PREM System - Paediatric Resuscitation Emergency Management

	Paediatric Resuscitation Emergency Management

For hospital and pre-hospital staff the call that a child is severely ill always causes alarm. Emotional issues compound the complexity of dealing with paediatric emergencies, whether it is a baby with a severe infection or an intoxicated teenager with inflicted head injuries. 'Does anyone know how much that seven year old with asthma weighs?' 'What's the adrenaline dose for a three year old with peanut-allergy anaphylaxis.' I've got a twelve year old in full cardiac arrest following a stabbing expected, when does the APLS algorithm for weight not work?'

Whenever we meet a challenging and unfamiliar situations expert guidance is crucial and for those encountering sick children The Paediatric Resuscitation and Emergency Management System (PREM) offers a clear, comprehensive and rapidly accessible system to aid care. PREM is designed by experienced resuscitation officers with great experience in training those at the coalface of paediatric emergencies. With the PREM tape children can be rapidly classified into age-weight categories and drug doses rapidly determined by the colour code system. The luxury of the dose being 'one vial' is rare in paediatrics, however PREM makes emergency drug dosing as easy as it can get! All the commonly needed drugs are there, and the time from 'need' to 'receive' will be shortened. Basic management algorithms for common paediatric emergencies are also included, allowing a structured rapid reference for paediatric emergency care. PREM provides a rapidly accessible, simple and effective system for ambulance staff, emergency department colleagues and paediatric teams to provide consistent and effective emergency care for children in the critical early hours of severe illness.
Dr Joe Brierley MRCP, MRCPCH, MA
Consultant Intensivist
Great Ormond Street Hospital for Children

London, WC1N 3JH

Systems have been purchased by the Wessex Paediatric group and

by the Cumbria Out of hours service

coming soon web based version of the PREM system.

email web@premsystem.co.uk for further details

PREM system
	The system is widely used with many NHS acute trusts. The updated system has current guidance from NICE, Meningitis Foundation, British Asthma society etc. See below for full contents list 28 drug zones ranging from 3kg to 40kg make the problem of drug calculation in resuscitation a thing of the past. The system contains of 10 disposable tapes. Fully kitted trolley systems are available.

	The PREM pocket book contains all the updated information needed by staff working in the front line of paediatric emergency care. All 28 drug zones are included in the book. . Eight books are included in the system

	Larger print version of the pocket book. The ideal reference guide to complement the PREM equipment trolley system. 28 drug zones and equipment list are included. Full list of contents is listed below. Two books are included n the system.

	28 easy to read drug zones. All infusion and bolus dosage. All pages are laminated to keep clean. Two drug books are included in the system.

Contents and Chapters of the PREM System

RESUSCITATION
Pathways Leading to Cardiac Arrest in Childhood (with examples of underlying causes)
Paediatric Basic Life Support
Paediatric Advanced Life Support
Newborn Resuscitation
Clearing Child’s Airway (Foreign Body Aspiration) Sequence of Instructions
CARDIAC EMERGENCIES
Algorithm for the Management of Bradycardia
Algorithm for the Management of Supraventricular Tachycardia
Algorithm for the Management of Ventricular Tachycardia
Classification of the Causes of Shock
Commonly Used Cardiovascular Drugs in Shock
RESPIRATORY EMERGENCIES
Primary Assessment and Resuscitation of the Child with
Breathing Difficulty
Symptoms in Respiratory Emergencies
Causes of Stridor
Normal Peak Expiratory Flow in Children Aged 5–18 Years
Features of Life-threatening Asthma
Management of Acute Asthma in Children in Hospital
Bronchiolitis - Characteristic Findings on Examination
Risk Factors for Severity in Bronchiolitis
Distinguishing Features Between Heart Failure and Bronchiolitis
POISONS AND CBRN
Rinse-wipe-rinse Method of Casualty Decontamination
Characteristics of Diseases and Agents Most Likely to be Used in a Deliberate Release
Characteristics of Toxins Most Likely to be Used in a Deliberate Release
Diagnostic Clues from the Primary Assessment
National Poisons Centre Telephone Number
Health Protection Agency
Poisons
Treatment Lines
Management of Children (< 12 years) Who Present Within 8 Hours of Ingestion N-acetylcysteine (NAC) (Parvolex)
FLUIDS AND ELECTROLYTES
Clinical Signs of Dehydration
Normal Water, Electrolyte, Energy and Protein Requirements
Commonly Available Crystalloid Fluids
Normal Fluid Requirements
Algorithm for the Management of Hyperkalaemia
Surface Anatomy for Intraosseous Infusions
CONVULSIONS
Disorders Causing Coma in Children
Algorithm for the Initial Management of Coma
Signs of Raised Intercranial Pressure
Treatment Protocol for Status Epilepticus
NICE Head Injury Guidelines
Glasgow Coma Scale
ANAPHYLAXIS
Background to Anaphylaxis
Management of Anaphylaxis Protocol
ANALGESIA
Analgesia in Children
Management of Pain in Children
TRAUMA
Template for Note-taking
Summary of Structured Approach to the Seriously Injured Child
The ABCDE Approach to Radiographic Interpretation
ACCEPT Model
DIABETIC KETOACIDOSIS
Major Complications of Diabetic Ketoacidosis
Diabetic Ketoacidosis
Management of Diabetic Ketoacidosis
MENINGOCOCCAL DISEASE
About Meningitis Research Foundation
Early Management of Meningococcal Disease