“There are no spe­cialised pae­di­atric facil­i­ties in remote Aus­tralia,” says Kylie Fis­ch­er, Remote Clin­i­cal Edu­ca­tor for the CRANAplus Pae­di­atric Emer­gency Care (PEC) and Pae­di­atric Advanced Life Sup­port (PALS) course.

“When you’re a remote area nurse, you must man­age a range of dif­fer­ent pre­sen­ta­tions includ­ing com­plex pae­di­atric presentations.”

Phys­i­cal and pro­fes­sion­al iso­la­tion, paired with a lack of avail­able cours­es, can present a bar­ri­er to access­ing pae­di­atric training.

“Unless you go and study pae­di­atrics as a spe­cial­i­ty such as a post­grad­u­ate cer­tifi­cate, you are unlike­ly to see these pre­sen­ta­tions reg­u­lar­ly,” Kylie says.

“When you are pre­sent­ed with a pae­di­atric patient, you want to have the con­fi­dence and nec­es­sary skills – and it’s the abil­i­ty to gain these things in a safe learn­ing envi­ron­ment that is attract­ing par­tic­i­pants to this course.”

Learn­ings from our PEC + PALS course

Your feed­back inspired us to add Pae­di­atric Advanced Life Sup­port to our recent­ly launched Pae­di­atric Emer­gency Care course.

The new com­po­nent focus­es on pae­di­atric arrest, clin­i­cal dete­ri­o­ra­tion, and post-resus­ci­ta­tion care, and builds upon the PEC com­po­nent deal­ing with trau­ma, med­ical emer­gen­cies, and the iden­ti­fi­ca­tion and man­age­ment of life threats.

Air­way, breath­ing and cir­cu­la­tion emer­gen­cies, shock, sep­sis, RHD sce­nar­ios, STIs, and med­ical emer­gen­cies are all covered.

“We’ve intro­duced human fac­tors and sit­u­a­tion­al aware­ness, recog­nis­ing and respond­ing to clin­i­cal dete­ri­o­ra­tion, car­diac arrest and peri-arrest rhythms, and we also focus on debrief­ing and family/​carer involve­ment,” Kylie adds.

As is the CRANAplus trade­mark, the course is con­tex­tu­alised to remote and iso­lat­ed set­tings that are char­ac­terised by ​“low resources includ­ing lim­it­ed staff and equip­ment, tech­nol­o­gy, com­mu­ni­ca­tions, and infrastructure.”

“Some­times you have to work with min­i­mal amounts of stock,” Kylie says. ​“There’s a lim­it­ed quan­ti­ty of med­ica­tions such as adren­a­line and flu­ids avail­able com­pared to a ter­tiary unit.”

Based on best prac­tice and guid­ed by ANZ­COR guide­lines, the evi­dence-based course is led by expe­ri­enced facil­i­ta­tors and includes guid­ed dis­cus­sions, real­is­tic sce­nar­ios, and hands-on skill sta­tions fea­tur­ing var­i­ous train­ing devices.

“We have a new lit­tle baby called TruBa­by X,” Kylie says. ​“He or she – you can change it – has the real­is­tic appear­ance, weight, size, and move­ment of a five-month-old. You can per­form Air­way Man­age­ment tech­niques (oral and nasal), Periph­er­al Venous Can­nu­la­tion, PICC line inser­tion, Lum­bar Punc­ture, IO Tib­ia, Nee­dle Tho­ra­cen­te­sis, Chest Drain, Ure­thral Catheter­i­za­tion (male and female), and Car­diopul­monary Resuscitation.

“We also have equip­ment for naso­gas­tric train­ing. It’s a trans­par­ent, child-size tor­so with all the inter­nal organs vis­i­ble. You can cor­rect­ly mea­sure and place a naso­gas­tric tube, take an aspi­ra­tion, and test that it is cor­rect­ly placed.”

Giv­ing pae­di­atric patients the best pos­si­ble chance 

Kylie has worked as a flight nurse out of Perth and the Kim­ber­ley, and on top of her present work for CRANAplus, she still does clin­i­cal place­ments for the Roy­al Fly­ing Doc­tor Ser­vice out of Alice Springs.

“You get to see what the remote area nurs­es are deal­ing with and man­ag­ing,” she says. 

“You realise how far away they are from help.

“I think that’s impor­tant, to be able to con­nect with par­tic­i­pants, to under­stand where they’re com­ing from. That’s how to be a good educator.”

While Kylie has pae­di­atric suc­cess sto­ries to share, she says remote area nurs­es are work­ing against the odds when a pae­di­atric arrest occurs.

“This pro­gram sets health prac­ti­tion­ers up to give patients the best chance,” she says. ​“If their pre-hos­pi­tal and hos­pi­tal care can be man­aged real­ly well, we know that their chances of sur­vival are much higher.”

What par­tic­i­pants are say­ing about our pae­di­atric courses:

“The pre-course learn­ing resources were very com­pre­hen­sive. I loved the way it was struc­tured and invit­ed fur­ther read­ing and insight via specialist’s pre­sen­ta­tions and demon­stra­tions. The infor­ma­tion pro­vid­ed was extreme­ly help­ful and the addi­tion­al links/​videos and ques­tions extend­ed learn­ing capabilities.”

“The course is pre­sent­ed by facil­i­ta­tors who pos­sess a mix of exper­tise in rural/​remote/​regional expe­ri­ence in dif­fer­ent plat­forms, i.e. RFDS/​Midwifery/​ED/​ICU. The con­tent is up to date and on point. You feel con­fi­dent that the infor­ma­tion being deliv­ered fol­lows and adheres to all cur­rent policy/​procedures by cred­itable organisations.”