Reducing the “Pucker Factor” in Pediatric Emergencies | EMS to Flight Nurse

Why do pediatric emergencies feel so intimidating — even for experienced providers?

In this episode, flight nurse Christopher Blake breaks down how to reduce the “pucker factor” and build real confidence in pediatric care.

Join Brittney and Felicia as they sit down with Christopher Blake — a flight nurse, pediatric advocate, and creator behind The Blakery Content — to explore the realities of pediatric emergency care.

From EMS to flight nursing, Christopher shares practical, real-world strategies for improving pediatric readiness, communicating effectively with families, and delivering high-quality care in high-stress situations.

This episode is packed with actionable insights for nurses, EMS providers, and anyone looking to feel more confident when caring for pediatric patients.

WHAT YOU’LL LEARN:

•  How to reduce anxiety in pediatric emergencies (“pucker factor”) 
•  What flight nursing is really like behind the scenes 
•  Strategies for improving pediatric readiness in EMS and hospitals 
•  How to communicate effectively with pediatric patients and families 
•  Why family-centered care improves outcomes 

ABOUT THE GUEST:
Christopher Blake is a flight nurse and pediatric content creator dedicated to improving pediatric emergency care through education and real-world insight.

RESOURCES & LINKS:

•  Pediatric Readiness Initiative: https://pediatricreadiness.org
•  TikTok: https://tiktok.com/@theblakerycontent
  
  

 If you’ve ever felt unsure in a pediatric emergency — this episode is for you.
 Drop a comment with your biggest pediatric challenge 👇

Proud Partner: Med Max Edu
Sponsored by Med Max Edu—where nurses grow, learn, and lead.

Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

Transcript

SPEAKER_01 0:02

This is Hold My Stethoscope. Hey everyone. Welcome back to Hold My Stethoscope. We are super excited because we have a very special guest today, Christopher Blake. So I'm so excited to be talking to him. Christopher, do you want to introduce yourself and kind of tell us a little bit about your background and your history and all the fun things?

SPEAKER_00 0:26

Sure. Absolutely. Thank you so much for having me. I've been looking forward to this since we talked a little while back. So my name's Christopher with the Blakery content, and my whole platform, a per se, is about pediatric readiness and reducing that pucker factor that we a lot of healthcare providers feel when dealing with pediatric patients. So my background this year is actually 25 years for me in healthcare first responder kind of world. And I started out as a firefighter paramedic. And so I did that for about 15 years. And I started out in my 20s. And I always say, uh, you know, I was in my 20s. I didn't have kids. I didn't want kids. I didn't know how to talk to kids. I didn't know how to deal with kids. I didn't know anything about them. And I got a couple pediatric calls at the fire station where I was like, where I had that pucker factor, right? Where my butthole actually puckered because I was so uncomfortable. And got there and felt like the parents could have handled that child way better than I had. And so that kind of sent me on this path of I just started and I didn't like that feeling. So I started just trying to take every pediatric class that I could to get a little bit more comfortable and get a little bit more exposure to it. And then through that, I ended up, I was like, you know what? I'm going to dive in and I'm going to go to the regional pediatric center. And I started out there. So I was still working as a firefighter paramedic. And I started there as like an in-house transporter for their PACU. So basically the kiddos would come out of the OR, they'd still be sedated. We would recover them. And then I would transport them to the floor or out to the car, depending on what that was. And it was one of those where they they were concerned about hiring me because they're like, you're going to be bored here. And I'm like, no, I'm not. Like, I'm not comfortable with kids at all. Like this is going to be great exposure. And I got in there and um I was doing things I'd never done before, right? I was, I was holding babies, I was feeding them, I was comforting them and snuggling them and bringing them toys and teddy bears and blankets and doing all the things. And it was it was great initial exposure, but they were right. And six to eight months in, I was bored out of my mind because I I could I wasn't doing any of my paramedic things. I was just moving patients around. So I went and talked to the manager, and she was very kind and allowed me to transfer early. And I transferred to the uh pediatric, so the like ALS team, where it was two paramedics and doing ground like interfacility transfer stuff for pediatrics. And so I transitioned to that and then and still working as a firefighter paramedic. And I did that for about six months, and then they were like, hey, we want to cross-train you for the critical care flight team. And I was like, Okay. Okay.

SPEAKER_03 3:34

Okay.

