New Protocol First Arrest On Route If my patient becomes VSA on route (first arrest) am I to complete the full 20 minutes of resuscitation roadside and then continue transport? Our previous protocol was to complete the full arrest protocol and continue transport. Should you be a short distance from the hospital would a BH patch be suggested or should we perform the 20 mins of resuscitation regardless of proximity to the hospital? Thank you. minutes? I understand the research is trending towards scene times longer than 10 minutes for pediatrics (in some studies) and that earlier epinephrine administration has been associated with ROSC but this also leaves PCP only rural services in a very difficult grey zone to be addressed. I am by no means advocating for a “scoop and run” mentality (the new wording in the directive rules that out quite nicely) but any further guidance or clarification is greatly appreciated!

In pediatric defibrillation, should I round-up, or down with available joule settings? For example, for a 10-month-old who weighs approximately 9.5kg, the initial suggested energy setting would be 19 Joules, followed by 38 Joules. Lifepack allows 15,20,30,50 Joules.

What is considered the most appropriate means of transporting a pediatric patient? Is securing a child/infant in a car seat provided by parents to the stretcher better than securing them in the neonate or pedimate? We have the pull down jump seat for toddler booster seat, but would like to know what our BHPs think of the car seat on stretcher versus pedi/neonate.

Would SWORBHP be ok with ACP paramedics utilizing the 4-2-1 rule for fluid maintenance rates in paediatrics. Especially, with the high incidence of RSV in the community compounded with sick kids who aren’t taking in as much fluids and may be fluid depleted. Their fast respiratory rates and poor feedings, fever etc increases the insensible fluid loss. I can appreciate the current model, for fluid boluses utilizing the 70 mmHg + (2 x age in years). However, at this point they are decompensating rapidly with the hypotension and progressing to pre-arrest (with signs of delayed peripheral and central cap refill, looks sick as per PAT etc). Is the current protocol 15 ml/hr for

Question from an ACP role, For a pediatric patient who has a HR less than 60 with poor signs of perfusion (cyanosis/pale and apneic€¦..start chest compressions with airway and ventilations via BVM. The question is do we follow it up with epi? In the PALS algorithm it states to do CPR/ventilations, epi, atropine and consider pacing. This is covered under the newborn arrest directive however it is not covered under the adult/pediatric medical cardiac arrest. What does our base hospital want us to? Would it be appropriate to follow the PALS Bradycardia algorithm?

For pediatric VSAs, at what heart rate do we initiate compressions?

The updated AHA guidelines indicate an increase in the ventilation rate to 20-30 breaths per minute for children and infants respective in INTUBATED patients. Does this apply to patients who have a supraglottic airway in situ as well? Thank you!

Why is nasotracheal intubation reserved for patients above the age of 8?

Question: For a pediatric VSA do you stay and run the full cardiac arrest, (4 analysis) or should you depart scene after the first analysis if they are in a non-shockable rhythm? PCP question.

Question: How fast can a pediatric Pt. burn through glucose stores? Scenario: Called for a 13y/o unconscious. Consumption of unknown amount of alcohol & unknown drugs or amount. AOx0, GCS 4=E2V1M1. Eyes open to pain as only response. Pt stable vital signs on Primary & throughout transport & BGL 5.8mmol/L on scene. Transport to appropriate children’s hospital code 4 CTAS 2with a 25 min transport time. On ED assessment Pt. was given an amp of dextrose as ED found BGL to be “low”…. or not able to read on meter, so possibly less than 1.6mmol/L. Crew’s service meter DID pass daily test procedure as per manufacturer’s guidelines. Thank you