EMSC Advisory Meeting - December 3, 2018

  1. Introductions

  2. Welcome: Beth Beckman, Chief Nursing Executive of Yale Health Systems and Jason Malia, Clinical Program Director; as well as a special thank you to Denine Baxter for all of her support, dedication and hard work over the years.  Denine was recently promoted and transitioning into her new role at Yale New Haven.  We wish them happiness and success in their new endeavors.

  3. Patient Story

  4. E-Broselow

    The response has been positive.  We will be discussing this more as we break out into smaller groups (what your experience has been, if there are any issues, etc).

  5. Baylor Modules

    35-40 different topics offered as part of the training modules.  Unfortunately, we have not had the amount of registrants that we had hoped for.  If interested the modules will be available until the end of February.


    STEP  1:  Complete  registration  for  program  at

    STEP  2:  During  the  FIRST  WEEK  of  the  NEXT  CALENDAR  MONTH  you  will  receive explicit

    instructions  on  how  to  access  the  modules  (including  username  and  password).  Your access  will  be  for  a  30  day  period  for  that  calendar  month.   If  you  do  not  receive  this

    code  or  have  any  issues  please  contact  cristina.carusone-­  

    STEP  3:   When  you  log­in  to  the  Texas  Children’s  Website  you  will  have  a  “dashboard”  

    with  37  diverse  elective  modules  that  we  have  collated  (complete  list  is  below).  After  

    completing  a  module  you  can  obtain  CEU  credit  through  the  site.  

    STEP  4:  Please  complete  the  two  assigned  modules  on  status  asthmatics  and epilepticus and  then  select  2-3  additional  modules  that  are  of  interest.  

    STEP  5:  Provide  feedback  to  CT  EMSC  and  apply  what  you  learned  to  your  patients.

    STEP  6:  Encourage  your  colleagues  to  sign  up  to  participate  in  this  program!  


    Cristina will send an email with the training information along with this week’s tip.


  6. National Pediatric Readiness Quality Collaborative (NPRQC)

    The teams participating in the initiative have 4 bundles to choose from: Weight in Kilos, Vital Sign Cards, Interfacility Transfers and Disaster. The data is being entered in and we are awaiting reports on the compiled data.  More information to come in case you are interested in implementing some of the things that are teams have tried.


    The team leaders will be attending the January conference, and we will have more information to share.


  7.  ECHO Series

    Dr. Auerbach (in collaboration with Dr. Gunjan Tiyyagura and Dr. Michael Goldman) are working on a slightly different program than ECHO Child Abuse. This will dive into the challenging decisions faced when taking care of children in community hospital as well as the academic children’s centers.


    The sessions will take place on the second Thursday of the month from 1-2pm.  The schedule thus far:

    Dec. 13th - Abdominal Pain - Dr. David Stitelman

    Jan. 10th - Bronchiolitis - Dr. Michael Goldman

    Feb. 14th - Vent Management - Dr. Ric Pierce

    Mar. 14th - Febrile Infants - Dr. Paul Aronson

    Apr. 11th - Airway/RSI - Dr. Joshua Nagler

    May 9th - Seizures - Dr. Niyati Mehta


    To register:


    Cristina will email the information flyer along with the Tip of the Week and the Baylor modules.


  8. Family Advisory Network (FAN)

    The group is working on projects such as File of Life and Stop the Bleed; and the goal is to implement these in the new year.


  9. Certadose – Dr. Mark Notash

    Dr. Notash, Medical Director of Day Kimball, spoke about a new color-bonded kit that works well with Broselow and E-Broselow.  He learned of these new kits at this year’s ACEP Conference.  The syringes are color-coded and should help to eliminate dosing errors, especially in those critical moments.  Some other positives are that these kits are significantly less expensive than the standard and the kits have a long shelf life.


    There are two kits currently being manufactured: (1)  Epinephrine and (2) PALS Syringe Holder.  The PALS Syringe Holder can hold multi-doses of the meds, therefore the provider can use the same syringe to administer another 2 doses.  Going forth, the company has plans to produce other kits ranging from a variety of medications.


