65 Defenses and Pediatrics

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(45:41) Lots of stuff on pediatrics and the body’s defenses. Let’s try a slightly different version of the show notes. Here’s my actual outline from the show.

From last week’s episode

Laryngospasm
Article about post op laryngospasm and management
1. succacoline does stop laryngospasm
2. ultimately they used lidocaine and did a “bilateral superior laryngeal nerve block”

What I Did this week

Medical Emergencies

Review of system defenses, mostly at the cellular level
Antigens and antibodies
Why you get a fever. An increase in temp makes bacteria unable to replicate their cell walls.
Anaphylaxis

Special Populations

Pediatrics
Continuing education: PALS, PEPP, APLS, PPC
Have you heard that sugar has a sedative effect on neonates?
“Don’t give them a glove to play with”
What do you talk to preschoolers about?
“Promote a sense of control, but don’t negotiate” – Kelly Grayson
PAT and TICLS
CUPS “We’re all good at extremes. A skilled provider is finding the middle and stopping it before it gets worse.”
EDD is contraindicated in pedi intubations
DOPE – what to check with ET isn’t working, Displacement, Obstruction (secretions), Pneumothorax, Equipment Failure
Do you use a Buratral
Foreign Body Airway Obstructions
Give St John’s a break. You do do back blows in pedi FBAO. (Responsive Infants – this isn’t under 15 months)

Clinicals

No babies being born
Kelly rants about L&D nurses.
Benydrill as a local anesthetic

Starting to review for Med Emergency exam on Monday
Tips on learning drugs and doses

Out of Side Kicks

Mentions:

Peter Gabriel – Sledgehammer video
St John’s Popcorn Video
The Management and Treatment of Recurrent Postoperative Laryngospasm (Full Text PDF)
KidO’s Bear
NIC the Dragon
Pediatric Advanced Life Support (PALS)
PEPP
APLS
ENPC – Emergency Nursing Pediatric Course
PPC appears to now be
EPC
The Sexual Assault Nurse Examiner – SANE

Listener Questions

None this week, send us yours

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  • Christine

    Not sure why, but I seem to get a LOT of pedi calls.  Way more than the average “10%”.  I have found that for a lot of kids (especially reading age), cell phone games are a cool reward for being brave during procedures.  They really seem to like the “Moron Test” app on my iPhone.  You definitely have to place a time limit on it though or you will never get your phone back.

    I had to laugh about the whole SANE nurse thing!  Yes, they carry a HUGE kit.  Experience has also taught me that you NEED to know where they are located.  Calling facilities while on scene before transporting is a great idea.  Some only have SANE coverage during certain hours of the day and if you transport a sexual assault to somewhere without a SANE nurse, they will need to be transported to another facility ASAP.  ER’s are not very happy if you did not do your homework first.  There is also a big difference between adult and pedi SANE capabilities and just because they can handle adults does not mean they do pedis.  These are also typically horrible calls.  Get your Kleenex box out, be prepared for an adult who is a basket-case, and don’t be afraid to ask for help for yourself after the call if you need it.