Paramedic Kardex

Comprehensive children emergency receiving center (CCERC)
New Updated 10/2021

Definition:

Child or Children: Defined to be under the age of 15 y/o

Comprehensive Children's Emergency Receiving Center (CCERC):  Emergency and referral center for children in Orange County

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Pediatric Base Hospital:  CCERC designated by OCEMS for on-line medical control

Pediatric Resource Center:   Available for advisory children's issues over the phone to EMS personnel or Emergency Departments in Orange County

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Transport Criteria:

1. A CCERC is the most appropriate, nearest emergency receiving center (ERC)

2. Child's parent or caretaker requests transport to a CCERC, and transport is reasonable

3. Child appears to be having an acute stroke or neurologic emergency

4. Child is an interfacilty transport from a health care facility or provider to a CCERC

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CCERC Radio Contact Criteria:

CCERC contact is encouraged and appropriate at any time a paramedic determines there is a benefit to do so.

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Respiratory Distress or labored breathing with:

• Intercostal retractions

• Nasal flaring with inspiration

• Respiratory less than approximately 12/min or more than approximately 50/min

• Cyanosis (lips and central face area)

• Complaint of difficulty breathing by child who can communicate

• Paramedic judgement

Circulatory compromise with:

• Poor skin color (pallor, cyanosis)

• Decreased capillary refill

• Altered mental status or confusion

• Mottling of skin

• Pale lips or finger beds

• Weak / thready pulse

• Paramedic judgement

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Pediatric patients identified in Standing Orders as requiring field treatment by EMS

ALTE / BRUE:

Apparent Life-Threatening Event (ALTE) 

Brief Resolved Unexplained Event (BRUE) 

DEFINITION:

ALTE or BRUE are defined as an episode that occurs in a child 3 years old and younger that is frightening to the observer and is characterized by some combination of:

Children with any of the acute symptoms below:

• Apnea episode

• Color change (cyanosis, pallor, erythema) episode

• Choking or gagging spontaneous, unrelated to food or fluid intake

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Radio Contact Process:

• When contacting OCC, the EMS personnel should request a CCERC for contact

• If there is a need to contacting the Base Hospital in an MCI with children involved, contact should be make to the normal Base Hospital per agency

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