00:11:22 Jason Snow: Jason Snow ED educator AHSV 00:11:27 allison bissette: Allison Bissette I am the PECC+ for Johnston County Emergency Services 00:11:53 Stephanie Ashford: Stephanie Ashford - Quality and Patient Safety Coordinator, St. Charles County Ambulance District 00:12:04 Rachael Alter: https://media.emscimprovement.center/documents/NPRP_Checklist_Final_Apr2021.pdf 00:12:10 Laura Garcia: Laura Garcia, RN PdLN PIH Health Whittier, CA 00:12:40 Amy Yates: Amy Yates, NRP, CCP, PECC, Education Coordinator Covington County Hospital , MS 00:12:54 Laura Garcia: Can you repeat the question? 00:14:20 Meredith Rodriguez: The question was about more specific pediatric medication lists. Something that goes beyond the NPRP checklist, as this tends to list general categories of medications to have 00:15:07 Laura Garcia: Is this prehospital or hospital based? 00:15:43 Meredith Rodriguez: This is an open office hours for all tracks (prehospital, hospital and EMSC programs) 00:16:04 Laura Garcia: sorry for the question? 00:16:21 Aspen: ImPACT program has 1st, 2nd, & 3rd line anticonvulsants recommendations and dosing 00:17:01 Stephanie Ashford: We use the Kangaroo 00:17:19 Meredith Rodriguez: The question was around safe transport 00:17:45 Stephanie Ashford: https://www.ferno.com/product/kangoofix-neonatal-restraint-system?hl=en-us 00:17:49 Stephanie Ashford: that's what we use 00:18:16 Rachael Alter: https://nasemso.org/wp-content/uploads/Pediatric-Transport-Products-for-Ground-Ambulances_v2.2.pdf 00:18:34 Stephanie Ashford: we only deliver about 6 babies a year, so we don't have a lot of data 00:19:17 Stephanie Ashford: we don't use kangoo if baby requires any resus or medical attention 00:19:24 Stephanie Ashford: we use the second truck 00:19:28 Erin Selby: We use the KangooFix 00:19:34 allison bissette: Thank You! 00:19:38 Erin Selby: We don't use it if baby needs any attention 00:19:53 Erin Selby: You can use it with dad, if mom needs to be transported separate too. 00:20:05 allison bissette: That is a great idea 00:20:08 Stephanie Ashford: Nice! 00:20:20 Erin Selby: We made them separate every time before we had the option. 00:20:32 Jason Snow: Hello I am having mic difficulties sorry 00:20:49 Laura Garcia: For the previous question, In Los Angeles County system, we use LA County EMS Drug Doses app for prehospital and LA County EDAP standards for hospital based specific drugs that are primarily the emergency drugs. 00:21:23 Brent Hahn/Mont Belvieu Fire Department: Yes, great program! A lot of information to absorb, but very helpful! 00:21:31 Laura Garcia: Yes, appreciate the program 00:21:34 Jason Snow: I do have a question: I want to track quality improvement for code whites in our ED. Does anyone have a good tool, resources, things to focus on to evaluate post code white quality? 00:22:08 Stephanie Ashford: can you explain the phrase code white 00:22:22 Jason Snow: pediatric cardiac arrest 00:22:34 Jason Snow: that would be great 00:22:47 Jason Snow: any info is appreciated. I don't want to re invent the wheel 00:23:21 Richard Harley: Thanks for clarifying, at our facility a code white is a Winter Storm emergency. 00:23:25 Stephanie Ashford: we measure time to first airway, time to first access (IO/IV), time to first epi 00:23:25 Aspen: Did you get a weight/length/color Is dosing correct 00:23:26 Casey DeWalt: Code white in my facility is any OB/neonate distress, post partum hemorrhage or eclampsia 00:23:59 Jason Snow: perfect, I have been using our code blue quality tool and trying to adapt it to pediatrics 00:24:04 Aspen: Are you following AHA PALS guidelines 00:24:17 Jason's iPad: medication safety during cardiac arrest. 