Pedi ER RN advice

Specialties Emergency

Published

New grad RN

5 years pedi homehealth as lvn

Start new pedi ER job feb 5th as RN (nights)

Advice??? Best references... Best shoes? Lol

What is the biggest thing to memorize and read up on...? I feel pretty good about it, just natural nerves. Loved clinicals there...

Tips & tricks? Anything you suggest i should buy?

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Specializes in Med-Surg, Emergency, CEN.

Just show up the first day. They have had lots of new people before and know how to get you from 0 to 60. You'll figure it out quick. Good luck!

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Thanks :) i'm sure you are right about that!

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Specializes in ER.

I'm new to Peds ER too. Almost at my 3 mos mark. Take PALS... ASAP if you don't have it already. Then take ENPC. Take home the protocols sheet and memorize it. Take home a

handout on splinting. Take home an orders sheet and look up all the meds bc they are the ones given frequently. Kids come in with resp issues and lacs a lot. Learn those things well. GL!

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HI there,

I am a cardiac nurse transferring it to the emergency department for more experiences. And, I am extremely nervous. As per the shoe recommendation, I LOVE LOVE LOVE my danskos...sooooo worth the price. I wore mine comfortably for two years, then a tear formed, the company sent me a brand new pair (same exact style) for FREE, love them, can't stress it enough.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

get the enpc course book and read it. pediatrics is a speciality all it's own. their airways are different....smaller and structurally....they can eat and breathe. remember that 1mm of swelling on an adult airway that is 5mm wide is completely than 1mm of swelling on a 1mm airway. vital signs are not a predictor of how sick a kid is for they can compensate forever and by the time they reflect it in their vitals....they are in critical trouble. the cap refill/urine output is a great indicator on the younger pedi population as an indicator of distress and end organ perfusion.

so when did they last pee and how many wet diapers in x amy of time is huge!!!! using accessory muscle is a huge sign of distress.

they need fluid, o2, and keep them warm. a crying and screaming kid is a stable kid....it's the quiet ones that will/should scare you. if the child has a congenital/chronic illness listen to the parent.....they have done this before and can help you.

rhythms for kids....slow, fast, and absent. familiarize yourself with the normal vital signs for the age group!

infants....was the baby full term, what was birth weight, weigh all babies regardless of what the parents say...emphasize how important it is as that is how the medicines are given. small mistakes have huge consequences for the pedi population. if they are small so should the dose be as all doses are weight based.

the enpc (emergency nursing peds course) has a terrific pets triage standard that should be used by all eds.

ciiamppedds: c is chief complaint, i is immunizations, i is isolation (has the child been exposed to any communicable diseases), a is allergies, m is medications,p is past medical history, p is parents impression of the child's condition, e is the event surrounding the illness or injury, d is diet, d is diapers (voids) and s is signs and symptoms

great power point triage assessment

http://webmedia.unmc.edu/bioprepare/2010symposia/goesch-pediatric%20triage.pdf

[TABLE]

[TR]

[TD=align: left]age group[/TD]

[TD=align: left]respirations[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left]heart rate[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]systolic blood pressure[/TD]

[/TR]

[TR]

[TD=width: 27%, bgcolor: #ffffff, align: left]newborn[/TD]

[TD=width: 23%, bgcolor: #ffffff, align: left]30-50[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left]120-160[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]50-70[/TD]

[/TR]

[TR]

[TD=width: 27%, bgcolor: #ffffff, align: left]infant (1-12 mo)[/TD]

[TD=width: 23%, bgcolor: #ffffff, align: left]20-30[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left]80-140[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]70-100[/TD]

[/TR]

[TR]

[TD=width: 27%, bgcolor: #ffffff, align: left]toddler (1-3 y)[/TD]

[TD=width: 23%, bgcolor: #ffffff, align: left]20-30[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left]80-130[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]80-110[/TD]

[/TR]

[TR]

