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Training paramedics: emergency care for children with special health care needs
D W Spaite1, K J Karriker, M Seng
1Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, USA.
Insights
Paramedics showed increased comfort in caring for children with special health care needs (CSHCN) after a continuing education program. The program improved emergency response skills for this vulnerable population.
Area of Science:
- Emergency Medical Services (EMS) education
- Pediatric emergency care
- Special Health Care Needs (CSHCN)
Background:
- Children with special health care needs (CSHCN) present unique challenges in emergency settings.
- Paramedic preparedness for CSHCN emergencies requires specialized knowledge and skills.
- Existing continuing education may not adequately address the specific needs of CSHCN.
Purpose of the Study:
- To evaluate an innovative continuing education program designed to enhance paramedic knowledge and comfort in managing CSHCN emergencies.
- To improve the assessment and management skills of paramedics for children with diverse health conditions.
Main Methods:
- Development of a self-study program focusing on common issues affecting pediatric airway, breathing, circulation, disability, and environment (ABCDEs) for CSHCN.
- Program components included a manual, video, practice mannequins, and skills evaluations.
- Training was delivered to paramedics at a municipal fire department.
Main Results:
- Significant increase in paramedic comfort levels with CSHCN assessment and management post-training (average 2.83 to 4.20 on a 5-point scale, p < 0.001).
- Skills evaluation revealed variable performance across 21 assessed skills.
- High perceived applicability of training topics (e.g., tracheostomies, central lines, shunts, gastrostomies, child abuse, latex allergy) to paramedic practice (74%-94%).
Conclusions:
- Specialized education is crucial for EMS providers to effectively manage emergency situations involving the growing population of CSHCN.
- The self-study program demonstrated a positive impact on paramedic confidence in caring for CSHCN.
- Further development and implementation of targeted CSHCN emergency care training are recommended.
Objective:
To enhance knowledge and comfort related to the emergency care of children with special health care needs (CSHCN) through an innovative continuing education program for paramedics.
Methods:
A self-study program presenting in-depth information about common problems that affect the assessment and management of a child's airway, breathing, circulation, disability, and environment (ABCDEs), regardless of the child's diagnosis, was developed. This program used a manual, a video, practice mannequins, and skills evaluations to teach skills to paramedics employed at a municipal fire department.
Results:
Pre- and posttraining surveys found that the paramedics were significantly more comfortable with the assessment and management of CSHCN after the completion of the self-study program, with a pretraining average of 2.83 and posttraining average of 4.20 on a five-point Likert-type scale, t(37) = 12.87, p < 0.001. A skills evaluation showed that skills performance varied widely across 21 skills, ranging from skills mastery to low skills knowledge. On the posttraining survey, between 74% and 94% of the paramedics rated each topic (tracheostomies, indwelling central venous catheters, cerebrospinal fluid shunts, gastrostomies, child abuse, and latex allergy) as applicable to their practices as paramedics.
Conclusion:
Given the growing population of CSHCN, it is important to provide specialized education to increase an EMS provider's preparedness to respond to emergency situations involving children with special health care needs.