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MDA Pediatric Transport

MDA Pediatric Transport. Pediatric Emergency Medicine October 13 th 2004. Talk Topics. EMS in Israel. Pediatric EMS in Israel. Pediatric transport in MCI. The Use of Pediatric I/O in MDA. Level Of Treatment. Two Tier System Basic And Advanced Life Support. Basic Level :

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MDA Pediatric Transport

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  1. MDA Pediatric Transport Pediatric Emergency Medicine October 13th 2004

  2. Talk Topics • EMS in Israel. • Pediatric EMS in Israel. • Pediatric transport in MCI. • The Use of Pediatric I/O in MDA.

  3. Level Of Treatment Two Tier System Basic And Advanced Life Support. • Basic Level : • B.L.S. Ambulance ( Including rural Ambulances) • Medic/Driver (E.M.T) + E.M.T / Volunteer. • E.M.T. Course - 205 Hours. • 125 Ambulances In Morningshift. All equipped with A.E.D.’s • 50-150 additional B.L.S. Units “on call”.

  4. Level Of Treatment • A.L.S. Level : • M.I.C.U - Mobile Intensive Care Unit • Physician, Paramedic, E.M.T / Driver. • Physicians - From Regional Hospitals. • 22 Units In Central Cities. • I.C.A - Intensive Care Ambulance • Paramedic, E.M.T / Driver. • 29 Units In Small Cities / Rural Areas

  5. ProfessionalActivities A.L.S Level Of Treatment • 50% Cardiac, Cardiopulmonary, and respiratory Problems • 4%-7% Resuscitations • 3%-5% Pediatric Cases • 10%-15% Trauma Cases

  6. Magen David Adom General and trauma activity Trauma calls per year (12%) Calls per year Ambulances per Shift ALS 52 ALS 150.000 ALS 14.000 MICU 22 (Physician) ICA 30 (Paramedic) BLS 125 BLS 300.000 BLS 36.000

  7. Training of M.D.A. B.L.S. providers • Total 205 course hours. • Pediatric resuscitation - 3 hours. • Pediatric Trauma – 1hour. • Pediatric Emergencies – 1 hour • Care of the newly born – 1hour

  8. Training of M.D.A. Paramedics • Total 1565 hours. • Stage 1: Class based - 18w. • Stage 2: Hospital clerkship – 10w. • Stage 3: Mobile Intensive care unit clerkship 80 shifts.

  9. Pediatric training in the various stages • Stage 1: • Pediatric resuscitation - 20h. • Pediatric emergencies - 16h. • The newly born -6h. • Stage 2: • Pediatric ED / PICU - 30h. • Labor and Delivery - 30h. • Adult and Trauma ED - 100h. • Anesthesia – 60h.

  10. Pediatric training in the various stages • Stage 3: • MICU – 640h. • PALS course. • PHTLS course.

  11. Pediatric Prehospital Care • In Israel: 3-5% of EMS calls. • In U.S.: 5-10% of EMS calls and only 5% involve life threatening problems. • A weak link in most EMS systems. • Controversial issues: • Scoop and Run Vs. Stay and play. • A.W. management in trauma.

  12. Pediatric Bone Injection Gun usage in MDA

  13. MDA experience • 2 types an adult and pediatric device. • Introduced to all A.L.S. units in 2001. • All attempts to use the device require reporting to medical division on a “special procedure form”.

  14. Success rate

  15. Age distribution

  16. Indication

  17. Prehospital outcome

  18. Bus number 2 explosion in Jerusalem

  19. August 20, 2003, 12:35pm EDT TWENTY KILLED, SCORES HURT INJERUSALEM BUS BOMBING A suicide attacker detonated a bomb on a packedJerusalem bus Tuesday, killing at least 20 people and wounding more than 100.

  20. Time table • 21.10- initial phone call: ”explosion heard”. • 21.11- M.C.I. protocol activated. • 21.15- First B.L.S. unit at the scene. • 21.17- Second B.L.S. unit at the scene. • 21.18- First A.L.S. unit at the scene. • 21.27- 5-B.L.S. and 3 A.L.S. units at the scene.

  21. Time table-evacuation • 21.10 Initial call • 21.20- 4 non urgent victims evacuated. • 21.21- 2 urgent and 1 non urgent victims evacuated. • 21.38- last urgent victim evacuated.

  22. Total units activated in this incident • 39 B.L.S. units. • 9 A.L.S. units. • 1 M.C.R.V. • Manpower: • Physicians-7 • Paramedics-30 • E.M.T.s -100

  23. DISTRIBUTIONofCASUALTIES

  24. Pediatric victims • Of the 136 injured 45 were children and babies. • Of the 23 casualties 6 were children. • 4 pediatric intubations were made at the scene. • 3 pediatric patients were transported in secondary diversion.

  25. Jerusalem bus explosion Secondary Diversion Hadassah EK Level I 2 Shaarei Zedek Level II Hadassah MS Level II 2 Bikur Holim Level III

  26. QUESTIONS ????????

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