Emergencies are common. Frequently show up in office
Note very few MDs/RNs have current training
Should receptionist be trained? At least BLS. Who pays for courses?
What if receptionist alone in office? How far is it to the nearest ER? What is the response time to your office if you call 9-1-1?
Practice, practice, practice Equipment of no use if no one knows where it is or how to use it
For medically complex kids, a med info sheet can be critical for hospital staff (read: intensivists!) – should list dx, meds (dose—in mg, not tsp, frequency), allergies, specialists, and BASELINE status. Update frequently
There are several compa
No need for nasal cannula or variety of masks Pulse ox is probably mandatory in today’s office IF you are not going to intubate with any regularity, it is far more important to have good BVM ventilation skills than it is to have airway equipment in your office. (Gausche study, JAMA 2000)
Defib – parents? Should be standard now. IVF – may be able to avoid a pump – use syringes to push in
Meds – need to know drugs, IV, IM, SQ, inhaled, PO dosing chart based on weight needs to be available If keeping IV meds, must have IV equipment!
Check tank periodically, have 2. Store properly
Several companies offer kits with medication and equipment. They also offer services to make sure that the equipment is regularly updated, and medications are not expired
Do not have unlimited supplies, equipment, personnel, etc… so call 911 Do not allow to feed Keep on monitor, if you have one
Intended to be basic review
‘sense of doom’
Watch for signs of impending respiratory failure
Sat monitor critical in decision for hospitalization vs. home Continuous albuterol? Terbutaline vs. epi Terbutatine for pt. not moving air
Sat monitor!
Bounding pulses in sepsis, thready in hypovolemic Blood pressure late finding
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