Armando Suarez Del Real seeks to accomplish sky-high goal as a PECC

Armando Suarez Del Real (R) and colleague Adam Livingston (L) (photo credit: Children’s Health Alliance of Wisconsin)

Armando Suarez Del Real just wants to help people, which is why he chose to be a Pediatric Emergency Care Coordinator (PECC) in his role as captain of the West Allis Fire Department.

The 39-year-old Milwaukee native has been a firefighter for over two decades and became the West Allis FD PECC almost eight months ago. When Suarez Del Real learned about the PECC program, he wasted no time getting the department enrolled.

To read more about Armando, please visit the Children’s Health Alliance of Wisconsin.

Best Practices for Pediatric Transport in The Ambulance

The “Working Group Best-Practice Recommendations for the Safe Transport of Children in Emergency Ground Ambulances,” a 2012 document published by NHTSA, tackles this very topic. Some states have even adopted their own administrative language toward the requirement of having appropriate pediatric transport devices stocked on all ambulances. And, following suit, multiple product vendors have developed devices that can either be affixed to a standard EMS cot, secured over a restrained parent on the cot, or even integrated into forward or backward facing seating within the patient compartment of the ambulance.

7 Safety Considerations for Pediatric Transport:

• Do tightly secure all monitoring devices and other equipment
• Do ensure available restraint systems are used by EMTs and other occupants, including the patient
• Do transport children who are not patients, properly restrained, in an alternate passenger vehicle whenever possible
• Do not leave monitoring devices and other equipment unsecured in moving EMS vehicles
• Do not allow parents, caregivers, EMTs or other passengers to be unrestrained during transport
• Do not have the child/infant held in the parent’s, caregiver’s or EMT’s arms or lap during transport.
• Do not allow emergency vehicles to be operated by persons who have not completed the DOT NHTSA Emergency Vehicle Operating Course (EVOC), National Standard Curriculum, or its equivalent

Prehospital Airway Management: A Systemic Review

Airway management is one of the most important aspects of prehospital care. It is critical to patient survival and it affects the potential for recovery from emergent illness or injury. Airway management includes ventilation assistance to promote oxygenation and may include protecting against aspiration, depending on the management approach. Historically endotracheal intubation has been considered the gold standard for airway management. However, the primary objective in the prehospital setting is to assure ventilation of the patient until the transfer of care to an emergency department (ED) or hospital.

Specifically, this review will focus on comparing the benefit and harms across three different airway management approaches: bag valve mask (BVM), supraglottic airway (SGA), and endotracheal intubation (ETI).

Given the possible variations in the prehospital setting, this review will also consider how the benefits and harms may differ across the following factors: (1) patient characteristics (e.g., demographics, type and severity of illness or injury, and the patient location/environment); (2) the techniques and devices used for each airway management approach; and (3) the characteristics of the EMS personnel (e.g., training, certification, and expertise).

As part of an effort to conduct a systematic review of the scientific evidence related to prehospital airway management, the Evidence-based Practice Center (EPC) Program at the Agency for Healthcare Research and Quality (AHRQ) is seeking unpublished scientific information relevant to the topic. The results of this request for information and systematic review will support the development of evidence-based recommendations and guidelines for prehospital airway management. The research protocol, which includes the review's scope, key questions and inclusion and exclusion criteria, was recently finalized and is available online.