Survey of nationally registered emergency medical services providers: Pediatric education

Glaeser, Peter W.; Linzer, Jeff; Tunik, Michael G.; Henderson, Deborah; Ball, Jane W.

doi:10.1067/mem.2000.107662

Cited by 69 publications

(61 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A survey of practicing paramedics found that only 30% reported feeling uncomfortable caring for critically ill pediatric patients. 9 As demonstrated by our study, selfefficacy does not decay at the appreciable rate of skill performance, nor is the former predictive of the latter. There appears to be a ''gap'' between self-efficacy and skill retention that may result in a paramedic feeling capable of performing a critical skill (self-efficacy) when in fact he or she is not able to correctly perform the skill (skill performance).…”

Section: Discussionmentioning

confidence: 72%

“…5,6 This is especially true with pediatric ETI, an even lower frequency, highercomplexity procedure than ETI in adults. [7][8][9] As respiratory failure is the predominant cause of pediatric arrest in epidemiologic studies, 10,11 pediatric airway skills are a critical component of paramedic training. Pediatric airway skills comprise part of the core curriculum for paramedic training published by the National Highway Traffic and Safety Administration and thus are taught in nearly every paramedic training program in the United States, with no predominant type of training (i.e., mannequin, cadavers, lectures, operating room experience) found in a nationwide survey.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Paramedic Self‐efficacy and Skill Retention in Pediatric Airway Management

Youngquist

Henderson

Gausche‐Hill

et al. 2008

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The objectives were to determine the effect of pediatric airway management training on paramedic self-efficacy and skill performance and to determine which of several retraining methods is superior.Methods: A total of 2,520 paramedics were trained to proficiency in pediatric bag-mask ventilation (BMV) and endotracheal intubation (ETI) on mannequins. Subjects were a convenience sample of 245 (10% of original cohort) presenting for voluntary retraining. A total of 212 of 245 (87%) completed skills testing. Self-efficacy was measured prior to and following initial training and retraining events. Paramedics were assigned to control (no retraining), videotape presentation, self-directed learning, or instructor-facilitated lecture and demonstration retraining. Following retraining, BMV and ETI skills were tested.Results: Paramedics from low-call-volume areas reported lower baseline self-efficacy and derived larger increases with training, but also experienced the most decline between training events. Pass rates for BMV and ETI were 66% (139 ⁄ 211) and 42% (88 ⁄ 212), respectively. However, overall cohort self-efficacy was maintained over the study period. In ordinal regression modeling, only the lecture and demonstration method was superior to control, with an odds ratio (OR) of achieving higher scores of 2.5 (95% confidence interval [CI] = 1.2 to 5.2) for BMV and 5.2 (95% CI = 2.4 to 11.2) for ETI. Poor performance with ETI but not BMV was associated with time elapsed since training (p = 0.01). Self-efficacy ratings were not predictive of skill performance.Conclusions: Training provides increases in self-efficacy, particularly among paramedics from low-callvolume areas. A gap exists between self-efficacy and skill performance, in that self-efficacy may be maintained even when skill performance declines. Pediatric airway skills decay quickly, ETI skills drop off more significantly than BMV skills, and a lecture and demonstration format seems superior to other retraining methods investigated.ACADEMIC EMERGENCY MEDICINE 2008; 15:1295-1303

show abstract

Section: Discussionmentioning

confidence: 72%

mentioning

confidence: 99%

Paramedic Self‐efficacy and Skill Retention in Pediatric Airway Management

Youngquist

Henderson

Gausche‐Hill

et al. 2008

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…The Institute of Medicine study "Emergency Care for Children: Growing Pains" 90 corroborates that the provision of even routine emergency care for children provokes stress and anxiety for EMS providers because of lack of knowledge, training, and pediatric-specific experience. 107,108 Increased training and information is desired by EMS providers 109 and seems to mitigate the discomfort in some settings. 26,29,109,110 There are no US studies of the needs of families of children at the scene of the death, although it is the time of the most tremendous shock and the time when EMS providers have the unique opportunity to positively affect the lives of the survivors forever.…”

Section: Discussionmentioning

confidence: 99%

“…107,108 Increased training and information is desired by EMS providers 109 and seems to mitigate the discomfort in some settings. 26,29,109,110 There are no US studies of the needs of families of children at the scene of the death, although it is the time of the most tremendous shock and the time when EMS providers have the unique opportunity to positively affect the lives of the survivors forever. Most existing advice regarding the needs of families affected by the sudden, unexpected death of a child is based on extrapolations from the hospital setting or on anecdotal evidence.…”

