00:01:16	Kelsey Palladino:	Will we have access to the slides for this break out session? - they were not uploaded on the website (at least that I could see)
00:01:36	Whitney Jerred:	Yes I cannot access the slides either
00:01:50	Michelle Moegling:	I will get them posted.
00:02:53	Kelsey Palladino:	Thank you
00:07:29	Michelle Moegling:	Slides cannot be posted until after the presentation, sorry.
00:10:38	tara davenport:	Do we have ability to get slides for this session,  these are not listed online. thank you
00:11:43	Robbie Besel:	Do you include specific ESI level that a pediatric patient with suspected NAT has to be? If they must be seen by MD or can it be a mid-level?
00:12:56	Michelle Moegling:	Slides will be posted after the Break out session, this afternoon.
00:14:36	Gabrielle Smith:	We assign an ESI 3 or 2 and require patients to be seen by a pediatrician in ED to consult our Abuse specialist for all cases suspected of abuse.
00:17:27	tara davenport:	Thank you!
00:20:10	Laura Garcia:	I am at a community hospital and do not have pediatricians readily available in the ED.  We do not specify a specific ESI for suspected child abuse alone, it is more related to the injury and presentation.  We do try to move the patient into the department right away to avoid elopements.  As far as the provider, we do not specify whether PA, NP or physician needs to see the patient, except by the severity of injuries or ESI level.
00:22:01	Whitney Jerred:	We are just starting to develop our inpatient pediatric program and standardizing ED protocols. What is the standard for taking BP in pediatrics < 5 years?
00:23:37	Robbie Besel:	Our policy states BP taken >2ys unless condition indicates it is needed for a younger child
00:24:31	Kaylee Briolat:	Robbie, ours is the same way. We have it written out along the lines of "BP obtained in those over 2 years old or at the discretion of the physician."
00:24:44	Tibor Bajor:	everyone should get a blood pressure, don't need one right away, our policy is within an hour.
00:25:33	julie mackie:	We also get a blood pressure on everyone or document cap refill if we are unable to get a BP.
00:26:21	Robbie Besel:	I like that, documenting cap refill, can't always get a BP on some kids.
00:27:02	Kaylee Briolat:	our physicians rely heavily on cap refill assessment in children, especially when deciding to put an IV in them.
00:27:11	Michelle Moegling:	If cannot get a BP document behavior. i.e. screaming, kicking, etc along with cap refill.
00:29:56	Laura Garcia:	We wrote our policy to be that every child will get a blood pressure and then addressed the exceptions.  If the child is under 2 for a minor complaint and is otherwise healthy, has all other vital signs that are normal including a normal cap refill, then we can omit a blood pressure.  But if anything is abnormal, they get the blood pressure.  This gets everyone used to taking a blood pressure as a routine rather than the exception.  This requires having size appropriate equipment readily available and staff trained on how to assess.
00:30:23	Lauren Pavletich:	We base our BP's for 2yrs old and under based on ESI level. If ESI 1,2 and 3 we do a BP with initial triage vital signs and if unable d/t screaming/combativeness we will attempt manuals first prior to documenting unable to obtain because an automatic might be too sensitive to take one but you could possibly still get one manually. Otherwise we document cap refill and LOC.
00:31:41	Kaylee Briolat:	"child screams when this worker gets close to them. consolable by mom after staff steps away. easily drinking bottle, cuddling with blanket. tracking staff around room."
00:33:46	Kate Piche:	We require BP's on all pediatric patients despite complaint. Don't want to miss something, especially with the little ones who can speak for themselves. It also drives our sepsis BPA if applicable.
00:40:24	Melissa Mulloy:	Does anyone have any good ideas of intake and funneling of feedback on what does and doesn't work on policies and procedures?
00:43:27	Melissa Mulloy:	thank you!
00:49:43	Melissa Mulloy:	what about for a review process
00:49:46	Nancy McGrath:	we have some generic policies on lapedsready.org
00:49:50	Sally Snow:	ESI | ENA University
00:49:52	Melissa Mulloy:	anyone have any suggestions how to tackle that yearly?
00:52:24	Sandra Chavez:	At our organization patient care policies need review every year, and non-patient care every 2 years.
00:53:54	Melissa Mulloy:	thank you!
00:54:04	Charlene C:	thank you
00:54:04	Robbie Besel:	Thank you
00:54:08	Rodney Pebley:	thanks awesome presentation
00:54:14	Nancy McGrath:	great job Sally!!