Short video (~Handtevy Minute) by Dr. Peter Antevy emphasizing the importance of pre-arrival planning for pediatric cardiac arrest. He contrasts adult protocols (predictable doses/sizes) with pediatric uncertainty and demonstrates assigning simple team roles and pre-calculating epinephrine dose, I-gel/king airway size, and defibrillation energy before arrival to enable confident on-scene resuscitation and earlier epinephrine within five minutes.
Chapters
Hey everyone, this is Dr. Peter Entevi with another edition of the Hand Tevy minute. Today I want to talk about pre arrival. It turns out that when you go treat an adult in cardiac arrest en route, you know exactly what dose of EPI you're going to give. If you're going to defibrillate the ET tube size or the Igel size. Well, for pediatrics, for many years, decades in fact, we've never known exactly what to give. You get on scene and the parents are looking at you, wanting to be sure that you know what you're doing. But if you don't know the dose of epi, the eye gel size, you don't know how much defibrillation dose to pick, all of a sudden you find yourself running onto the scene, feeling scared, coming in, taking that child and running. We'll teach you how to get that information in your mind, in your head before you get there. That will change the game. That pre arrival information is so critical. So watch this video to see how we get to the EPI dose, the Igel size, defibrillation dosing prior to arrival so that you can feel confident staying on scene. For pediatrics.
It's a seven year old, looks like a drowning. If it's an actual cardiac arrest.
You'Re going to be airway. You'll be cpr. I'll be monitor and drilling. All right.
Since you're airway, your kings will be either a 2.5 or a 3, depending on what size it is. But you can go either or. Right. Defibrillation. The first one's at 50, the rest are at 100. The EPI's are 2.5 ML.
Okay, so notice what our lieutenant did there. Each person has one or two pieces of information. They get to the scene and there's no talking. Someone can be talking to the mother, an officer on scene can be talking to the mother or. Which is a very, very important part of it. Now, a lot of times they'll come to the curb and they'll throw you, the kid at the curb and your instinct is to turn around and go into the rescue. I'm okay with that. But if the doors close, somebody has to be out there talking to the mom, explaining why we're not moving the wheels. Why is this rescue sitting here in the middle of my driveway when parents are typically conditioned that we're going to be going to the hospital rapidly with their child? This is not correct. Right. We need to treat that kid on scene. Bag, bag, bag. Push, push, push. Drill. Give epi. And if you can get that EPI on board within the first five minutes, the studies show that kids will come back to life. We have that responsibility. I'm trusting you guys to do that. Thank you very much for all that you do. This has been Dr. Peter Anteve. Thanks.