    Dr. Notash emailed the PowerPoint presentation to the EMSC group in case you are interested in purchasing these for your hospital.

10. On the Horizon for 2019
      a. Hospital-based

           i.  PEPP courses - Vicki will be teaching PEPP in Weston this coming Saturday (12/8) and next Monday (12/10).  These hybrid courses include  

               modules and hands-on skills.

           ii. Simulations -  these will typically be scheduled for the third Wednesday of each month.  We have already booked January, February and March.*

               If you are interested in having a sim day at your hospital, please contact Vicki to schedule.

           iii. Self-led Simulations

               For scheduling reasons, it is not possible for us to travel to all of the CT hospitals each year.  Dr. Auerbach will be launching Sim Box,   

               which includes an infant simulator and booklet.  This will allow you to hold your own simulations as often as you would like.

           iv. Vital Sign Cards

               We believe that most of the hospitals in the state have received a batch of cards.  If you are out of them, or have not received yours yet, please 

               contact Vicki. With additional grant funding, we will place a reorder of the vital sign cards.

           v. Tip of the Week

               We have been emailing the group a weekly tip to post and share with colleagues and staff.  We have gotten some feedback that the weekly  

               tips can get to be a bit much.  We will talk more about this when we break into small groups.

      b.  EMS agencies

            i.  PEPP Courses and PECC (Pediatric Champions) will be our focus for the coming year.

            ii.  Vital Sign Cards

            iii. Tip of the Week

Small Workgroup Discussion

        1. E-Broselow

            Verify regarding mixing instructions - the concentration used in the system seems to be different.

        2. Baylor modules

            The feedback from those that have taken the training modules said that they were of great quality and only took 15-20 minutes. 

            However, some issues that hospital leadership has run into are that nursing staff wanted to get compensated for the time that they worked on the 

            modules; and the lag time between when they registered and when they received their username/password (it was about a month turn-around). 

            Some suggested that we might get more users to register and use the modules if they would receive CEUs.

       3.  Tip of the Week

            The group feels that the tips are very helpful and some said that they have created a binder so that the staff can easily refer back to them 

            whenever needed.  However, some members mentioned that they do not always get to post/read the weekly tip as soon as it is email out.  Before

            you know it, they are getting another tip.


            To prevent inboxes from getting inundated, some suggest that we switch to a bi-weekly tip instead of a weekly tip.  Another suggestion that was

            brought up is that we focus on seasonal topics, such as burn being that we are now running fireplaces and stoves.

        4.  Post-Transport

             We have heard that the care team would like to find out what happens to a patient after being transported.  Dr. Goldman is currently working on a

             project that would update the medical care team of a patient's status, as well as getting a summary report (both positive and negative feedback)

             as to the care that medical team gave.

        5.  Base Camp

             Some of the members attended a base camp recently and feel that the experience was extremely positive.  They were able to learn while making 

             mistakes without having to worry about what their colleagues thought.  The group asked if we could replicate the program and offer it, even if it

             were on a smaller scale.

        6.  Sepsis

             Some members asked if we could offer resources on sepsis such as a guideline and checklist.

        7.  Pediatric Psychiatry patients.

             As the number of psychiatric issues rises, the group asked if we offer, or could we offer resources such as what to do when caring for a pediatric

             psychiatry patient, and what resources are available once the patient has been discharged such as mobile vans, in-home therapy, etc.

        8.  Stop the Bleed

             Some of the group asked if we will be offering this in the near future.  This is one of the items that the FAN group will be focusing on in the new

             year.  Dr. Karen Della-Giustina graciously offered to be an instructor and we will put her in contact with FAN.  As we know more information, we

             will reach out to the group to ask if anyone else would be interested in teaching as well.

* Since the meeting, April and May 2019 have been booked.  The simulation schedule is filling up quickly.  Please contact Vicki if you are interested in holding a simulation at your hospital.