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Encourage others to sign up for the PEDReady newsbrief, the PE2ARL, by sharing this link: http://bit.ly/flpearl
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Florida EMSC and PEDReady Updates and Announcements
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The PE2ARL is coming back on a monthly basis! The PEDReady Team took a summer “COVID break”. We are excited to begin this Fall with a new team and monthly format. Please encourage others to sign up for the newsletter at: https://airtable.com/shrov0Ha3DCVzXBSw. Send announcements, resources and requests for topics to pedready@jax.ufl.edu.
Thank you EMLRC for hosting the PEDReady website and newsletter!
Sincerely,
Phyllis Hendry, MD, FAAP, FACEP
Florida EMS-C Medical Director and Editor
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1. Announcements and Updates |
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Haitian Creole Communication Cards are now in stock!
Did you know that Haitian Creole is the third most commonly spoken language in Florida households? Florida ranks #1 in the country with homes speaking Creole. That’s why the PEDReady team has translated the medical communication cards into Haitian Creole in an effort to provide EMS, hospitals and EDs with another valuable tool. The cards are ideal for non-English speakers, non-verbal patients and as a distraction device. Special thanks to Midline Civil, Lorrianna JeanJacques, David Summers, Amy Kennedy and Dr. Roseline Desvaristes for helping with the translation.
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Updated 2020 PAMI Pain Management and Dosing Guide
The guide contains oral, nasal, parenteral and topical medications for acute and chronic pain and procedural sedation including pediatric and adult dosing. Revisions were made to the non-opioid, opioid and equianalgesic and topical and transdermal tables based on new literature, national guidelines and expert review. The PAMI team welcomes your clinical review and feedback to assist us in finalizing the 2020 version of the Guide. The PAMI website maintains the latest version as a downloadable PDF, meant as a tri-fold when printed for easy pocket storage. The Guide prints best as legal size (8.5” x 14”) and can be accessed online: https://pami.emergency.med.jax.ufl.edu/resources/dosing-guide/.
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2. PEDReady Champions of the Month: Dr. Madejczyk, AdventhHealth and EM PROS |
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Shout out to Dr. Katarzyna (Kasia) Madejczyk, Pediatric Medical Director for Emergency Medicine Professionals. She has been working with her colleagues to have a PECC physician and nurse champion in all EDs staffed by EMPros. Click here to learn more about becoming a pediatric emergency care coordinator/champion https://emscimprovement.center/collaboratives/pecclc/what-pecc/.
AdventHealth Daytona Beach:
Physician champion: Dr. Katarzyna Madejczyk
Nurse champion: Sarah Roberts, RN
AdventHealth Palm Coast:
Physician champion: Dr. Rebecca Lacayo
AdventHealth Deland:
Physician champion: Dr. Allyson Best
Nurse champion: Suzanne Thomson, RN
AdventHealth Deltona and Fish Memorial:
Physician champion: Dr. Claire Simpson
AdventHealth New Smyrna:
Physician champion: Dr. Peter Riga
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3. Announcing New Florida EMS for Children Advisory Committee Appointments |
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Appointment Date: 07/10/2020
Term ends: 07/10/2022
Assistant Professor
- University of Florida COM-Jacksonville, Department of Emergency Medicine
- Associate Medical Director for Pediatrics, Nassau County Fire Rescue
- Data Committee Research Representative
- NIH K23 awardee
Appointed Position:
Physician with Pediatric Experience
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Barbara Tripp, RN, EMT-P
Appointment Date: 07/10/2020
Term ends: 07/10/2022
Rescue Division Chief
- City of Tampa Fire Rescue
Appointed Position:
Emergency Medical Technician/Paramedic
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Nichole Shimko, RN, BSN, CCRN, CPN, C-NPT
Appointment Date: 07/10/2020
Term ends: 07/10/2022
Registered Nurse Supervisor
- Golisano Children’s Hospital of Southwest FL
Appointed Position:
Nurse with Emergency Pediatric Experience
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Marshall Frank, DO, MPH, FACEP, FAEMS
Appointment Date: 07/10/2020
Term ends: 07/10/2022
Medical Director
- Sarasota County Fire Department
Appointed Position:
Emergency Physician
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Felix Marquez, BA, RN, RMT-P
Appointment Date: 07/10/2020
Term ends: 07/10/2022
EMS Instructor
- Orlando Medical Institute
Appointed Position:
EMS Education Manager
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Sandra Nasca, RN
Appointment
Date: 12/29/2017
Term ends: 07/10/2022
Forensic Medical Investigator
Appointed Position:
Florida FAN Representative
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The children of Florida appreciate the service of past, current and future committee members and liaisons. Thank you to returning liaisons: Tracey Vause for Rural EMS and Michael Rushing for FL ENA. A complete committee roster with state and other liaisons will be forthcoming pending selection of new liaisons. Please share the following announcement with interested agencies, organizations and individuals |
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CALL FOR FLORIDA EMSC AND PEDREADY LIASION POSITIONS |
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The Florida EMSC Program is seeking liaison applicants in the following categories:
- PECC (Pediatric Emergency Care Coordinator or Champion) EMS representative
- PECC (Pediatric Emergency Care Coordinator or Champion) ED representative
- School nurse or school resource officer representative
- Child death-review representative
- Bioterrorism/disaster preparedness representative
- Law enforcement/police/highway safety representative
Interested applicants should forward a letter of interest and resume or CV to pedready@jax.ufl.edu. September 30, 2020 at 5 pm EST is the deadline for submissions. Liaisons will work collaboratively with the Florida DOH EMSC State Partnership grant program, the Florida EMSC Advisory Committee and the Florida PEDReady Program. Liaisons are expected to attend quarterly committee meetings (online +/- in person) and participate in program goals and deliverables.
