Emergency Stabilization Information

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There are many of resources for emergency stabilization of newborns, infants and pediatric patients at YKHC. These include guidelines such as RSI, seizures, Pneumonia etc. There are also pediatric weight based resuscitation guidelines that you are expected to use for ALL emergency stabilization wherever you are working in our system.

Our Weight are weight ranges that are color coded and coordinate with our pediatric code carts. There are RAVEN critical care order sets matched to them. The supplies and code carts in the ER, SRCs, Inpatient unit and OR are all set up the same for standardization and safety. It is important to use the doses on these sheets and in the RAVEN powerplans to decrease the likelihood of mistaken dosing and medical errors

When a pediatric patient is identified as needing emergency stabilization and care:

  • determine a weight
  • choose a color and make it clear to the team what color you are using for meds and equipment…It is safer to have doses be approximate and not take time to calculate and possibly make an error in calculation.
  • pull several color coded resuscitation sheets from the weight based resuscitation book to give to the nurse recorder, pharmacist, med nurse and tech staff to collect the appropriate size equipment you need
  • don’t forget to call RT, pharmacy, CRNA, another pediatrician, the ER doctor and anyone else you think you might need to stabilize a sick patient
  • order the pediatric critical care powerplan and choose with appropriate weight based for this order
  • be clear in communications with the staff; make sure you have enough help; get good read back confirmation that your orders and requests have been heard/received and are being executed; get staff to give you verbal confirmation of when meds go in, IVs are placed
  • always be clear who the lead physician is (the ER doctor, you or another physician who is more experienced for this particular emergency)
  • if a patient will need to be medevaced*get another provider to get an accepting physician and activate for you. Don’t wait until the patient is stable*this might be a long time and it is better to get the process going as quickly as possible.
  • call ANMC PICU doctor at 907 297*8809 for advice and consultation as soon as possible
  • ask for help from your pediatric partners if you need it!

When a newborn needs resuscitation and stabilization:

  • Bring patient to the nursery
  • call pharmacy and RT
  • get a neonatal resuscitation sheet off the neonatal crash cart and choose an estimated gestational age/weight (the patient will often be to sick or unstable to weight them)
  • hand out extra sheets to nursing and pharmacy with the chosen EGA/Weight columns circled
  • use neonatal resuscitation sheet to order meds and get appropriate size supplies meds
  • start neonatal resuscitation powerplan in RAVEN to order labs, Xrays, meds etc.
  • call Providence NICU at 212*3614 for help and advice
  • if a patient will need to be medevaced*get another provider to get an accepting physician and activate for you. Don’t wait until the patient is stable*this might be a long time and it is better to get the process going as quickly as possible.

NOTE: There are good references posted on the nursery wall and on the sliding glass door. These include…

  • Pediatric Reference Telephone Numbers
  • Premie Warm Welcome
  • Curosurf Administration Instructions
  • Hypoglycemia Protocol
  • I/T ratio calculation

Good Emergency Resources

Pediatric Critical Care Guide

Neonatal Resuscitation Summary

Glucose Screening in Late Preterm link

Curosurf Administration Link

Endocrine Emergency Guideline Link

Other Good Resources

Pediatric Specialty Table (links to pdf)

Endocrine Emergency Guideline Link

Endocrine Recommended Labs

Septo-optic dysplasia (common here)