EMS World

JAN 2019

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

Issue link: https://emsworld.epubxp.com/i/1061435

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Page 39 of 51

EMSWORLD.com | JANUARY 2019 39 Assess pulse oximetr y intermittently with adequate s aturation level being 90% or bet ter. In ca ses of sus tained desaturation below 90%, deliver supple- mental ox ygen via nasal cannula. 7 Less Is More As with any patient in respirator y dis- tress, performing a primar y assessment with the ABCs is paramount to the man- agement of bronchiolitis. Assessing the infant for retractions, nasal flaring, respi- rator y rate, skin color, and pulse oxim- etr y will yield insight into the severity of respirator y distress. Evaluate their mental status and use the p ediatric a s s e s sm ent triangle to ensure you're keeping up with the child's physiologic needs. Less is better when considering inter ventions. The hallmark of treatment is support- ive care, and administration of nebulized albuterol and epinephrine is not routinely recommended. REFERENCES 1. Drayna PC, Browne LR, Guse CE, et al. Prehospital pediatric care: Oppor tunities for training, treatment, and research. Prehosp Emerg Care, 2015 Jul–Sep; 19(3): 441–7. 2. Gong C, Byczkowski T, Mc Aneney C, et al. Emergenc y depar tment management of bronchiolitis in the United States. Pediatr Emerg Care, 2017 Apr 24. 3. Hall CB, Weinberg GA, Blumkin AK, et al. Respirator y sync ytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics, 2013; 132(2): e341–8. 4. Miller EK, Gebretsadik T, Carroll KN, et al. Viral etiologies of infant bronchiolitis, croup and upper respirator y illness during 4 consecutive years. Pediatr Infect Dis J, 2013; 32(9): 950 –5. 5. Mullins JA, Lamonte AC, Bresee JS, Anderson L J. Substantial variabilit y in communit y respirator y sync ytial virus season timing. Pediatr Infect Dis J, 2003; 22(10): 857–62. 6. Shefrin A, Busuttil A, Zemek R. Wheezing in Infants and Children. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM, eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8th ed. New York, NY: McGraw-Hill Education, 2016. 7. Ralston SL, Lieber thal AS, Meissner HC, et al. Clinical prac tice guideline: The diagnosis, management, and prevention of bronchiolitis. Pediatrics, 2014; 134(5): e1,474- 1,502. 8. Gadomski AM, Scribani MB. Bronchodilators for bronchiolitis. Cochrane Database Syst Rev, 2014 Jun 17; (6): CD001266. 9. Chavasse R, Seddon P, Bara A, McKean M. Shor t ac ting beta agonists for recurrent wheeze in children under 2 years of age. Cochrane Database Syst Rev, 2002; (3):CD002873. ABOUT THE AUTHORS Michael Supples, MD, EMT-I, is an emergenc y medicine resident at Wake Forest Baptist Medical Center in Winston-Salem, N.C. He attended medical school at Eastern Virginia Medical School and previously worked as an EMT-I in Durham, N.C. Reach him at msupples1@gmail.com. Adam Johnson, MD, is a pediatric emergenc y medicine physician and assistant professor of emergenc y medicine at Wake Forest Baptist Medical Center in Winston-Salem, N.C. He attended medical school at the Universit y of Florida and completed his residenc y in pediatrics at the Universit y of Alabama at Birmingham, and fellowship in pediatric emergenc y medicine at the Universit y of Colorado. Because you protect others, we protect you WoodmenLife ® is grateful for the dedication you show in your community. As EMT's and paramedics, you serve unselfishly to protect others' families. We value what you do and want to help protect your family by being there when you need us most. Our products are designed to provide financial assistance to families should the unthinkable happen. In addition, we offer a $25,000 benefit 1 to the family of a member who has died in the line of duty as a First Responder. Find out more at WoodmenLife.org/first-responders 1. Member benefits are available to members. An individual becomes a member by joining our shared commitment to family, community and country, and by purchasing a WoodmenLife product. These benefits are not contractual, are subject to change and have specific eligibility requirements. CD1506 11/18 Woodmen of the World Life Insurance Society: Omaha, NE

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