EMS World

MAR 2018

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/944334

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Page 43 of 59

EMSWORLD.com | MARCH 2018 43 calculations are made much easier. Instead of having to calculate the proper dilution or concentration, all you'll need is the age or color range of your pediatric patient and their specific medication, and the system does all the math! Imagine this: Your ambulance service only stocks one concentration of Narcan (nalox- one)—1 mg/mL. When you click on the app, that's all you'll see. The dose is calculated to that concentration and shows you not only the mg, but also the mL to push. This is a huge help, since mental math under stress is not your friend. And since change is inevitable, these electronic systems can be updated quickly and easily, with no need to print and replace guidebooks or handouts. Medication safety is also improved because if a drug gets a new "black box" warning or the recommended dosing changes, adjustments can be distributed to all consumers immediately. If one concen- tration or medication becomes unavailable, alternatives can be chosen and program- ming adjusted as needed. And there's even more: eBroselow and its SafeDose mobile app (a specific EMS version is coming soon) have recently intro- duced barcode scanning of all medications. Using the camera on your mobile device, you can scan the label on the vial of medication, and the system will provide you with all the needed dosing and administration informa- tion, even if the medication is new in your formulary or supply system. And both pedi- atric systems are either currently integrated with or actively working on integration into common industry EMR systems. Benefits Consider the following situations: Intubation—A 1-year-old needs to be intu- bated. We must figure out what size endo- tracheal tube to use. Now, what was that formula? Age plus something divided by something? Or was it age divided by some- thing plus something? Even if you remember the formula, you still have to do the math. And on top of that, what's the deal with an uncuffed tube versus a cuffed tube? And if we figure out the tube size, where do we tape it? And then what size suction cath- eter, what size NG/OG tube, what size urinary catheter? Oh, and did we mention it's 4 a.m. and toward the end of a hectic shift? Feel- ing the stress? Or would you rather use a measuring device or select a color-coded age-specific card? Or maybe just open an app and enter the age (or color code) of the patient? In a second or two, you have everything you need right in front of you: ET tube sizes, taping points, and sizes for suction and urinary catheters as well as NG tubes, without hav- ing to make a single calculation. Medications—A 1-year-old child has a femur fracture after falling down stairs. Pain relief is certainly appropriate, but what is the dose of fentanyl? It's something per kg, because it almost always is something per kg. But how much, and is the nasal dosing Top: eBroselow guides seen in app view (Photos courtesy Dr. Robert Luten). Right: Handtevy system guides seen in app view. (Photos courtesy Dr. Peter Antevy).

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