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Pediatric pain ems

Sriram Ramgopal, Jonathan Elmer, Jeremiah Escajeda, Christian Martin-Gill
OBJECTIVE: To evaluate whether completion of vital signs assessments in pediatric transports by emergency medical services (EMS) differs by patient age. STUDY DESIGN: We reviewed records by 20 agencies in a regional EMS system in Southwestern Pennsylvania between April 1, 2013 and December 31, 2016. We abstracted demographics, vital signs (systolic blood pressure, heart rate, respiratory rate), clinical, and transport characteristics. We categorized age as neonates (≤30 days), infants (1 month to <1 year), toddler (1 to <2 years), early childhood (2 to <6 years), middle childhood (6 to <12 years), adolescent (12 to <18 years), and adult (≥18 years)...
May 11, 2018: Journal of Pediatrics
Hilary A Hewes, Mengtao Dai, N Clay Mann, Tanya Baca, Peter Taillac
IMPORTANCE: Historically, pain management in the prehospital setting, specifically pediatric pain management, has been inadequate despite many EMS (emergency medical services) transports related to traumatic injury with pain noted as a symptom. The National Emergency Services Information System (NEMSIS) database offers the largest national repository of prehospital data, and can be used to assess current patterns of EMS pain management across the country. OBJECTIVES: To analyze prehospital management of pain using NEMSIS data, and to assess if variables such as patient age and/or race/ethnicity are associated with disparity in pain treatment...
March 2018: Prehospital Emergency Care
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVES: The objective was to determine the interobserver agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
December 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Lorin R Browne, Manish I Shah, Jonathan R Studnek, Daniel G Ostermayer, Stacy Reynolds, Clare E Guse, David C Brousseau, E Brooke Lerner
BACKGROUND: The National Association of Emergency Medical Services Physicians' (NAEMSP) Position Statement on Prehospital Pain Management and the joint National Highway Traffic Safety Administration (NHTSA) and Emergency Medical Services for Children (EMSC) Evidence-based Guideline for Prehospital Analgesia in Trauma aim to improve the recognition, assessment, and treatment of prehospital pain. The impact of implementation of these guidelines on pain management in children by emergency medical services (EMS) agencies has not been assessed...
November 2016: Prehospital Emergency Care
Eric V Ernest, Tom B Brazelton, Elliot D Carhart, Jonathan R Studnek, Patricia L Tritt, Genghis A Philip, Aaron M Burnett
UNLABELLED: Introduction Traditionally, Emergency Medical Services (EMS) educators have divided the pediatric population into age groups to assist in targeting their clinical and didactic curriculum. Currently, the accrediting body for paramedic training programs requires student exposure to pediatric patients based entirely on age without specifying exposure to specific pathologies within each age stratification. Identifying which pathologies are most common within the different pediatric age groups would allow educators to design curriculum targeting the most prevalent pathologies in each age group and incorporating the physiologic and psychological developmental milestones commonly seen at that age...
August 2016: Prehospital and Disaster Medicine
Kari B Haley, E Brooke Lerner, Clare E Guse, Ronald G Pirrallo
BACKGROUND: An estimated 20% of patients arriving by ambulance to the emergency department are in moderate to severe pain. However, the management of pain in the prehospital setting has been shown to be inadequate. Untreated pain may have negative physiologic and psychological consequences. The prehospital community has acknowledged this inadequacy and made treatment of pain a priority. OBJECTIVES: To determine if system-wide pain management improvement efforts (i...
November 2016: Prehospital Emergency Care
Lorin R Browne, Manish I Shah, Jonathan R Studnek, Brittany M Farrell, Linda M Mattrisch, Stacy Reynolds, Daniel G Ostermayer, David C Brousseau, E Brooke Lerner
BACKGROUND: Pediatric prehospital research has been limited, but work in this area is starting to increase particularly with the growth of pediatric-specific research endeavors. Given the increased interest in pediatric prehospital research, there is a need to identify specific research priorities that incorporate the perspective of prehospital providers and other emergency medical services (EMS) stakeholders. OBJECTIVES: To develop a list of specific research priorities that is relevant, specific, and important to the practice of pediatric prehospital care...
