Pediatric Training

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EMSSam

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As I'm sure a lot of trainees do, I struggle to deal with pediatrics. I barely know where to start! They're like another species to me.

Can anyone recommend a good book or some other resources which could help me out in dealing with kids?

Thank you
 
Do you mean you struggle with Ped protocols? Or do you struggle mentally/emotionally during tx?
 
Not so much the protocols but yes interacting with them I find difficult.
 
If you have trouble interacting with kids it would seem the solution is to interact with them more, not read a book about them?
 
Go to youtube, learn some songs... It takes me two choruses of the Spongebob theme song to get respirations.. I quietly sing it to the child while I count breaths or check a pulse.. Sometimes they'll join in.

Eye level... If the situation allows, don't tower over them.. You're a scary stranger. Try not to make unnecessary eye contact. Gentle smiles that don't show all your teeth.. No one like a creep with huge fangs.. If mom/dad are in an emotional state to be helpful, let them..

Find somewhere to volunteer. YMCA, babysit a nephew, a day camp, somewhere you can go to get comfortable. Our FD reserves one Saturday a month to do birthday parties for little kids, they're always looking for someone to help host, put on the Smokey bear suit and dance around like an idiot..

Look around, ask around it's not something you can learn by reading.
 
you just have to talk like a little kid would and be very patient. i know it's tough but you just need more interaction with them
 
Start hanging around kids more. Not like a creeper at a park or anything, but do you have any friends/family with young kids?

Get comfortable holding smaller children. Support the necks for infants/neonates, don't drop them.

I find that giving the younger kids a penlight works sometimes (most of the time they'll throw it on the ground...sometimes shine it in their own eyes...or yours). Blowing up a glove and showing them how to pull on the knotted end to launch it is fun. For the kids that are really upset I keep a cheap (brand new) teddy bear in the rig, giving it to the child only after asking the parents if it's OK.

*Edit*

One more thing to add.

I've had a ped or two that wanted to be held during Tx when we had them in a pedimate on the gurney or in the child seat on the gurney.

Usually playing with them (or the aforementioned teddy bear) works.

As much as I might wanna comfort a ped (especially when they are crying!) my concern would be a sudden braking or a swerve that would have either me or the child being injured.
 
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Volunteer at a Children's hospital! We have tons of volunteers where I work. It's amazing once you get comfortable around children to see how different their little personalities can be even at the earliest of ages.

Start your exam from the feet up. Play with them, smile, don't look scary or nervous. Be honest with them. (Age appropriate) include them in their care and decisions, when appropriate.
 
Last night I watched one of the new urgent care RNs pull some Oobi eyes out of pocket and put them on her hands.. Holycowmonkeys, it was brilliant. It's some kids' TV show on cable, the kid knew instantly what it was about..

She spoke as a hand puppet, got vitals without any problems, it was the most entertaining thing I've seen all week..

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PALS, PEPP, EPC, PTLS.


Try to see if your agency can get your some clinical time at the local pediatric facility, or if your med-director knows a pediatrician who will let you work with them in the office for a bit.
 
Broselow tape is a good resource if you're not already using it and then the Pals book of course, but that is ALS. Other than that its just memorization. They metabolize quicker and have smaller bodies is the brunt of it I think.
 
Lil Medic said:
Broselow tape is a good resource if you're not already using it and then the Pals book of course, but that is ALS. Other than that its just memorization. They metabolize quicker and have smaller bodies is the brunt of it I think.
Click to expand...

Lol, you think it is that simple?

If you have ever taken a biology course you may have studied life stages of various creatures like insects.

Humans have the same thing. The very proteins of blood cells change over time. As does metabolism, major immune system changes, I could go on...

There is much to know about peds.
 
Veneficus said:
Lol, you think it is that simple?

If you have ever taken a biology course you may have studied life stages of various creatures like insects.

Humans have the same thing. The very proteins of blood cells change over time. As does metabolism, major immune system changes, I could go on...

There is much to know about peds.
Click to expand...

