Research Report Highlights IO Access in Pediatric Population

A new study reported in Pediatric Anesthesia analyzes anatomic dimensions of the proximal tibia in the pediatric population with respect to intraosseous needle placement and needle tip position. Authors report that “radiographs from 190 patients (104 boys/86 girls) were included. When fully inserted to skin level, up to 10.5% of needles do not reach medullary cavity at one and 18.5% at two patient's fingerbreadths distal to tibial tuberosity. The opposite cortical wall is touched or penetrated in 16% and 25%, respectively. Up to 96% of too deep needle tip positions occur in children younger than 24 months, as do too superficial tip positions in 59%.” Conclusions suggest that infants and toddlers are at highest risk for malpositioning. Access the article at https://onlinelibrary.wiley.com/doi/full/10.1111/pan.13979

AHRQ Highlights Patient Handoff Tool for Pediatrics

A new article based on research funding from the Agency for Healthcare Research and Quality (AHRQ) describes one pediatric hospital’s experience adapting and implementing the I-PASS handoff program for inpatient nursing bedside report, physician handoff, and imaging/procedures handoff. The project demonstrates that I-PASS can be successfully used across a hospital system in various settings to reduce handoff-related errors. Click here to read more.

The National Association of State EMS Officials (NASEMSO) Joins National Orgs on Uniform Guidance in Prehospital Use of Ketamine for Trauma Patients

Several national associations have collaborated to establish consensus-based uniform guidance on the use of ketamine in the care of the trauma patient. It is intended for use by emergency medical services (EMS) personnel, EMS medical directors, emergency physicians, trauma surgeons, nurses and pharmacists in their treatment of acute trauma patients both in and out of the hospital and within their respective domains. The document, now published online in Prehospital Emergency care, is not intended to be a comprehensive discussion of pain control options in the trauma patient. Instead, it combines the collective expertise of the author organizations with current published evidence to offer unified guidance on the role of ketamine in this patient population. Dr. Aaron Burnett, State EMS Medical Director for MN, represented NASEMSO on the panel. Read more at https://www.tandfonline.com/doi/full/10.1080/10903127.2020.1801920.

New resource! Take a look at this new AAP advocacy report, which details the Academy's COVID-19 related efforts at the state and federal level.

Last week, the AAP joined with five other leading medical organizations in sending a letter to congressional leadership expressing the urgent need to support the nation's immunization infrastructure and the physicians who deliver needed vaccinations to children and families.

"A strong vaccine delivery system must be an essential part of the strategy to end the COVID-19 epidemic," the groups said. "It is critical to ensure that as many patients as possible catch up on missed vaccinations, receive the flu shot this fall, and receive a COVID-19 vaccine when it is available."

Please continue to visit this AAP webpage for critical updates on COVID-19, including this page for advocacy information.

State-level reports are the best publicly available data on child COVID-19 cases in the United States. The AAP and the Children’s Hospital Association are collaborating to collect and share all publicly available data from states on child COVID-19 cases (definition of “child” case is based on varying age ranges reported across states; see report Appendix for details and links to all data sources).

On October 1, the age distribution of reported COVID-19 cases was provided on the health department websites of 49 states, New York City, the District of Columbia, Puerto Rico, and Guam. While children represented only 10.6% of all cases in states reporting cases by age, over 657,000 children have tested positive for COVID-19 since the onset of the pandemic.

A smaller subset of states reported on hospitalizations and mortality by age, but the available data indicated that COVID-19-associated hospitalization and death is uncommon in children.

At this time, it appears that severe illness due to COVID-19 is rare among children. However, states should continue to provide detailed reports on COVID-19 cases, testing, hospitalizations, and mortality by age and race/ethnicity so that the effects of COVID-19 on children’s health can be documented and monitored. Access a summary of findings (data available as of 10/1/20) by clicking here .

The first week of October, NEDARC staff emailed data quality reports regarding the EMS agency contact information in the online Contact List Management System. These reports are designed to reduce the burden for EMS for Children Program Managers in their efforts to update and verify this information which is vital to the 2021 data collection from EMS agencies. EMS for Children Program Managers are urged to schedule time with their NEDARC technical assistance liaison to review these data quality reports before the end of October.