SPEAKER_00 3:35

Yeah. And then by eight months, so only a couple months later, they moved me over full-time to the flight team. And so I was working full time, you know, I was working full-time as a uh pediatric flight medic and still doing like part-time firefighter paramedic thing. Uh, I did that for four almost five years, uh, while I was also going to nursing school.

SPEAKER_02 3:59

Okay.

SPEAKER_00 4:00

And then straight out of nursing school, uh, I had to come off the helicopter because you have to do, you have to have so many years of experience. So uh my first job out of a school as a new grad was pick you. So I did pediatric ICU as my new grad job. And I did that for 14 months, and that is where I fell in love with family-centered care. And I'm sure that's one of the things that we will discuss at some point here, because that is one of my soapboxes and one of my passions. But I and we can circle back to that, but I I did that uh for like 14, 16 months, I believe. And then I left there and I went to an adult level one trauma ER because there was a certain program I wanted to fly with. The whole reason I became a nurse was to fly with a very specific flight program. Okay. And they don't fly paramedics, they only fly nurses. So, like that was the only reason I went to nursing school was to fly with this program. So I ended up going to work at that hospital that that flight program was with to start networking and getting exposure and experience at that facility. And so I worked in their level one trauma ER. I did that for a year and just got spanked for a year. And then I transitioned to the a surgical ICU slash trauma ICU.

SPEAKER_01 5:23

Okay.

SPEAKER_00 5:23

And while I was doing that, like I had done enough networking that the flight program had actually reached out to me and was having me teach pediatric stuff to them before I was even working with them.

SPEAKER_01 5:35

Oh, that's so cool. Wow.

SPEAKER_00 5:38

Yeah. So then right when I hit my three-year mark as a nurse and like was at the bare minimum requirements to be able to fly, uh, a spot opened up on this team. And I had reached out and I was like, hey, is this like a real position or are you guys just moving people around? And they're like, no, it's real. Apply. And I ended up getting hired and uh started out with that program. And then uh life happened. And uh like 12 almost a year later, I had to walk away from that program uh and do life and do family. Um, but they were like, we better be your first call when you're ready. And uh so I I did some other things. Uh I went back to the pediatric center and worked as I actually went back as one of the pediatric and neonatal critical care flight nurses on that program. And then I transitioned into an educator role. I was the EMS coordinator for this pediatric center. And I did that for three-ish years. And I made that decision. I was like, listen, like I was non-clinical for three years. I was like, you're you either need to accept that you're never gonna do it again or you need to go now. I, you know, I sent some text messages and the director got back to me and he's like, hey, uh, we have a position, apply. The you know, same thing happened, and and I applied and I got that position, and that's where I'm at now. I'm back at that program that is the whole reason I went to nursing school, and that's where I'm working at full time doing that.

SPEAKER_02 7:16

That's awesome.

SPEAKER_01 7:17

Wow, it's like literally all the stars like aligned exactly like they should have.

SPEAKER_00 7:21

Yeah.

SPEAKER_01 7:22

That's a right.

SPEAKER_00 7:23

I I I'm one of those people that I never really I never really bought into things happen for a reason. However, there are so many things in my life that makes it very difficult to argue that fact.

SPEAKER_02 7:39

You're right. Exactly. So that's amazing.

SPEAKER_01 7:44

That is super cool. Did you always kind of see yourself like, you know, and you said that transition from EMS, but did you find yourself like wanting to do flight when you first went into medicine? Like kind of like about flight nursing?

SPEAKER_00 7:56

I did, yeah. So when I was a brand new EMT basic, I had done EMT school and then just got hired on the fire department. And then I spent a year going through fire school. And then as I was in paramedic school, I worked as a tech in an adult ICU. Okay. I was called a unit assistant. And this is back when the physicians would come in and actually like write, scribble out their orders on paper.

SPEAKER_04 8:24

Yes.

SPEAKER_00 8:25

And then and then I had to I had to go through and figure out what they wrote, yes, put those orders into a DOS system. I know fax it to the pharmacy to get the meds ordered and all that stuff.

SPEAKER_01 8:38

So the youngins don't know that pain, they don't understand.

