• Developing understanding and awareness of children’s distress, distraction techniques and holding

      Preston, Christopher; Bray, Lucy (2015-03)
      Abstract published with permission. Purpose: This project aimed to evaluate the influence of an education session on ambulance clinicians’ understanding and awareness of children’s distress, distraction techniques and holding in the pre-hospital setting. Methods: An inter-professional education session that focused on raising awareness of children’s distress, the use of distraction techniques and clinical holding during pre-hospital care was provided. A mixed methods approach was then used to evaluate both existing and newly acquired knowledge and opinion through the use of questionnaires (n=26) and focus group discussion (n=20). Results: Despite literature suggesting that ambulance clinicians may not use distraction techniques during pre-hospital care, data gained from this project indicates that use of distraction techniques is widespread (92%, n=24) and has been adapted to fit within pre-hospital care. The inter-professional education event was reported as being of value for ambulance clinicians. Conclusions: Ambulance clinicians endeavour to provide a positive experience for children undergoing procedures, despite reported limitations in education, exposure and equipment. By using a collaborative and consultative education event, it is possible to facilitate ambulance clinicians to challenge their practice and improve their reported knowledge of dealing with children during procedures in the pre-hospital setting. Additional work needs to be undertaken to further explore and improve pre-hospital practice in relation to children’s distress and clinical procedures.
    • The use of the Paediatric Assessment Triangle in the management of the sick child

      Ogden, Kimberley (2016-09)
      Background The Paediatric Assessment Triangle (PAT) has been proven to be effective in the general impression of the health status of the child and can interlink the potential underlying pathophysiology so to alert the clinician into how critically ill/ injured the child might be. It is a rapid ‘hands off’ approach when you first encounter the child. The aim is to highlight the use of this assessment tool to allow the clinician a step wise approach to paediatric care so to enhance our treatment in the prehospital environment. Method A mixed method approach was used to gather quantifiable data from auditing patient report forms over a 3 month period during the implementation of the PAT which was followed by a questionnaire to gather qualitative information from the staff regarding their feelings towards using it. Results Data gathered from patient report forms over the 3 month period after the introduction of the PAT showed an initial baseline of 12% of it being used. Once the tool had been implemented an increase to 63.3% showing a significant uptake from the staff who were trained in its use. The questionnaire indicated that staff were welcoming of the use of the assessment tool and felt more confident when assessing a child. Conclusion The PAT showed a marked increase in being used throughout this project and the majority of staff appeared to be able to utilise it appropriately. An attempt to perform this on a larger scale would be beneficial to gauge whether it would be welcomed on a broader spectrum amongst staff and managers. Recommendations would include receiving more training for paediatrics and for consideration to be made to create a clinical performance indicator for child patients to ensure that patient report forms are being completed appropriately and quality care is being delivered to this category of patients. https://emj.bmj.com/content/emermed/33/9/e4.4.full.pdf This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ http://dx.doi.org/10.1136/emermed-2016-206139.16