May 2016: Prehospital Emergency Care
Lorin R Browne, Jonathan R Studnek, Manish I Shah, David C Brousseau, Clare E Guse, E Brooke Lerner
OBJECTIVE: Prior studies have identified provider and system characteristics that impede pain management in children, but no studies have investigated the effect of changing these characteristics on prehospital opioid analgesia. Our objectives were to determine: 1) the frequency of opioid analgesia and pain score documentation among prehospital pediatric patients after system wide changes to improve pain treatment, and 2) if older age, longer transport times, the presence of vascular access and pain score documentation were associated with increased prehospital administration of opioid analgesia in children...
2016: Prehospital Emergency Care
Remle P Crowe, Roger Levine, Melissa A Bentley
OBJECTIVE: In the prehospital setting, helicopter air ambulances (HAAs) are used to bring advanced care to patients and reduce time to definitive care. Research related to emergency medical service (EMS) professionals' access to medical helicopters, protocols for HAA use, and prevalence of HAA transport for different patient types is sparse. Our first objective was to describe EMS professionals' access to HAA and the prevalence of written protocols regarding their use. Next, we looked at HAA use for specific patient types (trauma, nontraumatic chest pain, stroke, and pediatric)...
November 2015: Air Medical Journal
Leigh Ann Diggs, Manasi Sheth-Chandra, Gianluca De Leo
Children have unique medical needs compared to adults. Emergency medical services personnel need proper equipment and training to care for children. The purpose of this study is to characterize emergency medical services pediatric basic life support to help better understand the needs of children transported by ambulance. Pediatric basic life support patients were identified in this retrospective descriptive study. Descriptive statistics were used to examine incident location, possible injury, cardiac arrest, resuscitation attempted, chief complaint, primary symptom, provider's primary impression, cause of injury, and procedures performed during pediatric basic life support calls using the largest aggregate of emergency medical services data available, the 2013 National Emergency Medical Services Information System (NEMSIS) Public Release Research Data Set...
2016: Prehospital Emergency Care
Amaly Rahman, Sarah Curtis, Beth DeBruyne, Sunil Sookram, Denise Thomson, Shari Lutz, Samina Ali
INTRODUCTION: The undertreatment of pediatric pain is a significant concern among families, clinicians, and researchers. Although some have examined prehospital pain management, the deterrents to pediatric analgesia administration by Emergency Medical Services (EMS) have not yet been examined in Canada. Problem This study describes EMS pain-management practices and prehospital provider comfort treating pediatric pain. It highlights differences in pain management between adults and children and assesses the potential barriers, misconceptions, difficulties, and needs related to provision of pediatric analgesia...
February 2015: Prehospital and Disaster Medicine
Matthew Hansen, Garth Meckler, Caitlyn Dickinson, Kathryn Dickenson, Jonathan Jui, William Lambert, Jeanne-Marie Guise
OBJECTIVE: Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. METHODS: The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels...
April 2015: Prehospital Emergency Care
Greg Friese
Finally, always let training objectives drive the training methodology. An objective to review a pain management protocol is easily accomplished by acknowledging receipt and reading of an electronic document. An objective to assess and appropriately treat a pediatric patient with pain secondary to musculoskeletal trauma is better accomplished through case review and simulation. Opportunities for online CE are continuing to expand. Smartphones and tablets are encouraging educators to develop training content that has increasing interactivity and immediate feedback...
November 2013: JEMS: a Journal of Emergency Medical Services
E Brooke Lerner, Peter S Dayan, Kathleen Brown, Susan Fuchs, Julie Leonard, Dominic Borgialli, Lynn Babcock, John D Hoyle, Maria Kwok, Kathleen Lillis, Lise E Nigrovic, Prashant Mahajan, Alexander Rogers, Hamilton Schwartz, Joyce Soprano, Nicholas Tsarouhas, Samuel Turnipseed, Tomohiko Funai, George Foltin
OBJECTIVE: To describe pediatric patients transported by the Pediatric Emergency Care Applied Research Network's (PECARN's) affiliated emergency medical service (EMS) agencies and the process of submitting and aggregating data from diverse agencies. METHODS: We conducted a retrospective analysis of electronic patient care data from PECARN's partner EMS agencies. Data were collected on all EMS runs for patients less than 19 years old treated between 2004 and 2006...
