Medic One Pediatric (MOPed) cards: standardising paramedic paediatric resuscitation
| Autor: | Lila O'Mahony, Michael R. Sayre, Brandon Woods, Amanda Vander Tuig, Thomas D. Rea, Mary King, David Carlbom, Benjamin Lang, Carolyn B Blayney |
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| Rok vydání: | 2019 |
| Předmět: |
Quality management
Quality Improvement Report Leadership and Management Calculation error medicine.medical_treatment Paediatric resuscitation quality improvement 03 medical and health sciences 0302 clinical medicine medicine Emergency medical services Intubation 030212 general & internal medicine Dosing business.industry Health Policy Public Health Environmental and Occupational Health 030208 emergency & critical care medicine Medication administration medication safety medicine.disease Advanced life support critical care prehospital care Medical emergency teamwork business |
| Zdroj: | BMJ Open Quality |
| ISSN: | 2399-6641 |
| DOI: | 10.1136/bmjoq-2018-000534 |
| Popis: | ObjectivePaediatric resuscitation is highly stressful, technically challenging and infrequently performed by paramedics. Length-based equipment selection, weight-based medication dosing and less familiar paediatric clinical scenarios create high cognitive load. Our project aimed to decrease cognitive load and increase paramedic comfort by providing standardised paediatric resuscitation cards across an entire Emergency Medical Services (EMS) system.MethodsAfter 2 years of collaboration between EMS and regional paediatric subspecialists, we created and implemented a novel set of length-based, colour-coded cards: Medic One Pediatric (MOPed) cards. MOPed cards standardise the approach to paediatric scenarios, such as rapid sequence intubation (RSI), seizure management and cardiac arrest. We standardised drug concentrations across all five EMS agencies to allow for volume-based dosing, removing medication calculations, simplifying the process of medication administration and potentially decreasing both calculation error and time to intervention. We consolidated medications on MOPed cards to the 12 most commonly used in Paediatric Advanced Life Support scenarios. We surveyed 240 EMS personnel before and after implementation to determine use and effect on paramedic comfort.ResultsAfter 12 months of implementation, 97% of respondents reported using the new cards as their primary reference, and 94% reported improved speed and accuracy of medication administration. Specifically, RSI medication administration received the greatest improvement in comfort (p=0.001). Additionally, paramedics increased the use of MOPed cards when selecting endotracheal tubes: 45% of the respondents had done so by 6 months, and 60% had done so after 12 months of implementation (p=0.01).ConclusionsMOPed cards were well adopted across a large EMS system, with improvement in paramedic comfort in managing some paediatric resuscitation scenarios. |
| Databáze: | OpenAIRE |
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