Section: Discussionmentioning

confidence: 99%

Withholding or Termination of Resuscitation in Pediatric Out-of-Hospital Traumatic Cardiopulmonary Arrest

Fallat¹,

Cooper²,

Salomone³

et al. 2014

Pediatrics

View full text Add to dashboard Cite

This multiorganizational literature review was undertaken to provide an evidence base for determining whether recommendations for outof-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospital termination of resuscitation for adult traumatic cardiopulmonary arrest when there is no expectation of a good outcome, children are routinely excluded from state termination-of-resuscitation protocols. The decision to withhold resuscitative efforts in a child under specific circumstances (decapitation or dependent lividity, rigor mortis, etc) is reasonable. If there is any doubt as to the circumstances or timing of the traumatic cardiopulmonary arrest, under the current status of limiting termination of resuscitation in the field to persons older than 18 years in most states, resuscitation should be initiated and continued until arrival to the appropriate facility. If the patient has arrested, resuscitation has already exceeded 30 minutes, and the nearest facility is more than 30 minutes away, involvement of parents and family of these children in the decision-making process with assistance and guidance from medical professionals should be considered as part of an emphasis on family-centered care because the evidence suggests that either death or a poor outcome is inevitable. Pediatrics 2014;133:e1104-e1116

show abstract

“…1 Pediatric prehospital seizure management is characterized by variability in care related to providers' infrequent exposure to children, difficulty maintaining skills, and limited knowledge of pediatrics. [2][3][4][5][6][7][8] Prehospital providers may have more difficulty in rapidly obtaining intravenous (IV) access in children relative to adults, 9,10 and the stress of managing critically ill children poses an added challenge. 11,12 While high quality studies are available to guide the management of adult patients with seizures in the prehospital setting, 12,13 more research is needed to guide the practice of pediatric seizure management in the prehospital setting.…”

Section: Introductionmentioning

confidence: 99%

An Evidence-based Guideline for Pediatric Prehospital Seizure Management Using GRADE Methodology

Shah¹,

Macias²,

Dayan³

et al. 2013

Prehospital Emergency Care

View full text Add to dashboard Cite

Objective. The objective of this guideline is to recommend evidence-based practices for timely prehospital pediatric seizure cessation while avoiding respiratory depression and seizure recurrence. Methods. A multidisciplinary panel was chosen based on expertise in pediatric emergency medicine, prehospital medicine, and/or evidence-based guideline development. The panel followed the National Prehospital EBG Model using the GRADE methodology to formulate questions, retrieve evidence, appraise the evidence, and formu- The panel finalized a draft of a patient care algorithm in 2012 that was presented to stakeholder organizations to gather feedback for necessary revisions. Results. Five strong and ten weak recommendations emerged from the process; all but one was supported by low or very low quality evidence. The panel sought to ensure that the recommendations promoted timely seizure cessation while avoiding respiratory depression and seizure recurrence. The panel recommended that all patients in an active seizure have capillary blood glucose checked and be treated with intravenous (IV) dextrose or intramuscular (IM) glucagon if <60 mg/dL (3 mmol/L). The panel also recommended that non-IV routes (buccal, IM, or intranasal) of benzodiazepines (0.2 mg/kg) be used as first-line therapy for status epilepticus, rather than the rectal route. Conclusions. Using GRADE methodology, we have developed a pediatric seizure guideline that emphasizes the role of capillary blood glucometry and the use of buccal, IM, or intranasal benzodiazepines over IV or rectal routes. Future research is needed to compare the effectiveness and safety of these medication routes.

show abstract

Survey of nationally registered emergency medical services providers: Pediatric education

Cited by 69 publications

References 17 publications

Paramedic Self‐efficacy and Skill Retention in Pediatric Airway Management

Paramedic Self‐efficacy and Skill Retention in Pediatric Airway Management

Withholding or Termination of Resuscitation in Pediatric Out-of-Hospital Traumatic Cardiopulmonary Arrest

An Evidence-based Guideline for Pediatric Prehospital Seizure Management Using GRADE Methodology

Contact Info

Product

Resources

About