January 2014: Prehospital Emergency Care
Daniel P O'Donnell, Luke C Schafer, Andrew C Stevens, Elizabeth Weinstein, Charles M Miramonti, Mary Ann Kozak
BACKGROUND: Pain associated with pediatric trauma is often under-assessed and under-treated in the out-of-hospital setting. Administering an opioid such as fentanyl via the intranasal route is a safe and efficacious alternative to traditional routes of analgesic delivery and could potentially improve pain management in pediatric trauma patients. OBJECTIVE: The study sought to examine the effect of introducing the mucosal atomization device (MAD) on analgesia administration as an alternative to intravenous fentanyl delivery in pediatric trauma patients...
October 2013: Prehospital and Disaster Medicine
Young Ho Kwak, Do Kyun Kim, Hye Young Jang
This study was conducted to examine the nation-wide emergency department (ED) utilization pattern by children in Korea. Most referral hospital EDs provide their essential ED information to the National Emergency Medical Center through the National Emergency Department Information System (NEDIS). We analyzed the NEDIS data on pediatric visits (< 19 yr old) during three years, from June 1, 2008 to May 31, 2010. A total of 2,072,664 children visited 124 EDs during the study period, and this patient population comprised 31...
October 2012: Journal of Korean Medical Science
David M Williams, Kirsten E Rindal, Jeremy T Cushman, Manish N Shah
OBJECTIVE: To identify and investigate the barriers and enablers perceived by paramedics regarding the administration of analgesia to pediatric emergency medical services (EMS) patients. METHODS: This was a qualitative study in which in-depth semistructured interviews of a purposively-sampled group of 16 paramedics were performed before achieving redundancy. The interviews were structured and the data were thematically analyzed. Emerging themes were categorized into four domains, and novel themes were identified and further explored...
October 2012: Prehospital Emergency Care
Konstantinos N Stamatiou, Ioannis Heretis, Dimitrios Takos, Vaios Papadimitriou, Frank Sofras
PURPOSE: To compare the efficacy and safety of the electromagnetic lithotripter in the treatment of pediatric lithiasis to that of the earlier electrohydraulic model. MATERIALS AND METHODS: Two groups of children with lithiasis aged between 10 and 180 months who underwent extracorporeal shock wave lithotripsy (ESWL). In the first group (26 children), ESWL was performed by using the electrohydraulic MPL 9000X Dornier lithotripter between 1994 and 2003 while in the second group (19 children) the electromagnetic EMSE 220 F--XP Dornier lithotripter was used from April 2003 to May 2006...
November 2010: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Julie C Leonard, Nathan Kuppermann, Cody Olsen, Lynn Babcock-Cimpello, Kathleen Brown, Prashant Mahajan, Kathleen M Adelgais, Jennifer Anders, Dominic Borgialli, Aaron Donoghue, John D Hoyle, Emily Kim, Jeffrey R Leonard, Kathleen A Lillis, Lise E Nigrovic, Elizabeth C Powell, Greg Rebella, Scott D Reeves, Alexander J Rogers, Curt Stankovic, Getachew Teshome, David M Jaffe
STUDY OBJECTIVE: Cervical spine injuries in children are rare. However, immobilization and imaging for potential cervical spine injury after trauma are common and are associated with adverse effects. Risk factors for cervical spine injury have been developed to safely limit immobilization and radiography in adults, but not in children. The purpose of our study is to identify risk factors associated with cervical spine injury in children after blunt trauma. METHODS: We conducted a case-control study of children younger than 16 years, presenting after blunt trauma, and who received cervical spine radiographs at 17 hospitals in the Pediatric Emergency Care Applied Research Network (PECARN) between January 2000 and December 2004...
August 2011: Annals of Emergency Medicine
George L Foltin, Peter Dayan, Michael Tunik, Mollie Marr, Julie Leonard, Kathleen Brown, John Hoyle, E Brooke Lerner
UNLABELLED: Up to 3 million US children are cared for by emergency medical services (EMSs) annually. Limited research exists on pediatric prehospital care. The Pediatric Emergency Care Applied Research Network (PECARN) mission is to perform high-quality research for children, including prehospital research. Our objective was to develop a pediatric-specific prehospital research agenda. METHODS: Representatives from all 4 PECARN nodes and from EMS agency partners participated in a 3-step process...
October 2010: Pediatric Emergency Care
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