00:24:37 allison bissette: Prehospital we measure times(CPR. Meds,airway, etc), success of airway, med doses, cpr quality. I am not sure if that helps or not. 00:24:40 Erin Selby: AHA has some direction with Get with the Guidelines 00:24:45 Jason's iPad: team debriefing is a great thing to do as well 00:24:58 Kevin D: I put a device that you might want to consider 00:25:12 Erin Selby: https://www.heart.org/en/professional/quality-improvement/get-with-the-guidelines/get-with-the-guidelines-resuscitation/get-with-the-guidelines-resuscitation-clinical-tools 00:25:19 Stephanie Ashford: do you have pads that measure CPR quality? 00:25:54 Jason Snow: perfect, thank you all for your information! 00:26:09 elen.rodriguez: I would like to see what screening tools pediatric hospitals are using for NAT. We have a NAT guideline as a level II adult trauma center. I am pushing for a pediatric screening tool for our Cerner system as its not the friendliest and using a modified screening tool with the 10-4 faces. What are outher centers using? 00:26:17 allison bissette: Kevin we had researched those as well and I think overall the Kangoo fix is a better fit for us as it has more crash testing, etc and the Aegis was a single use device, so cost was a factor as well. 00:26:22 Rachael Alter: The Aegis “testing” is a little misleading. There are no testing standards, so we don’t know what the tests showed. 00:26:41 Lisa Gray: I like that you all are sharing ideas with one another! Great way to get ideas and places to start! Keep doing that. Examples are great! 00:27:14 Erin Selby: And the Aegis went up in price a lot! And, there are 5 sizes. We leaned that way first, then turned to the KangooFix because of all of the above. 00:27:40 Jason Snow: good thinking, I will have to check out our pads and see. thanks so much. 00:28:04 allison bissette: yes 00:31:16 Erin Selby: Agree! 00:32:28 allison bissette: I agree! We have an average of 2-5 pediatric codes a month and it took training across the board, including the FD and PD in the training made a huge difference. 00:32:46 Rachael Alter: I love the cross training collaboration! 00:33:05 Brent Hahn/Mont Belvieu Fire Department: can you share this program or details stephanie? 00:33:18 allison bissette: We work hard to train with our other agencies and try and include the hospitals when we can as well. 00:34:40 Meredith Rodriguez: That’s a great example of how improvement takes time and how we introduce these small changes slowly. 00:36:29 Stephanie Ashford: perfection is the enemy of progress 00:37:07 elen.rodriguez: can you share the disaster bundle and plan ? we are getting ready to do one region wide and would like to be able to have something to measure against and grab ideas from 00:38:08 Gil Torres: just wanted to share this link. We are using handtevy system for pediatrics. https://www.handtevy.com/ 00:38:30 elen.rodriguez: thank you ! This is exciting! 00:39:05 Meredith Rodriguez: PRQC Disaster Bundle: https://emscimprovement.center/collaboratives/prqc/members/intervention-bundles/bundle-4-disaster-planning/ 00:39:14 Stephanie Ashford: :) 00:39:16 allison bissette: For our dosing we use our protocol app which is built through acid remap, which is a searchable PDF. Its simple to build. 00:40:10 Jason Snow: Allison can you share more about that dosing tool> 00:40:55 allison bissette: Sure! We make our own dosing chart let me see if I can find it! 00:41:32 Jason Snow: thanks so much, that is a common question to me from our ED docs - a reference for dosing aside from braslow 00:41:37 Stephanie Ashford: we also have this laminated in the ped bag.... large print, bright colors... 