I always enjoying giving a new medicine, using a new gadget or following a new procedure for the first time. I clearly remember the first time I gave Ativan on standing order, the first time I gave Cardizem, fentanyl, zofran, and ketamine, all new meds at one time. I remember the first time I did a 12-lead ECG (we didn’t have them when I started), the first time I used CPAP, the first time I used capnography, the first time I used a spinal motion restriction protocol where I didn’t have to tie someone to a board, the first time I gave whole blood.
A few weeks ago I got to follow a new procedure that was quite different and very cool.
EMS does many calls for emotionally disturbed children, EDPs for short. These calls are either from homes where a mom can’t control her kid or from school where a youngster is acting out. The calls can take up a lot of time, particularly when they are at a school and they can’t get a hold of the parent. Once we get a hold of the parent or a relative, we take the kid to the children’s hospital. The children’s hospital is almost always overrun with similar calls. There are no beds, kids are sitting in chairs, and Ed is overloaded. There is not much the staff can do, but babysit. It’s an unpleasant situation for all. Sometimes, the ED goes on diversion. To go on diversion the hospital has to find another hospital willing to take the kids. They usually find a hospital in a distant part of the state. EMS is not required to transport to the receiving hospital, and it wouldn’t serve anyone to take a kid an hour or more away from their home, so they just end up at another ED that really isn’t prepared to handle them.
The new protocol I am referring to was written to address this situation. For kids who are not violent, not chemically sedated, or not on police committal papers, we can call one of four children’s urgent crisis centers (well only 1 in our area of the state). I call for the first time. I explain what we are dealing with and the nurse I spoke to said, sure we’ll take him. So instead of driving a 12-year old boy having a bad day to a crowded ED (with an overrun and exasperated staff), we drive him to a peaceful place called the Village, where he is met by a friendly nurse and interviewed in a quiet room by a female doctor on staff. His mom meets us shortly after. When we walk back to the ambulance, we see children playing outside in a big yard with a dog under the watchful eye of a staff member.
So much better for everyone. Thanks to all on making something like this happen.