SPEAKER_00 8:41

Yeah. The the the pain of calling that physician that just walked out of there and was like, what what what did you write? Yes, you know, yeah. And they're like, I clearly ordered clearly, I clear Yeah. So I I started out doing that, and while I was in paramedic school, so the nurses were phenomenal. Like some of the smartest people I ever met are still the nurses that I met way back then. And they knew I was going to paramedic school. So they're like, hey, and I was also like a tech where I, you know, I would help roll and do bed changes and all that stuff in between answering the phone and sending, you know, reviewing orders. But they uh so they would pull me in the room and be like, hey, come help me do this dressing change, right? Come look at this open belly. Or and then as I finished, you know, I was almost done with paramedic school, it was like, hey, I can't get labs, I can't get an IV. Can you cut it right? And it they just really included me and made me feel comfortable. So while I was brand new to the fire and EMS world and actively falling in love with 911 and getting in an ambulance and doing all that stuff, I was actively falling in love with the critical care side of it. And that's where that decision was made very early on in my career. I was like, I gotta fly. I want to fly because that is the, you know, I I have a huge respect for fired EMS, but I want to be the guy that they call when they need help, right? I want to land at that scene, I want to land in the middle of the road or a field and jump in the back of their ambience be like, hey, what's up? How can I help you? Yeah.

SPEAKER_01 10:24

So that's another thing, kind of talking about it. What is kind of like the reality of flight nursing? Because you you know, a lot of people want to kind of go into flight nursing, but maybe don't really understand it. So let's give us a little behind the scenes, like what's it really like? Yeah, like what's a typical shift look like for you?

SPEAKER_00 10:43

I think I think the very first and important statement to make about flight nursing or flight medic, right? If you're in an area that flies flight paramedics, it is achievable. It is achievable. If that's what you want to do, you can do it for sure. It takes a lot of work, uh, but it it's definitely achievable. So for me, we do uh 24 hour shifts. So when I'm at the airbase, I arrive, I try to arrive early. I'm not a very punctual person and or a morning person. But yeah, I try to arrive a little bit early. And then what happens is the first thing that I do is we gotta pull blocks. And what that is is the uh uh four units of whole blood on every mission.

SPEAKER_03 11:32

Okay.

SPEAKER_00 11:33

So we have to uh we have to pull the blocks, like the cooler ice pack thing out of the freezer and let them sit for a little bit and then change those out. So I start that first thing in the morning, and then I go through and I do my checks. I check the blood, you know, expiration dates, I make sure it looks good, I do all that stuff, and then I do drug counts. And then once I do that, I go out to check the aircraft. And I go, I'm one of those that I've been doing this for a long time, but I still, every single shift, I go out and I pull every single item out of every single pouch, out of every bag. I go through it, I make sure it's all there, and I put it, I repack it how I want it. Right, like in the same space, but organized so that I know when shit hits the fan, I can reach in and grab and I know exactly where it is that day because I put it there. Right. I check the aircraft very thoroughly. And then I come in and I check our balloon pump. So we do have a balloon pump at our base, and then um, and then we do our safety brief with the pilots and all of the other uh crews that are on, all of our ground units, all of our other air bases, our uh dispatch center, administration. Everyone jumps on the same call and we run through all the things and and talk about staffing and weather and concerns for the day. And then essentially at that point, the day is mine. I have the rest of the day to, you know, uh we do CQI or like QA QI stuff. So we do QA and QI like the previous day's uh charts. Uh and then obviously we have a ton of ongoing education and journal club and all those things that we do. Um, so we'll work through that stuff, but essentially the day is is mine. However, the expectation is when that page goes off that we are in the aircraft and ready to launch in like seven minutes. So there's a lot that goes into that constant state of readiness. And then as we get into the evening period, we our pilots will switch out and then uh we'll do our safety brief again, and then I'll prepare uh my night vision goggles uh for the night shift and go out and dial those in and make sure they're appropriate to to mine and then um go from there. Some days we get no requests, and other days, you know, I think the the I think the busiest uh day that I personally have had is five flights in uh in 24 hours. That's a lot. It is, and some of those flights are you know 45 minutes one direction, right? So, and then bedside times and all that stuff. And and there's a lot of like doing five calls on an ambulance is one thing, but when you're in a helicopter, the temperature's different, the vibrations are different, the positioning's different, like it it is just very taxing on your body. Uh, so it it definitely adds up. But um, but that is it. And then someday, like I said, some days, and then some days weather is terrible, and we may go by ground and end up in the back of an ambulance for a long period of time, but every day is a little bit different, and you never know what's gonna come. And we do everything from pediatrics up through adults, so and we do scene runs and we do interfacilities, so we do ICU transfer. Um so you never know if you're gonna land in the middle of a road or in the middle of a field or at a hospital and and do that.

SPEAKER_01 15:05

That's no, like that's super cool. How like I guess extensive is your region that you cover.