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4. Pediatric COVID Information and Resources |
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A. COVID-19–Associated Multisystem Inflammatory Syndrome in Children
CDC MMWR August 7, 2020
COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United States, March–July 2020
Summary
What is already known about this topic?
Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe condition that has been reported approximately 2–4 weeks after the onset of COVID-19 in children and adolescents.
What is added by this report?
Most cases of MIS-C have features of shock, with cardiac involvement, gastrointestinal symptoms, and significantly elevated markers of inflammation, with positive laboratory test results for SARS-CoV-2. Of the 565 patients who underwent SARS-CoV-2 testing, all had a positive test result by RT-PCR or serology.
What are the implications for public health practice?
Distinguishing MIS-C from other severe infectious or inflammatory conditions poses a challenge to clinicians caring for children and adolescents. As the COVID-19 pandemic continues to expand in many jurisdictions, health care provider awareness of MIS-C will facilitate early recognition, early diagnosis, and prompt treatment.
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Geographic distribution of 570 reported cases of multisystem inflammatory syndrome in children — United States, March–July 2020
AAP Multisystem Inflammatory Syndrome in Children (MIS-C) Interim Guidance
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B. Sample MIS-C Clinical Pathways
Does your agency or ED have a pathway for children with COVID associated MIS? Please share by sending to pedready@jax.ufl.edu.
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CDC student-becomes-sick-diagnosis-flowchart
Back to School Checklist
The University of Miami’s Mailman Center for Child Development together with the Florida Chapter of the American Academy of Pediatrics and the Family Network on Disabilities developed a checklist—available in both English and Spanish—to help families discuss the best school option with their family provider.
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D. Tips for Making Face Masks Fun for CSHCNs
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E. Vaccinations and COVID: Help us get vaccinations back on track!
One of the greatest impacts of COVID on children and adolescents is the dramatic decrease in routine childhood immunizations. Ask about the immunization status on all pediatric encounters especially if presenting with fever.
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There are national and state initiatives to get vaccinations back on track! Check out the CDC video series on how to recommend vaccinations to your pediatric and adolescent patients. #HowIRecommend Vaccination Video Series
What are you doing to help get vaccinations back on track? Here is an example of a Jacksonville initiative:
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5. Rural EMS Project ECHO Schedule |
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Rural EMS Project ECHO Schedule
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6. Poetry and Literature Update |
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Poetry
Will You Take Care of My Children? By Dr. Sylvia Owusu-Ansah, MD, MPH, Assistant Professor of Pediatrics, Associate Vice Chair of Diversity, Equity, and Inclusion, UPMC Children's Hospital of Pittsburgh, Prehospital-EMS Medical Director (Medical Command Physician MD- 22)
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Literature Update
1. Check out the latest Florida EMSTARS publication!
A STATEWIDE ANALYSIS OF EMS’ PEDIATRIC TRANSPORT DESTINATION DECISIONS by Kayla McManus, DO, Erik Finlay, MPH, Sam Palmer, MAURP, Jennifer F. Anders, MD, Phyllis Hendry, MD, Jennifer N. Fishe, MD. https://doi.org/10.1080/10903127.2019.1699211
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ABSTRACT
Introduction: Deciding where to transport a patient is a key decision made by emergency medical services (EMS), particularly for children because pediatric hospital resources are regionalized. Since evidence-based guidelines for pediatric transport destinations are being developed, the purpose of this study was to use a large statewide EMS database to describe current patterns of EMS providers’ transport destination decisions for pediatric patients. Methods: This is a retrospective study of pediatric
transports from 2011-2016 in EMS Tracking and Reporting System (EMSTARS), Florida’s statewide EMS database. We included patients greater than 1 day and less than or equal to 18 years who were primary EMS scene transports. Our primary outcome variable was ‘reason for choosing destination.’ We performed descriptive and comparative analysis between closest facility and all other ‘reason for choosing destination’ choices. We used geospatial analysis to examine destination choice in urban and rural counties. Results: Our final study sample was 446,274, and 48.2% of patients had closest facility as their ‘reason for choosing destination.’ The next largest category was patient/family choice (154,035 patients, 35.7%). Closest facility patients were older (median age 12 versus 10 years, p<0.0001) and had shorter median EMS transport times (11.3 versus 15 minutes, p<0.0001) compared to all other destination decisions. Notably, 60% of respiratory distress patients’ and 44% of seizure patients’ reason for choosing destination was something other than closest facility. Geospatial analysis revealed that fewer rural patients were documented as closest facility compared to urban (43.9% versus 47%, p<0.0001). Correspondingly, more rural patients’ destination decision was patient/family choice
than urban patients (36.3% versus 34.3%, p<0.0001). Conclusions: This large, statewide study describes EMS’ reason for choosing destination for pediatric patients. We found that just under half of patients were documented as closest facility, and over one-third as patient/family choice. Significant differences in destination reasons were noted for rural versus urban counties. This study can help those currently developing pediatric EMS destination guidelines by revealing a high proportion of patient/family choice and identifying conditions with high proportions of destination reasons other than closest facility.
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2. Enhancing CPR During Transition From Prehospital to Emergency Department: A QI Initiative.
Erin F. Hoehn, Mary K. Cabrera-Thurman, Jennifer Oehler, Adam Vukovic, Mary Frey, Mathew Helton, Gary Geis and Benjamin Kerrey. Pediatrics May 2020, 145 (5) e20192908; DOI: https://doi.org/10.1542/peds.2019-2908
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Stay Safe, Pediatric Champions! |
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The Florida PEDReady Program
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