[TD=width: 27%, bgcolor: #ffffff, align: left]preschooler (3-5 y)[/TD]

[TD=width: 23%, bgcolor: #ffffff, align: left]20-30[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left]80-120[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]80-110[/TD]

[/TR]

[TR]

[TD=width: 27%, bgcolor: #ffffff, align: left]school age (6-12y)[/TD]

[TD=width: 23%, bgcolor: #ffffff, align: left]18-25[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left]70-110[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]85-120[/TD]

[/TR]

[TR]

[TD=width: 27%, bgcolor: #ffffff, align: left]adolescent (13y +)[/TD]

[TD=width: 23%, bgcolor: #ffffff, align: left]12-20[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left]55-110[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]100-120[/TD]

[/TR]

[TR]

[TD=width: 27%, bgcolor: #ffffff, align: left]adult[/TD]

[TD=width: 23%, bgcolor: #ffffff, align: left]16-20[/TD]

[TD=width: 24%, bgcolor: #ffffff, align: left] 70-100[/TD]

[TD=width: 26%, bgcolor: #ffffff, align: left]

[/TR]

[/TABLE]

triage course - nursing continuing education (ce) - nurse ce - ceufast.com

pews.....the pediatric early warning (pew) score system can help nurses assess pediatric patients objectively using vital signs in the pediatric intensive care unit. the scoring system takes into account the child's behavior, as well as cardiovascular and respiratory symptoms. http://academics.ochsner.org/uploadedFiles/Research/Nursing/EBP%20PEWS%20v2.pdf

ahrq innovations exchange | pediatric early warning (pew) score system

this is another great assessment tool for assessment short and sweet but informative.

http://www.ucdenver.edu/academics/colleges/nursing/documents/pdf/sim_pews_tch.pdf

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Parents welcome....sitting in a in a chair, without wheels, only. Parents like Gomers will go to ground.:D

(I couldn't resist "The House of GOD" reference)

If they have tears have no fears.....If the pacifier's wet they're all set. :lol2:

Learn nursery rhymes and learn the popular kids shows.... NOW! ;)

They are going to cry from the moment you begin to hold them...forage on! YOu and the parents will remember it much longer than they will.

Beads will find places where no bead has gone before......:eek:

The art of calming a parent that although their child is bleeding and it's important to everyone.....the child will survive the injury.:hug:

OP you are already doing what you should....educate yourself.:yeah:

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Esme and rizz, WOW, THANK YOU SO MUCH, that is unbelievably helpful! I will get on that asap! Should I go buy the books now or wait until I take the classes? This is all incredible info and advice, just what I was needing. I am only at ease when I feel prepared at least a little bit. My orientation date was pushed back a week since my drug screening results didnt come back in time. I'll use this time to explore the links you posted Esme! Lionette, thanks! I want some since they are supposed to last forever, I just hope I can walk in them! ☺️

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Just skimmed over the links, they are fantastic, appreciate it greatly!

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Good Luck to you!! It is a wild ride working with peds in an ER. I've only been doing it two years, but my one recommendation is to trust your instincts. Young parents bring their infants to the ER because they have no idea how to take care of them, let alone what to do when they are sick. You can tell the difference between critical ones and the ones that just need a dose of Tylenol and antibiotics for their ear infection. Listen to your gut; if the parent states he is happy and full of energy usually but you see a listless, pale, glossy eyed baby...something is wrong! If he is smiling, cooing, and pink cheeked, it is probably not life threatening.

Time is your enemy with peds, trust your training, and listen to the parents. You can do this :)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I would get the ENPC book...it is really full of useful information.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

In addition to the ENPC book (and take the course when you can!), I love Scott DeBoer's CPEN Review book. It's great just for general knowledge, though I did use it (heavily) to prepare for and pass my CPEN. Oh, and PALS first, as someone else said. At the end of a year, take the CPEN exam. Your time as an LVN in peds home health will only help you! Good luck!

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