Pediatric EMS study: ‘They’re not little adults’

OHSU study published in Journal of Pediatrics

Mike Verkest, an AMR paramedic and training officer in Multnomah County, shows the different size backboards used for safely moving adults and children, Aug. 20, 2015 (KOIN)
Mike Verkest, an AMR paramedic and training officer in Multnomah County, shows the different size backboards used for safely moving adults and children, Aug. 20, 2015 (KOIN)

PORTLAND, Ore. (KOIN) — It’s a scary situation when a child is having a medical emergency. A new study by researchers at OHSU also finds there is anxiety for many first responders during pediatric calls.

A pediatric guide was developed to help EMS personnel in emergency situations with children, Aug. 20, 2015 (KOIN)
A pediatric guide was developed to help EMS personnel in emergency situations with children, Aug. 20, 2015 (KOIN)

“We see thousands of adult patients every single year, but the pediatric sample that we get is very small,” said Mike Verkest, a paramedic and AMR training officer in Multnomah County. “It’s no wonder that the study identified things like anxiety around pediatric patients and things like that, because they’re not just little adults.”

Verkest said children have a completely different physiology. Paramedics don’t see children very often, which is why the study from OHSU was important.

Of their 65,000 calls for service each year, only about 10% — fewer than 500 — are children under the age of 18.

About the study

The study, part of a multiphase study funded by the National Institute of Child Health and Human Development (National Institutes of Health), covered 44 states and looked at factors surrounding the safety of dealing with children in an emergency.

The study, published in the Journal of Pediatrics, recommends more pediatric doctors should get involved “in EMS training, medical oversight and policy development.”

AMR has been involved since the inception of the study, Verkest said.

In an email to KOIN 6 News,  study director Dr. Jeanne-Marie Guise said, “We are partnering with several local EMS agencies in developing and testing scenarios to provide the additional pediatric training and experience that was reported as a high priority in our national survey, given that actual cases of life-threatening children’s emergencies are relatively infrequent.”

Mike Verkest, an AMR paramedic and training officer in Multnomah County, shows the different size backboards used for safely moving adults and children, Aug. 20, 2015 (KOIN)
Mike Verkest, an AMR paramedic and training officer in Multnomah County, shows the different size backboards used for safely moving adults and children, Aug. 20, 2015 (KOIN)

OHSU gathered the data and then shared it with AMR “so we could work with them to figure out how can we improve pediatric care across the United States, especially here in our area.”

OHSU worked with AMR and the teams at Portland Fire & Rescue to sort through the data and turn it into best practices to help improve emergency pediatric care.

One of the things they found helpful was a pediatric backboard, a child-size plank to safely transport children. They also now have airway devices that are child-size — now “part of our everyday equipment that we carry,” he said.

The study also identified ways the public can help EMS providers: stay calm, designate one person to talk with the first responders, and give first responders adequate room to take care of the child.

“Otherwise you have 10 people barking different things, and it’s a lot for one person to take in,” he said.

There were also errors surrounding medication and miscommunication among team members, OHSU said. However, the study found “these factors ranked much lower than what was seen in in-hospital settings.”

A pediatric guide was developed to help EMS personnel in emergency situations with children, Aug. 20, 2015 (KOIN)
A pediatric guide was developed to help EMS personnel in emergency situations with children, Aug. 20, 2015 (KOIN)

The AMR paramedics also carry a pediatric guide, developed in 2010, that helps cut down on medication errors.

“We compiled a specific pediatric length-based guide that, depending on whatever the emergency is, we have everything figured out for them in advance.”

What’s next

Verkest said the Multnomah County EMS providers go through pediatric training every year. Many paramedics take pediatric advanced life support training every 2 years.

AMR is continuing to assist in the next steps of the OHSU study and will take part in training scenarios with mannequins “that are very life-like. They blink, they cough, they can talk, actually,” he said.

From there they will develop safety issues identified in the study and then train on those.

“We can spread the word and make all responders that much better for pediatric calls,” he said. Their participation is “to help develop those best practices that can be shared with EMS providers across the country.”

“I’m super excited about it,” Verkest told KOIN 6 News. “It raises the opportunity for improvement and that’s what medicine is all about.”

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