Guidelines for Equipment and Supplies for Use in Pediatric Patients in the ED (Excerpt)
Guidelines for Equipment and Supplies for Use in Pediatric Patients in the ED (Excerpt)
Monitoring Equipment
- Cardiorespiratory monitor with strip recorder
- Defibrillator with pediatric and adult paddles (4.5 cm and 8 cm) or corresponding adhesive pads
- Pediatric and adult monitor electrodes
- Pulse oximeter with sensors and probe sizes for children
- Thermometer or rectal probe*
- Sphygmomanometer
- Doppler blood pressure device
- Blood pressure cuffs (neonatal, infant, child, and adult arm and thigh cuffs)
- Method to monitor endotracheal tube and placement +
- Stethoscope
Airway Management
- Portable oxygen regulators and canisters
- Clear oxygen masks (standard and nonrebreathing — neonatal, infant, child, and adult)
- Oropharyngeal airways (sizes 0-5)
- Nasopharyngeal airways (12F through 30F)
- Bag-valve-mask resuscitator, self-inflating (450- and 1,000 mL sizes)
- Nasal cannulae (child and adult)
- Endotracheal tubes: uncuffed (2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, and 6.0 mm) and cuffed (6.5, 7.0, 7.5, 8.0, and 9.0 mm)
- Stylets (infant, pediatric, and adult)
- Laryngoscope handle (pediatric and adult)
- Laryngoscope blades: straight or Miller (0, 1, 2, and 3) and Macintosh (2 and 3)
- Magill forceps (pediatric and adult)
- Nasogastric/feeding tubes (5F through 18F)
- Suction catheters — flexible (6F, 8F, 10F, 12F, 14F, and 16F)
- Yankauer suction tip
- Bulb syringe
- Chest tubes (8F through 40F)**
- Laryngeal mask airway (sizes 1, 1.5, 2, 2.5, 3, 4, and 5)
Vascular Access
- Butterfly needles (19-25 gauge)
- Catheter-over-needle devices (14-24 gauge)
- Rate limiting infusion device and tubing ** %
- Intraosseous needles (may be satisfied by standard bone needle aspiration needles)
- Arm boards
- Intravenous fluid and blood warmers**
- Umbilical vein catheters** # (size 5F feeding tube may be used)
- Seldinger technique vascular access kit**
Miscellaneous
- Infant and standard scales
- Infant formula and oral rehydration solutions**
- Heating source (may be met by infrared lamps or overhead warmer**
- Towel rolls, blanket rolls, or equivalent
- Pediatric restraining devices
- Resuscitation board
- Sterile linen ++
- Length-based resuscitation tape or precalculated drug or equipment list based on weight
Specialized Pediatric Trays
- Tube thoracotomy with water seal drainage capability**
- Lumbar puncture
- Pediatric urinary catheters
- Obstetric pack
- Newborn kit**
- Umbilical vessel cannulation supplies**
- Venous cutdown**
- Needle cricothyrotomy tray
- Surgical airway kit (may include a tracheostomy tray or a surgical cricothyrotomy tray)**
Fracture Management
- Cervical immobiliation equipment**##
- Extremity splints**
- Femur splints**
Medical Photography Capability
Adapted from Committee on Pediatric Equipment and Supplies for Emergency Departments, National Emergency Medical Services for Children Resource Alliance.
* Suitable for hypothermic and hypterthermic measurements with temperature capability from 25°C to 44°C.
+ May be satisfied by a disposable CO2 detector of appropriate size for infants and children. For children 5 years or older who are (greater than/equal to sign) 20 kg in body weight, and esophageal detection bulb or syringe may be used additionally.
** Equipment that is essential but may be shared with the nursery, pediatric ward, or other inpatient service and is readily available to the ED.
Equipment or supplies that are desirable but not essential.
% To regulate rate and volume.
# Ensure availability of pediatric sizes within the hospital.
++ Available within hospital for burn care.
## Many types of cervical immobilization devices are available, including wedges and collars. The type of device chosen depends on local preferences and policies and procedures. Chosen device should be stocked in sizes to fit infants, children, adolescents, and adults. Use of sandbags to meet this requirement is discouraged, because they might cause injury if the patient has to be turned.
The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
Source: American College of Emergency Physicians, Dallas, and the American Academy of Pediatrics, Elk Grove Village, IL. Used with permission. Excerpt from Care of Children in the Emergency Department: Guidelines for Preparednes; 2001.
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