mda pediatric transport
DESCRIPTION
MDA Pediatric Transport. Pediatric Emergency Medicine October 13 th 2004. Talk Topics. EMS in Israel. Pediatric EMS in Israel. Pediatric transport in MCI. The Use of Pediatric I/O in MDA. Level Of Treatment. Two Tier System Basic And Advanced Life Support. Basic Level : - PowerPoint PPT PresentationTRANSCRIPT
MDA Pediatric Transport
Pediatric Emergency Medicine October 13th 2004
Talk Topics
EMS in Israel. Pediatric EMS in Israel. Pediatric transport in MCI. The Use of Pediatric I/O in MDA.
Level Of Level Of TreatmentTreatmentTwo Tier System Two Tier System
Basic And Advanced Life Support.Basic And Advanced Life Support.Basic LevelBasic Level : :
B.L.S. Ambulance ( Including rural Ambulances)B.L.S. Ambulance ( Including rural Ambulances)
Medic/Driver (E.M.T) + E.M.T / Volunteer.Medic/Driver (E.M.T) + E.M.T / Volunteer.
E.M.T. Course - 205 Hours.E.M.T. Course - 205 Hours.
125 Ambulances In Morning125 Ambulances In Morningshift. All equipped with A.E.D.’sshift. All equipped with A.E.D.’s
50-150 additional B.L.S. 50-150 additional B.L.S. Units “on call”.Units “on call”.
Level Of Level Of TreatmentTreatment
A.L.S. LevelA.L.S. Level : :
M.I.C.U - Mobile Intensive Care UnitM.I.C.U - Mobile Intensive Care Unit
Physician, Paramedic, E.M.T / Driver. Physician, Paramedic, E.M.T / Driver.
Physicians - From Regional Hospitals.Physicians - From Regional Hospitals.
22 Units In Central Cities.22 Units In Central Cities.
I.C.A - Intensive Care AmbulanceI.C.A - Intensive Care Ambulance
Paramedic, E.M.T / Driver.Paramedic, E.M.T / Driver.
29 Units In Small Cities / Rural Areas29 Units In Small Cities / Rural Areas
ProfessionalProfessional ActivitiesActivities
A.L.S Level Of TreatmentA.L.S Level Of Treatment
•50% Cardiac, Cardiopulmonary, and 50% Cardiac, Cardiopulmonary, and respiratory Problemsrespiratory Problems
•4%-7% Resuscitations4%-7% Resuscitations
•3%-5% Pediatric Cases3%-5% Pediatric Cases
•10%-15%10%-15% Trauma CasesTrauma Cases
Magen David Adom Magen David Adom General and trauma activityGeneral and trauma activity
ALSALS5252
BLSBLS125125
ALSALS150.000150.000
BLSBLS300.000300.000
ALSALS14.00014.000
BLSBLS36.00036.000
AmbulancesAmbulances per Shiftper Shift
CallsCalls per yearper year
Trauma callsTrauma calls per year (12%)per year (12%)
MICU 22MICU 22(Physician)(Physician)
ICA 30ICA 30(Paramedic(Paramedic))
Training of M.D.A. B.L.S. providers
Total 205 course hours. Pediatric resuscitation - 3 hours. Pediatric Trauma – 1hour. Pediatric Emergencies – 1 hour Care of the newly born – 1hour
Training of M.D.A. Paramedics
Total 1565 hours. Stage 1: Class based - 18w. Stage 2: Hospital clerkship – 10w. Stage 3: Mobile Intensive care unit
clerkship 80 shifts.
Pediatric training in the various stages
Stage 1: Pediatric resuscitation - 20h. Pediatric emergencies - 16h. The newly born -6h.
Stage 2: Pediatric ED / PICU - 30h. Labor and Delivery - 30h. Adult and Trauma ED - 100h. Anesthesia – 60h.
Pediatric training in the various stages
Stage 3: MICU – 640h. PALS course. PHTLS course.
Pediatric Prehospital Care
In Israel: 3-5% of EMS calls. In U.S.: 5-10% of EMS calls and only
5% involve life threatening problems.
A weak link in most EMS systems. Controversial issues:
Scoop and Run Vs. Stay and play. A.W. management in trauma.
Pediatric Bone Injection Gun usage in MDA
MDA experience
2 types an adult and pediatric device.
Introduced to all A.L.S. units in 2001.
All attempts to use the device require reporting to medical division on a “special procedure form”.
Success rate
Pediatric BIG
83%
13%4%
good flow
device malfunction
insertion error
Age distribution
47%
24%
29%
0-1y
1-2y
>2y
Indication
Indication
29%
11%
60%
Trauma
SIDS
Other
Prehospital outcome
58%
42%
Alive to ED
pronounced dead
Bus number 2 explosion in Jerusalem
August 20, 2003, 12:35pm EDT
TWENTY KILLED, SCORES HURT IN JERUSALEM BUS BOMBINGA suicide attacker detonated a bomb on a packed Jerusalem bus Tuesday, killing at least 20 people and wounding more than 100.
Time table 21.10- initial phone call: ”explosion
heard”. 21.11- M.C.I. protocol activated. 21.15- First B.L.S. unit at the scene. 21.17- Second B.L.S. unit at the
scene. 21.18- First A.L.S. unit at the scene. 21.27- 5-B.L.S. and 3 A.L.S. units at
the scene.
Time table-evacuation
21.10 Initial call 21.20- 4 non urgent victims
evacuated. 21.21- 2 urgent and 1 non
urgent victims evacuated. 21.38- last urgent victim
evacuated.
Total units activated in this incident
39 B.L.S. units. 9 A.L.S. units. 1 M.C.R.V. Manpower:
Physicians-7 Paramedics-30 E.M.T.s -100
TOTALPr. 3Pr. 2Pr. 1
289910Hadassah E.C. ( level 1)
251852Hadassah M.S. ( level 2)
271854Shaarei Zedek ( level 2)
292630Bikur Cholim ( level 3)
109713216TOTAL
18Dead on the scene
DISTRIBUTIONDISTRIBUTION ofof CASUALTIESCASUALTIES
Pediatric victims
Of the 136 injured 45 were children and babies.
Of the 23 casualties 6 were children. 4 pediatric intubations were made
at the scene. 3 pediatric patients were
transported in secondary diversion.
Jerusalem bus explosion Secondary Diversion
2
2
Shaarei ZedekLevel II
Hadassah EKLevel I
Bikur HolimLevel III
Hadassah MSLevel II
QUESTIONSQUESTIONS
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