This will be the last PEARL for 2019. Thanks everyone for a great year. Please share your awesome ideas, presentations, courses, champions, etc. by emailing pedready@jax.ufl.edu .

Quick Links:
Encourage others to sign up for the PEDReady weekly newsbrief, the PE 2 ARL, by sharing this link: http://bit.ly/flpearl
December 19, 2019
2019 PEDReady Medley & 2020 New Year’s Resolutions
1. News of the Week: A Christmas Miracle
Two missing Jacksonville children found safe! Way to go, JFRD & JSO.
This story provides a great ending to 2019 after a very stressful, 3-day massive search for two missing children.

Jacksonville Sheriff’s Office (JSO) and Jacksonville Fire & Rescue Department (JFRD) personnel were searching on foot when one rescue member thought he heard a child’s voice. The team members fanned out and both children were discovered inside a pump house. A rescuer said the boy and girl were “tired, hungry, thirsty” and didn’t let go of first responders. The children also asked for cheese pizza, “which we delivered,” the sheriff said. Can’t beat those smiles!
2. PEDReady Champion of the Week: Steve White
Special thanks to Steve White for developing pediatric case simulation scenarios. Steve serves as a Florida EMSC Advisory Committee Member and is Program Director of Emergency Medical Service Programs at Gulf Coast State College. An EMS and ED scenario will be posted on the PEDReady website. 
3. Pediatric Infographic of the Month
The opioid crisis is the deadliest drug epidemic in U.S. history, leaving virtually no community unscathed. The immense toll of opioids has been well documented by media organizations and researchers, but one aspect that has received little attention or study is the long-lasting impact on children of people suffering from opioid use disorder as well as the children’s caregivers.

In March 2019, United Hospital Fund (UHF) examined this critical issue in a report titled The Ripple Effect: The Impact of the Opioid Epidemic on Children and Families . Below are some infographics from the report:
Fig. 1: Children affected by the opioid epidemic in 2017:
Fig. 6: Number of children affected by the opioid epidemic in 2017 by age:
Fig. 10: Projected societal cost of the opioid epidemic by state:
4. 2019 Review and 2020 New Year's Resolutions
Dear PEDReady Champions and Friends,

It is an honor to serve as Florida’s EMS for Children Medical Director and Editor of the PE 2 ARL, Florida’s PEDReady and PECC newsletter. I wear many different hats, but EMSC is my favorite! The following is a summary of some key accomplishments by our EMSC Program, the FL EMSC Advisory Committee and our PEDReady Champions, ending with 2020 New Year’s Resolutions.

Florida EDs continue to expand, and especially free-standing EDs ( click here to see the latest lists). Due to the size of Florida and number of EDs (280) and EMS agencies (287), the PEDReady program gives priority to rural counties or EDs and EMS agencies with > 30 min transport times to tertiary care. 
EMSC continues to work closely with the EMS Advisory Council Data Committee, EMSTARS program, Biospatial, Inc. and other data partners to better understand pediatric emergency care and improve outcomes. This includes developing an EMSC data dashboard with critical procedures, medications, mechanism of injury, quality improvement initiatives and collaborating in DOH IRB-approved, EMSTARS-related studies.

Congratulations to Dr. Jennifer Fishe for successfully conducting, presenting and publishing results from pediatric EMSTARS-related studies:
PEER-REVIEWED PUBLICATIONS:

McManus K, Finlay E, Palmer S, Anders JF, Hendry P, Fishe JN. “A Statewide Analysis of Reason for EMS’ Pediatric Destination Choice.” Prehospital Emergency Care. 2019. [ Accepted for publication ]

Fishe JN, Finlay E, Palmer S, Hendry P. “A Geospatial Analysis of Distances to Hospitals that Admit Pediatric Asthma Patients.” Prehospital Emergency Care . 2019;23:882-886.

Fishe JN, Lynch S. “Pediatric behavioral health-related EMS encounters: A statewide analysis.” Prehospital Emergency Care . 2019;23(5):654-662.

Fishe JN, Palmer E, Finlay E, Smotherman C, Gautam S, Hendry P, Hendeles L. “A statewide study of the epidemiology of emergency medical services’ management of pediatric asthma.” Pediatric Emergency Care . 2019. DOI: 10.1097/PEC. 0000000000001743. [ EPub ahead of print ].

Fishe JN, Gautam S, Blake K, Hendry P, Hendeles L. “Emergency Medical Services Administration of Systemic Corticosteroids for Pediatric Asthma: A Statewide Study of Emergency Department Outcomes.” Academic Emergency Medicine . 2019;26(5):549-51.

NATIONAL PRESENTATIONS:

Fishe JN, Hendry P. “Challenges and Opportunities for Rural Prehospital Pediatric Care” National Association of EMS Physicians Annual Meeting, January 2020. San Diego, CA. [ Scheduled ]

POSTER PRESENTATIONS:

McManus K, Finlay E, Palmer S, Anders JF, Hendry P, Fishe JN. “A Statewide Analysis of Reason for EMS’ Pediatric Destination Choice.” National Association of EMS Physicians Annual Conference. San Diego, CA. [ Accepted for presentation January 9, 2020 ].

Fishe JN, Lynch S. “Pediatric Behavioral Health-Related EMS Encounters: A Statewide Analysis.” Society for Academic Emergency Medicine. May 2019, Las Vegas, NV.

