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Standards of Care for Children in Emergency Departments Version 3.0 ______International Federation of Emergency Medicine

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Standards of Care for Children in Emergency Departments Version 3.0 ______International Federation of Emergency Medicine ______________________________________________________________________________________________ Standards of Care for Children in Emergency Departments Version 3.0 ______________________________________________________________________________________________ International Federation of Emergency Medicine This document is a consensus document aimed at assisting hospitals around the world in defining minimum standards of care for children aged 0-18 years in the Emergency Department. Each chapter contains: • essential and desirable recommendations • explanatory text • references • resources INTERNATIONAL FEDERATION FOR EMERGENCY MEDICINE 34 Jeffcott Street West Melbourne VIC 3003 T +61 3 9320 0444 | F +61 3 9320 0400 E [email protected] | www.ifem.cc Produced by: International Federation for Emergency Medicine ISBN: 978-0-9873901-0-3 Further copies of this publication can be obtained from the International Federation for Emergency Medicine website at: www.ifem.cc/resources/ifem-policies-guidelines/ Disclaimer: Content within this publication was accurate at the time of publication. This work is copyright. It may be reproduced in whole or part for study or training purposes subject to the inclusion of an acknowledgment of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above, requires written permission from the International Federation for Emergency Medicine. © International Federation for Emergency Medicine 2019 Published: July 2012 Updated June 2014 Updated April 2019 Paediatric Special Interest Group I Table of Contents ~ STANDARDS OF CARE FOR CHILDREN IN EMERGENCY DEPARTMENT _______________________________ INTRODUCTION CHAPTER TWELVE Message from the Standards Lead………………..III Policies, Procedures and Guidelines……………..…...71 Standards Contributors………………………….....V CHAPTER THIRTEEN PEMSIG………………………………………..VIII Information System and Data Analysis…………..…..75 IFEM…………………………………………..….X CHAPTER FOURTEEN Address from PEMSIG Chair…………...……….XI Pre-Hospital Care………………………………..…...81 CHAPTER ONE CHAPTER FIFTEEN Introduction Standards 3.0……………………...….1 Mass Casualty/ Patient surges………………….…….87 CHAPTER TWO CHAPTER SIXTEEN Scope of Standards…………………………….......5 Safeguarding Children & Young People…………..…93 CHAPTER THREE CHAPTER SEVENTEEN Challenges facing PEM…………………………....9 Adolescents, Mental Health & Substance Use…..….105 CHAPTER FOUR CHAPTER EIGHTEEN An Integrated Service…………………………….17 Death of a child in the ED………………………..….111 CHAPTER FIVE CHAPTER NINETEEN Child and Family Centered……………………….23 Advanced Training and Academic Research…….…117 CHAPTER SIX CHAPTER TWENTY Initial Assessment of an Ill or Injured Child……...29 Essential Recommendations………………………...123 CHAPTER SEVEN CHAPTER TWENTY-ONE Stabilising and Treating an Ill or Injured Child…...37 Desirable Recommendations…………………...…...131 CHAPTER EIGHT CHAPTER TWENTY-TWO The Staffing of an Emergency……………………45 List of Abbreviations…………………………....…..137 CHAPTER NINE CHAPTER TWENTY-THREE Staff Training and Competencies……………....…53 Appendix 1…….....…………………………….……139 CHAPTER TEN CHAPTER TWENTY-FOUR Equipment, Supplies and Medications……………61 Appendix 2………………………………….….…...145 CHAPTER ELEVEN CHAPTER TWENTY-FIVE Quality and Safety………………………….….....65 Appendix 3………………………………….….…...153 INTRODUCTION _______________________________ MESSAGE FROM THE STANDARDS LEAD ~ Dr. Rodrick Lim _______________________________ Dear colleague, Thank you for caring for children, and seeking out resources related to improving paediatric emergency care systems across the world. These Standards are the work of an amazing group of people, who care very deeply about care for children. Our hope, is that with the guide of these Standards, it will provide guidance, information, and urgency to your local health system, so that we can move the needle for children’s health. This work would not have been possible without the countless hours people have donated in order to provide their wisdom to this project. Without the organisation IFEM, none of this work would be possible. The collaboration between countries and people is truly astounding! « Children are the world’s most valuable resource and its best hope for the future » John F Kennedy Thanks again, and please do not hesitate to reach out and help us improve this resource! Or better yet, come join us! DR. RODRICK LIM Standards Lead PEMSIG III IV STANDARDS CONTRIBUTORS _______________________________________ Paediatric Emergency Medicine SPECIAL INTEREST GROUP STANDARDS v3.0 CONTRIBUTORS _______________________________________ EXECUTIVE REVIEW COMMITTEE: Dr Baljit Cheema, MD Emergency