Pediatric Clinical Practice

 

Lost in the OB Desert

Johanna Thompson, BS, FP-C, CCP-C, CP-C, TP-C, C-NPT
Life Link III

Maternal morbidity and mortality are on the rise in the United States, particularly in rural and underserved areas known as "OB deserts," where access to obstetric care is severely limited. This session will explore EMS providers' critical role in managing obstetric emergencies in these challenging environments.

Participants will analyze key assessment findings, vital signs, and appropriate prehospital interventions through an engaging case study of an eclampsia patient. The session will then examine the impact of OB deserts, presenting alarming statistics and discussing the systemic loss of maternal healthcare services in the United States.

To improve outcomes, we will explore solutions such as robust EMS guidelines, structured flowcharts, continuing education through simulated scenarios, and the integration of real-time medical direction. Participants will leave with actionable strategies to enhance their preparedness and response to obstetric emergencies. A Q&A and wrap-up discussion will conclude the session.

Mama Mia, Here We Go Again.....My My, Improving OB Care!

Amy Loucks, RN, BSN, CCRN, CFRN, EMTP, FPC
University of New Mexico Hospitals Lifeguard Emergency and Critical Care Transport

Maternal health is at a crossroads. While advances in obstetric care continue, challenges in maternal morbidity and mortality such as hemorrhage, hypertension, sepsis and health disparities don't just persist, but are getting worse. How can we ensure every mother receives the highest quality care?

This engaging and interactive session will explore the latest advancements and evidence-based strategies in obstetric care to improve outcomes. From early risk identification to timely interventions to standardized protocols, we'll dive into solutions you and your team can implement. Gain actionable insights and best practices to improve outcomes for mothers and babies everywhere! Come be part of the solution to make a lasting impact on maternal care!

Milk, It Does a Body Good…or Does It Almost Kill You? Pediatric Non-Allergic Near-Death Milk Experience

Teri Campbell, MSN, RN, PHRN, CEN, CFRN
University of Chicago UCAN

We’ve all heard the tagline. Our moms served milk with every meal. Come to this shocking pediatric case study to learn how the interface of Autism, ARFID, and milk led to a profound pericardial tamponade and near-lethal cardiovascular consequences. Milk mustache optional!

This lecture will define ARFID, a new(er) eating disorder and describe how patients with Autism Spectrum Disorder are at risk. Participants will learn about the pathophysiology of milk-induced anemia and how the profound iron deficiency affects every system in the body. Parents often do not seek medical care until the child has significant anasarca. This case study is unique as this child had 350cc in a pericardiac effusion tamponade related to third spacing from the iron deficiency anemia, that required urgent cath lab intervention. Complicating care was a hemoglobin of 1.36 and a hematocrit of 5! How was this child alive?

Pediatric Jeopardy: What You Should Know for Kids During Transport

Jennifer Flint, MD
Children's Mercy Hospital

This an interactive Jeopardy session that caters to all learners. Whether you want to sit in the front row and actively participate in the audience response system and compete against your peers, or sit in the back as a silent observer, all will enjoy this engaging session on pediatric transport.

Learners can test their knowledge on a variety of pediatric topics specific to transport medicine and can compete as an individual or as a team. Categories include Trauma Rama , O baby, AMS, teenagers with bad decisions, what's the status asthmaticus, and pediatric transport potpourri. A variety of questions including True/False and multiple choice will be followed by short answers, evidence-based explanations, or short videos demonstrating content in true Jeopardy style using a platform with Jeopardy tiles and score-keeping technology.

Additional Jeopardy questions will be available at the CMH booth for learners who want more content or a more in depth discussion of the learning objectives.