Fishe JN, Smotherman C, Gautam S, Finlay E, Palmer E, Hendry P, Hendeles L. “Epidemiology of Prehospital Pediatric Asthma Encounters: Demographic and Clinical Characteristics.” National Association of EMS Physicians Annual Meeting, January 2019. Austin, TX. 
Our state is fortunate to have so many outstanding pediatric emergency leaders, champions, researchers and educators like Dr. Peter Antevy. Click here to see his recent article in JEMS.

Also, you better get your autograph soon from Dr. “Banana Phone” Ben Abo (EMSC Committee member), and check out his History Channel show, the Kings of Pain .

Please email pedready@jax.ufl.edu to let us know when you have an article, abstract, publication or podcast related to pediatric emergency care. 
PEDReady Newsletter and Website

In April 2019, a weekly PEDReady/PECC newsbrief named the PE 2 ARL was launched . Our newsbrief includes a topic of the week, case presentations, resources, announcements, upcoming conferences, PECC/champion recognition and more. We currently have over 500 direct subscribers, but thanks to social media and large ED group signups, our total dissemination is much larger. This could not have been accomplished without the wonderful partnership between EMSC, DOH, EMLRC and Samantha League. Don't forget that the PEDReady website contains a PEARL archive of topics. And next month, the entire website is getting a fresh, new look!

Florida EMSC Program and EMSC Advisory Committee

A new program manager, Lorrianna Jean-Jacques, started in October 2019 and is off to a great start! The EMSC Advisory Committee, led by chair Julie Bacon, added two new rural EMS/ED liaisons (Dr. Mary Anne Kolar and Tracey Vause), conducted the first EMSC Day Facebook live event, disseminated PEDReady Toolkits, and developed two new working groups on Pediatric Emergency Care Coordinators and Infant Mortality. New committee appointments will be made in 2020. Sadly, the EMSC Advisory Committee says farewell to Dr. Lou Romig, a dedicated committee member for many, many years and a former EMSC Medical Advisor. Thank you, Lou, for your commitment to EMSC and the children of Florida!

PEDReady Products and PECCs (Pediatric Emergency Care Champions/Coordinators)

A PECC listserve and spreadsheet has been developed for Florida EDs and EMS agencies with known PECCs to streamline communication. In addition to this...
Over 400 Pediatric Communication Cards have been disseminated to Florida EMS agencies and EDs
Over 80 PEDReady Toolkits have been distributed thanks to the Bureau of Emergency Medical Oversight, EMSCAC, the Resuscitation Academies, Tom DiBernardo (FL CARES Coordinator), Jane Bedford (FL DOH Rural EMS Liaison), and David Summers (FTSAC member and Health Care District Palm Beach County)
The PEDReady ABCs and More Resource was developed this year. Find the basic information you need to manage a pediatric emergency in one place with this two-sided resource.
Visit the website to view or request products!
COMING IN 2020:

  • EMSTARS pediatric data dashboard
  • More PEDReady research
  • ED and EMS PECC quarterly conference calls
  • Safe Sleep/Infant Mortality Reduction Initiative
  • PEDReady PECC Instructor Course
  • Contact list for pediatric EDs, children’s hospitals, trauma and burn centers
  • PEDReady Family Guide to EMS, EDs and transfers
  • New PEDReady products
  • New collaborations
  • Pediatric presentations at NAEMSP in January (Antevy, Fishe, Abo, Hendry) and other national/state meetings—send us your presentation information!
  • CEU/CME pediatric trauma module in collaboration with Florida Trauma System Advisory Council
  • and much more!
Join me in dedicating some of your 2020 resolutions to pediatric care!

In 2020, I will…
a) Make sure my agency or ED has specific pediatric protocols
b) Review my pediatric equipment
c) Conduct a pediatric mock code
d) Take an online or in person pediatric emergency course
e) Offer free spots to a rural county paramedic, nurse or physician in my pediatric course
f) Write or provide content for the weekly PEARL
g) Provide free pediatric distraction devices, books or toys to my local EMS agency or ED
h) Thank a PEDReady Champion
i) Email the registration link for my pediatric emergency/trauma course to pedready@jax.ufl.edu for inclusion in the newsletter
j) Tell my colleagues or employees about PEDReady
k) Give a hug or an extra smile to the parents of a child with special needs
l)  Encourage and support a co-worker who recently witnessed a pediatric death or resuscitation
m)    ????????????????????
What will you choose? Share your resolution!


Sincerely,
Phyllis L. Hendry, MD, FAAP, FACEP 
5. Events & Education
Free Webinar: Drugs of Abuse During Pregnancy & Lactation
1.0 CE | Expires January 2, 2020
Hosted by: EMLRC

Substance abuse among pregnant women in the U.S. is increasing. Emergency care providers must be able to recognize and manage the immediate consequences of substance abuse in a pregnant patient. Dr. Sara Baker will review pregnancy complications associated with drugs of abuse, impacts on maternal wellbeing and fetal development, and appropriate treatment options during pregnancy and the postpartum period.
Are you planning pediatric emergency educational courses for 2020? Please share the information and dates with FL PEDReady by emailing pedready@jax.ufl.edu . Course information will be added to our website and weekly newsletters. 
Thanks for being a Pediatric Champion!
The Florida PEDReady Program
pedready@jax.ufl.edu | 904-244-8617