00:41:58 allison bissette: https://media.acidremap.com/media/4180/221.pdf?&Expires=1637261190&Signature=cRPhXQH-ohqgEuR0VP5EVgrPJwZer8fA9~JTRu5Xyj~clMapUTCuyDgRIhKh6CO08VcO1exVM4hBPtZs8uSRPfrs5JHc523a--GXNBdnJ9szzJQR76nHua1RaWVC7yplsWZpVnjYXWKtgT3AlfyB7O2YDRJcT28PdS6X7WYAs1mqjQc3vxP0EL9UsYy3loOv2ocXAdHGr7YtTuzABZKcJch31gfYHESj847RDxypsuTYYcuIZDdNTVkJC~44p5I9RsmN-rwLi2hchwxYCYd3n48wnXFLYfEy-kpv4vv~Yv0Gscgk37~S7CnDSgsq4btcdnrxh9vT2nYwAMmG5zkwZw__&Key-Pair-Id=KBL3VFRBIY34E 00:42:06 Stephanie Ashford: MI-Medic cards are great too 00:42:08 Jason Snow: please and thank you 00:42:19 Greta James-Maxfield, Texas Parent to Parent Familly Support: Do apps fail in high concentrated cell tower use areas or during events when the networks are overwhelmed? 00:42:27 RChambers: We use Certadose for peds dosing. Very accurate and easy to use. 00:42:37 Meredith Rodriguez: MI-MEDIC https://www.michigan.gov/documents/mdhhs/MI-MEDIC_2.0_597134_7.pdf 00:42:38 allison bissette: We have it printed and laminated in our beds bags as well. We can update it anytime we had a drug or carry drugs that are not the same mg/ml 00:42:40 Stephanie Ashford: sort of 00:42:43 Erin Selby: on the phone 00:42:45 allison bissette: You download it to your phone 00:42:46 Stephanie Ashford: most apps have a download option 00:43:04 Jason Snow: certadose is an app also? 00:43:32 allison bissette: We normally do not have an issue with our app and we are in rural areas. 00:43:35 RChambers: No, it is a device 00:43:42 Jason Snow: oh a device!! 00:43:53 Jason Snow: wow, I will look that up thanks. 00:44:03 allison bissette: Ive heard about certadose, have you found it successful? 00:44:07 Rachael Alter: https://www.certadose.com 00:44:27 Gil Torres: handtevy is an app and is downloaded, no internet needed once downloaded. dosages are listed in ml's to administer. 00:44:37 Stephanie Ashford: we don't use certadose but there was a presenter from texas on the first call that gave a talk on his PECC role, and he mentioned using it 00:44:45 RChambers: www.certadose.com 00:44:50 allison bissette: Thank you! 00:45:33 Jason Snow: quick question if someone knows: is certadose designed for just braslow colors? or handtevy too? 00:45:57 Jason Snow: we are moving to handtevy in the next year - so I want to be sure our equipment works with that as well. 00:46:01 Gil Torres: braslow only for braslow and not for handtevy 00:46:02 Meredith Rodriguez: I think it’s this recording: https://youtu.be/40tApPqDAys 00:46:19 Erin Selby: Handtevy and broselow are the same 00:46:24 Gil Torres: handtevy does have a measurement tape 00:46:34 Erin Selby: same colors that is 00:47:05 Gil Torres: also braslow does not include pain management doses and has rsi meds listed that can be confused and used for pain management 00:47:11 Jason Snow: ok same colors - so certadose would work still when we move from braslow to handtevy. thanks so much. 00:47:18 Erin Selby: yes! 00:47:45 Stephanie Ashford: the color scheme for broslow has come out of copyright, so anyone can use it 00:48:47 Stephanie Ashford: it has in Missouri 00:48:57 Jason Snow: I missed a session - I would be willing to be involved in that if possible. 00:49:16 Jason Snow: california 00:49:17 Erin Selby: I'll say for Colorado, it has been awesome, but the Program Manager position is currently vacant. :( 00:49:36 Jason Snow: No problem. 00:49:39 Zoom user: I have not yet in WI 00:50:06 Erin Selby: :( 00:50:09 Laura Garcia: Will there be a repository for the links/policies/procedures shared? 