Errors in prehospital paediatric resuscitation

paeds

When compared to adult resuscitation, paediatric resuscitation has anatomical, pharmacological, procedural, social, and emotional differences that may make it more difficult and therefore more prone to error.

The authors of this study (full text pdf – NOT hosted on this site) used a simulated paediatric emergency (infant with altered mental status, seizures, and respiratory arrest) to look at errors in paediatric resuscitation by two person EMS teams.

What emerged were issues regarding equipment familiarity/use/misuse, failure to check BSL, and drug errors. Calculations of drug doses were difficult under stress. Failure rates in some of these domains exceeded 50%.

This study, coupled with our low incidence of significant paediatric resuscitation, suggests that we must have ongoing training in paediatric emergencies (simulation and otherwise) to mitigate these risks, and consider new ways of avoiding error. Given the high rate of smartphone use by HEMS personnel, this app is possibly a good start!

 

Motion sickness

airsick

Motion sickness among aeromedical staff is an important factor that may limit our ability to deliver effective in-flight patient care. Having experienced this once in the helicopter (an aerial search of the bays of the Manukau Harbour in gusty winds is not an excursion I would recommend to anyone wanting a sightseeing flight!), I can say that it is truly debilitating.

The Emergency Medical Retrieval Service of Scotland have a published SOP relating to air-sickness, including practical non-pharmacological methods of improving symptoms.

A detailed discussion of motion sickness from Medscape can be found here