Pediatric IV's...

[vs-eh?]

I think most paramedics will concede that pediatric assessment and management is not on their list of forte's...

I'm curious as to your frequency of starting IV's on pediatric patients while working land EMS.

For this poll we'll say a pediatric is a patient 12 or under...

If you could also briefly list...

- Why you start the IV - i.e. critically sick child? simple post-ictal? simple trauma? critical trauma?

- Why you don't normally start IV's on children - non-confidence, children don't generally need IV access by EMS, child is too scared, parents don't want it...

- Your general proficiency.

- How many (if any) IV's you attempted/successful during your clinical/preceptor experience prior to autonomous practice.

Peace.

[Ridryder 911]

I have to admit I stick more in ER, but yet again, I get more ped.'s cases in ER. I usually stick at least 10 12 times a week.

R/r 911

[AZCEP]

Most of the time, we don't have the extra help needed to hold the semi-sick kiddoes still enough to get the line secured before they rip it out.

If the kid tolerates it, fine, if not I will go without one. Knowing that when they go out, I can get one isn't really a good fall-back, but often that is what it comes down to.

[chbare]

Ridryder911, you may be on to something. Most of the sick kids I see are brought into the ER by family and not by EMS. Perhaps this is because the little critters compensate so well and do not look too bad to the family, but are actually knocking on deaths door. Most of the kids that come in by EMS are BS cases from Mexico and kids from fender benders where the parents get taken to the hospital. However, when EMS brings in a sick kid, that kid is usually critical.

Take care,

chbare.

[mediccjh]

I stick sick kids, ie dehydrated, AMS, or s/p febrile sz w/ high heart rates and other signs of poor perfusion, ie cap refill. I stick about 5 kids a month.

The excuse of not sticking a sick kid b/c it's a kid is bullsh-t. You treat your patients, no matter what your age. I

If you need to hug your kids when you go home, there is absolutely nothing wrong with that. We're all human.

For the record, my first pediatric arrest was on Mother's Day 2002, an 8 d/o. And that was after spending all day w/ my 8 m/o niece. Needless to say, kids don't bother me anymore, and I'd rather treat a kid than some adults.

[windsong]

Peds vs. Adult

I saw a woman who was 24 yrs of age, had their fore arm taped to a board, kinda like what you would see a peds would have.

Why would they do this? She seemed to a point not a risk to pulling it out, perse.

[ffpm41]

- Why you start the IV - i.e. critically sick child? simple post-ictal? simple trauma? critical trauma?

I start about 5-10 peds IV's a year. most of the time it's on Sz patients, but have also had a few traumas.

- Why you don't normally start IV's on children - non-confidence, children don't generally need IV access by EMS, child is too scared, parents don't want it...

If a kid needs an IV I start it, if it is marginal I wait, no sense in poking a kid twice (1 IV, 1 blood draw).

- Your general proficiency.

I've done alright, my favorite is the AC or foot (big vein, easier place to start due to straight veins, less upsetting because the don't get their arm tied up in

an arm board).

- How many (if any) IV's you attempted/successful during your clinical/preceptor experience prior to autonomous practice.

I started 38 in school with 30 successes.

If a kid needs an IV they need it, from what I've seen the PM's with kids feel more comfortable when they have their own. Peds is the weak point of EMS, please take the time to educate yourself as much as you can.

[Yummymedic05]

I start IVs on peds mainly in the ER or ped floor of the hospital. I've started them for breathers, seizures, dehydration, and had a 13mo with severe anaphylaxis.

I'm always the one to start them because it doesn't bother me and I seem to be the best on night shift to do it, so they let me do it.

Honestly I've missed 3 that I can think of on peds, that being the first stick. I always get one, just takes longer sometimes.

Hmmm....I think I had about 75-90 sticks during school, don't remember exact.