00:50:13 Jason Snow: What is the program in LA called again? I would love to be involved - we are in ventura county right next door 00:51:00 Meredith Rodriguez: https://pdln.net/ 00:51:15 Jason Snow: perfect 00:51:48 Jason Snow: oh yes, my old ED used to be EDAP. perfect thank you. 00:52:28 Rachael Alter: https://lapedsready.org 00:54:07 Meredith Rodriguez: Prehospital Pediatric Readiness Project: https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-readiness/ 00:54:12 Pauline Convocar: I hope you don’t mind me staying, I’m Pauline, an EM physician from the Philippines, very challenging time difference (2am here) and health systems difference, too. I am very keen about how we may start improving our PEM care both in EMS and ED. Thank you very much for all the resources. 00:54:52 Meredith Rodriguez: Wow Pauline!! Thank you for waking up in the middle of the night to join us. I’m so glad to have you here! 00:57:10 Pauline Convocar: Hello. 😃 00:58:21 Brent Hahn/Mont Belvieu Fire Department: grant/funding opportunities? 00:59:22 Rachael Alter: Sample PECC job descriptions: https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-readiness/pprp-toolkit/interactions-systems-care/pecc-rolesjob-descriptions/ 00:59:27 allison bissette: Firehouse subs is a good place to start peds equipment 00:59:36 Laura Garcia: Excited to see the growth of pediatric readiness throughout the continuum of care. 01:00:50 allison bissette: In NC we had 12 agencies picked to be part of a PECC+ program funded by UNC, the state OEMS, etc. to start our programs. See if your state is looking at doing something like this. 01:00:55 Stephanie Ashford: https://www.lexipol.com/solutions/grant-services/ 01:01:32 Lisa Gray: I recently heard someone speak on pitching to their local/community Rotary Club for funding. Not sure how much support it entailed, but an idea?? 01:02:10 allison bissette: Good idea Rachael for funding past the grant life 01:03:11 Stephanie Ashford: https://firstwatch.net/event/grants-20211104/ 01:03:17 Greta James-Maxfield, Texas Parent to Parent Familly Support: are there any tools to identify persons with known extra healthcare needs to have access to ems/ed/pecc to prepare in case of the sorts of events that are likely in such pediatric patients? Are there initatives to help those patients with possible onsite treat no transport? 01:04:01 Stephanie Ashford: STARS Program = the best ever 01:04:15 Rachael Alter: https://www.glennon.org/what-we-do/stars-special-needs-tracking-and-awareness-response-system/ 01:04:20 Stephanie Ashford: (my BFF made it) 01:04:44 Erin Selby: Love it, would love states to champion models like this 01:05:20 Rachael Alter: HERO Kids (Oregon) https://media.emscimprovement.center/documents/11_Bakewell-HEROKidsRegistryPoster_FINAL.pdf 01:05:52 Rachael Alter: This is the website, previous link is a poster http://www.herokidsregistry.org 01:06:08 Stephanie Ashford: Shes a rockSTAR 01:07:27 Greta James-Maxfield, Texas Parent to Parent Familly Support: Treating without transporting seems to be difficult for agencies to reconcile. I think I've heard that STARS may help mitigate that billing concern for agencies 01:08:04 Greta James-Maxfield, Texas Parent to Parent Familly Support: thanks 01:08:28 Jason Snow: Thanks so much for all of your help! Much appreciated. Looking forward to the next meeting. 01:08:46 Greta James-Maxfield, Texas Parent to Parent Familly Support: Treat without transport could really help families that have ongoing stressful care needs. 01:09:11 allison bissette: Yes it would Greta 01:09:32 allison bissette: Speaking as a paramedic and special healthcare needs mom :) 01:09:32 Brent Hahn/Mont Belvieu Fire Department: THANK YOU! Awesome opportunities! Have a great Thanksgiving to all! 01:09:41 allison bissette: Thank you all for the great ideas! 01:09:45 Stephanie Ashford: Thank you