Tiny Patients, Big Lessons: Neonatal Case Studies

Callie Searley, BSN, C-NPT
Children’s Hospital Colorado

This lecture offers flight team professionals an in-depth exploration of neonatal cases that can be encountered in transport, focusing on critical conditions of the newborn. Using real-life case studies, participants will examine key clinical signs, diagnostic tests and transport considerations for managing critically ill infants from birth through 1 month of life. The participants will engage in interactive discussions on differential diagnoses, lab work, physical exam, treatment options and transport considerations for each case. They will gain insight into current neonatal transport protocols, including updated NRP recommendations. Explore the clinical presentation of a three-week old infant with "breath holding spells" and possible seizure activity. Examine the complexities of a neonatal resuscitation during an emergency delivery at rural ED, including a discussion on PALS vs NRP. Discuss the current recommendations for neonatal RSI for a five-day-old with apneic episodes and what the underlying etiology might be. This lecture is designed to provide healthcare professionals with the knowledge and tools necessary to handle high-risk neonatal and pediatric transports, ultimately improving outcomes for critically ill and injured infants.

APRV in Kids: The Good, The Bad and The Ugly

Jennifer Flint, MD
Children's Mercy Hospital

This is a case-based discussion on how to use APRV in children. Cases include a near-drowning patient with ARDS and a patient with Glenn single ventricle physiology with bronchiolitis. This talk will discuss clinical indications for APRV during transport and how APRV works physiologically. Case-based presentations will guide the learner on how to transition from traditional modes of ventilation to APRV, how to pick initial settings, and how to titrate settings in addition to what hemodynamic and ventilator waveforms to monitor during the transition.

A brief overview of cardiopulmonary interactions using APRV as a ventilation strategy will also be discussed. This will include review of a paper describing the hemodynamic changes associated with APRV compared to conventional ventilation in pediatric patients with right ventricular dysfunction and/or Cavo pulmonary shunts such as the Glenn and Fontan circuit. This talk will also discuss some of the risk and difficulties with APRV, especially in younger patient populations.

Hypotension in the Neonate: They're NOT Just Little Adults

Chad Barber, MD
Cook Children's Medical Center

What is hypotension in a neonate and how do you treat it appropriately? Is this based purely on the mean blood pressure, or are there other factors to consider? When a baby is born and the cord is cut, many things change. As the cardiovascular system of a preterm neonate matures over time, the actual composition of a baby's cardiac structure changes, which impacts how babies respond to different pressors.

This session will review the physiological development of the preterm and term newborn's cardiovascular system, and attempt to define hypotension in the newborn. Then, we will explore various treatment options, including volume expanders and different pressors. Once you understand the physiology, the treatment options and how they work in both preterm and term neonates, you can make a more informed decision when choosing the best pressor for your patient, no matter their gestational age. You will become confident in managing hypotension in neonates, even if your treatment choices are limited while transporting our tiniest patients.

Paramedic Led Air Medical Transport of Conjoined Twins

Othman Basawil, AlphaStar Air Ambulance
Bader Al-Motariri, FPC-PNCCT, AlphaStar Air Ambulance

In this presentation, we will present a case study for the air medical transport of conjoined twins for the first time by certified and highly trained flight paramedics. This presentation will focus on the history of the patients, pre transportation management, transportation challenges, flight paramedic training, and required teamwork for a successful transfer. Neonatal air transport is complex, requiring specialized skills, advanced planning, and multidisciplinary coordination to ensure patient safety.

This real-life case study of transporting conjoined twins will detail the clinical conditions, transport logistics, and obstacles faced during the mission. This includes equipment modifications, space limitations, and in-flight medical care essential for neonatal transfers.

Additionally, we will highlight the training provided to flight paramedics, covering neonatal resuscitation, ventilator management, and handling critical conditions mid-flight. The session aims to share key lessons learned and best practices to improve the safety and efficiency of neonatal air medical transport, ensuring better outcomes for critically ill infants.

Tiny Baby, Big Problem: Neonatal Transport Strategies for The Smallest Patients

Courtney McLean, MD, MS, Children's Nebraska

In the United States, about 10.4% of all births are born premature. Ideally, preterm infants are transported before birth to a delivery hospital with appropriate NICU capabilities. However, premature babies can be born anywhere. The smaller the infant, the more complex and fragile the infant may be. The smallest of patients will require the smallest of equipment and specialized neonatal teams and incubators to stabilize and transport. In this session, we will review the risks, rates and outcomes of premature infants. This session will help educate why premature infants are at such high-risk during transport and what steps teams can take to be aware and prepared for the smallest of patients.

Learn skills, techniques and necessary supplies to help transport the smallest infants.