, or roughly adequate with no excessive force) -Verbalize "squeeze-release-release" and use 1:2 I-to-E ratio. -Attach cardiac monitor electrodes to chest.* -Check pulse. (absent) -Begin chest compressions.* -Begin chest compressions within 60 seconds. -Perform compressions at a rate of >100/min OR Correct EMT's slow compressions. -Correct EMT's hand position. -Call for additional, backup help. Play audio: "mother-baby not breathing." Starting rhythm: asystole. EMT informs paramedic at the start of the scenario that "the infant's extremities and trunk are cyanotic." Mother is unable to answer questions. Provide information about physical exam only if requested. Paramedic should start BVM ventilations before turning over the task to the EMT.

A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services

“…This limits the ability to compare our simulation curriculum against a less expensive pediatric education modality. Recent work suggests that less expensive, low-fidelity simulation may be adequate for improved performance in pediatric education for paramedics which we will consider for future efforts ( 37 ). Our qualitative results do suggest the interactive cases and real-time feedback from facilitators were important to participants.…”