Medicine Society of South Africa – SOUTH AFRICA Dr Ffion Davies, MD Royal College of Emergency Medicine - UK Dr Marianne Gausche-Hill, MD American College of Emergency Physicians - USA Dr. Rodrick Lim, MD Canadian Association of Emergency Physicians - CANADA GROUP ADVISOR: Felix Hay Paediatric Advanced Nurse Practitioner in Children’s Emergency Medicine - UK V CHAPTER CONTRIBUTORS: Dr. Baljit Cheema Chapters 1,3 (LMIC),6,7 Dr. Camilo Gutierrez Chapters 3 (HIC),14 Dr. Rodrick Lim Chapters 2,9,17 Dr. Ffion Davies Chapters 4,8 Dr. Marianne Gausche-Hill Chapters 4,8,14 Dr. Prinetha Moodley Chapter 5 Dr. Heloise Buys Chapters 5,6 Dr. Indumathy Santhanam Chapter 7 Dr. Simon Chu Chapter 8 Dr. Rahim Valani Chapter 9 Dr. Sashikumar Ganapathy Chapter 11 Dr. Teng Sung Shin Chapter 11 Dr. Brianna McKelvie Chapter 11 Dr. Zaw Lwin Chapter 11 Dr. Simon Chu Chapter 12 Dr. Ed Oakley Chapter 12 Prof. Dr. Patrick VandeVoode Chapter 13 Prof. Yehezkel (Hezi) Waisman Chapter 15 Prof. Andrew Rowland Chapter 16 Dr. Javeed Sukhera Chapter 17 Dr. Adriana Yock-Corrales Chapter 18 Prof. Franz Babl Chapter 19 STANDARDS 1.0-2.0 CONTRIBUTORS: Dr. Ffion Davies, MD Dr. Marianne Gausche-Hill, MD Dr. Simon Chu, MBBS DCH FACEM MMed Dr. Baljit Cheema, MD Dr. Angelina Ang, MD Dr. Liliana Caceres, MD Prof. Yehezkel (Hezi) Waisman Jason Gray, Emergency Children’s Nurse Dr. Steven Krug, MD Thank you to Renée Vachon for her time and effort copyediting this book. This document should be cited as follows: Paediatric Emergency Medicine Special Interest Group: Standards of Care for Children in Emergency Department. Version 3.0. International Federation of Emergency Medicine. 2019 VI PAEDIATRIC EMERGENCY MEDICINE SPECIAL INTEREST GROUP VII Paediatric Emergency Medicine SPECIAL INTEREST GROUP A network of international health care professionals with interest in Paediatric Acute Care joined in a virtual community VIII INTERNATIONAL FEDERATION OF EMERGENCY MEDICINE Locally, and globally, the goal is the same- for all to lead healthier, more productive lives, regardless of where they were born. -Dr. Claudia Fernandez IX ______________________________________________ ______________________________________________ IFEM will promote access to, and lead the development of, the highest quality of emergency medical care for all people. exchange information on topics of international interest; provide a mechanism for international collaborative research; provide a mechanism for international elective opportunities for trainees in emergency medicine programs; provide an avenue for international sabbatical and exchange opportunities for practitioners of emergency medicine; act as a forum for common problems and approaches to solving problems specific to emergency medicine; offer advice and guidance to emergency medicine practitioners worldwide in the formation of national associations and training and certification programs; provide a network system of centers to facilitate international cooperation in the event of national or man-made disasters; organise an international conference on topics of interest in emergency medicine, and act as a resource in the development of emergency medical services. X ADDRESS FROM PEMSIG CHAIR _______________________________ Address from PEMSIG Chair STANDARDS 3.0 ~ Dr. Camilo E Gutierrez _______________________________ IFEM: Paediatric Emergency Medicine Special Interest Group As the development of emergency medicine and acute care systems is well underway globally with over 50 countries where the specialty is fully recognised and another 30 or 40 more working to establish their own systems, the development of Paediatric Emergency Medicine systems is lagging. In the United States, a thirteen year gap existed between the recognition of emergency medicine and paediatric emergency medicine care, and it became apparent in many ways that recognition, understanding, and management priorities in paediatric patients do differ from the approach to adult counterparts. We are reaching a point in which the establishment of acute care systems globally is imminent, we know the general challenges that regions and countries have, and we We now have a membership of need to identify specific challenges related to our individual environments. almost 100 clinicians with a special interest Within the Paediatric Emergency Medicine Special Interest Group (PEMSIG) of in PEM, representing IFEM, we have undergone a similar transformation, from a small group back in 2010 over two dozen countries and of eight individuals; we now have a membership of almost 100 paediatric care multiple national clinicians, representing over two dozen countries and multiple national associations. associations. It is time to realise that as emergency and acute care systems develop, we need to include actively the awareness of the important differences that children require in their care. We can
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