(The friendly version)

Well, this is a BLS discussion. He is a trainee. For any interventions that he could possibly be concerned with, that is the easiest information for him to get ahold of to help him grasp the subtleties of what his job is. I put it very simply. I could have told him to to go to school for 8 years, and specialize in pediatrics, but that wasn't what he was looking for. Obviously pediatric treatment is extremely different from adult treatment for some of the very reasons you listed. It is a topic that pre-hospital education does not go into enough detail on, in my opinion. But that's why we have broselow tapes and medical control. Because we don't need to be pediatric physicians. What he was looking for was some material to help him with his interactions, introductory assessment and basic treatments of children.

As far as introductory interventions and procedures go, I think those are two solid core concepts, faster metabolic rate and smaller/proportioned bodies. Just trying to help.
 
EMSSam said:
As I'm sure a lot of trainees do, I struggle to deal with pediatrics. I barely know where to start! They're like another species to me.

Can anyone recommend a good book or some other resources which could help me out in dealing with kids?

Thank you
Click to expand...

Your best and most reliable resource in the field is always going to be parents,siblings or care givers.

Find a pediatric assessment class,most providers recieve very little training when it comes to dealing with peds let alone how to do a proper pediatric specific assessment.
 
There's no substitute for lots of experience. You just have to treat a lot of patients.

If it is any consolation, most EMS folks struggle with peds, mostly due to lack of exposure.

I agree with a few earlier posters. If you can get in some clinical rotation time at a peds hospital, that would be ideal.

PALS, PEPP, PEARS, etc. are only as good as the instructor who teaches them, which usually means...not very good at all. Most of the instructors typically have as little experience as the folks they are teaching, and they just got the card course and teach without much depth of experience.

If you do take a course, I think PEARS would be good for a basic level provider. Take it at a pediatric specific facility. Don't go to a fly by night operation. I promise the education will be better.
 
CANMAN13 said:
Start your exam from the feet up.
Click to expand...

There's lots of really good advice in this thread but this specific piece is HUGE.

If you start at the head and work down they're usually going to freak because they don't know what you're doing and think you may be trying to hurt them. If you start from the feet up they can watch you and see what you're doing and, in my experience, are perfectly ok with you touching them by the time you get to the torso and head.

Getting down to their level is key as well, I believe it was already said but I skimmed through pretty quickly.

I always let kids play with stuff before I use it on them. Stethoscope? If they want to, put it in their ears and let them listen to your lungs/heart tones first before you auscultate them, time permitting of course.

I've found that the SpO2 stickers work much better than the reusable ones as well.
 
Lil Medic said:
As far as introductory interventions and procedures go, I think those are two solid core concepts, faster metabolic rate and smaller/proportioned bodies. Just trying to help.
Click to expand...

What made you pick those 2 things?
 
Robb said:
There's lots of really good advice in this thread but this specific piece is HUGE.

If you start at the head and work down they're usually going to freak because they don't know what you're doing and think you may be trying to hurt them. If you start from the feet up they can watch you and see what you're doing and, in my experience, are perfectly ok with you touching them by the time you get to the torso and head.

Getting down to their level is key as well, I believe it was already said but I skimmed through pretty quickly.

I always let kids play with stuff before I use it on them. Stethoscope? If they want to, put it in their ears and let them listen to your lungs/heart tones first before you auscultate them, time permitting of course.

I've found that the SpO2 stickers work much better than the reusable ones as well.
Click to expand...

Indeed! You take a little human in physical pain, add some stranger danger, throw in bizarre equipment that you're planning on putting on their body, escalate the stress of their caregiver, and then try to invade their personal space.. They're going to go in lockdown/defense mode and view everyone as a threat..

There's three kinds of peds, an unresponsive one where you don't have to worry about your approach and how they view you. The screaming-out-of-control ped where you don't have to worry too much about your bedside manner because it's doubtful you can calm them down. And and the responsive terrified one who's watching every move you make and JUDGING you.

Starting out slow, being gentle, smiling while you check a babinski reflex (if time allows), counting their piggy toes, singing the "toe bone's connected to the foot bone" song... Taking the extra time to show you're not a threat can ultimately save time and make it easier as you get to more important parts of the exam where accuracy is vital.

Peds are like dogs and bees, they can smell your fear. They're so stinking receptive to body language and tone of voice.
 
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