SPEAKER_00 15:12

Yeah, so uh we will do as far as scenes go, we're a little bit limited just because usually those are time sensitive. And but uh outside of that, like the facility stuff, I mean we can we'll go uh we go quite a ways. I mean, like like I said, the one facility we go to is like two hours and 15 minutes by ground.

SPEAKER_02 15:35

Wow.

SPEAKER_00 15:36

Yeah, so I mean we can go, you know, we we can go pretty far. Yeah.

SPEAKER_02 15:43

Yeah, that's that's quite a ways away.

SPEAKER_00 15:46

Yeah.

SPEAKER_02 15:47

I mean, do you find it kind of scary? Like, how do you know how to be prepared for the unknown though, with these transports? Like, unlike being in an emergency room setting, in a trauma setting, you know, at an emergency room or whatever, we know that pretty much all the things were there, but you're very limited.

SPEAKER_00 16:10

Yeah, absolutely. So there there's a yeah, so there's a couple things that go into that, right? And I think that's where let's talk about not even the flight side, but the pre-hospital side, right? So, like even just 911, um, I think there's a big disconnect between ER nurses and paramedics and EMTs, right? Yes. And so as a level one trauma center in the trauma bay, you have all the people, all the things, all the things, all the resources, all the yep, and and all the brain power, right? And the patient comes in essentially packaged and somewhat started, right? Right now, let's rewind that a little bit and kind of portray what EMS finds, right?

SPEAKER_03 16:57

Okay.

SPEAKER_00 16:58

So they get on scene and that horn is still blaring, that airbag is still smoking, and that patient is still screaming, right? So we're talking sounds, we're talking smells, we're talking uh visuals, right? Right, and and so that disconnect of well, why didn't you do this? It's like well, because I didn't have time. Right. I was doing right, so there is definitely we are all trying to do the same job, but we're doing it in very different environments with very different resources, yeah, right. So then uh and then throw that to the the flight side, where okay, let's say we are showing up at a scene, we're now jumping in someone else's ambulance, or if we go to another hospital, we're showing up at somebody else's ER or ICU. Like there's some kid gloves that go into that, right? Of being some PR side of that, of getting in somebody else's space, yes, and supporting them and essentially taking over without taking over, right? Right, without feel making them feel that. But yeah, you know, I had uh some nurses that I worked with for quite a while, like they saw me in my flight suit and they're like, they were kind of teasing me there because I had a uh flush in one of my pockets, and they're like, Oh, flush, you never know when you're gonna need that. And then I took them up to the helicopter and I put them in there and they're like, Oh, I don't, I don't, I don't have a Pixis. I don't have a med room to go get right. So if and and once I'm buckled in, right? I have a helmet on, I have a visor down, I'm talking on a microphone, and I I'm strapped in with a five-point harness. And if I can't reach it, so I have to prop place my bags properly, depending on what I may need, because if I can't reach it, I can't get it. And I right, so the space aspect and the equipment aspect, like we do things with very limited resources. Right. But going back to your like, how do you prepare for that unknown? I think that's part of the experience, right? And the requirement of having to have so much time to get into this position, right? So I spent all those years as a firefighter paramedic getting to that point, uh, you know, of responding to all these 911 calls and and managing these patients and getting them to the ER. And then I spent time in the pediatric world. And then I spent time, which happened to also be a burn center, right? So then I was getting, I was getting burn a pediatric and adult burn center. So I was getting exposure to that. And then I worked level one trauma ER. And then I did surgical ICU, trauma ICU, right? So I've got to see the whole spectrum of like EMS is very much, what do I need to do right now so you don't die? Right. And then ER is very much, all right, what do I need to do right now to either turf you and get you out of here or get you up to the floor? Yes. Right. And then ICU is very much, if I do this right now, what's gonna happen in seven days?

SPEAKER_03 20:12

Yes.

SPEAKER_00 20:12

Right. So those are very big differences, but we're all trying to do the same thing. And when you work that whole spectrum, you start to understand why each area has the frustrations that they have and why they ask the dumb questions that they ask, what feels to be dumb questions. Yeah, but then when you can step back and take all of that, that's how you because oftentimes when we get paged, we don't we get very minimal information. Okay, and we can talk about that a little bit more too. But there's you know, there's sometimes that we get adult trauma, and that's all the information you get. No weight, no history, no mechanism, no nothing. Adult trauma unknown. Okay, and we're in the air. And we don't know until we get in the back of their ambulance of what do you got? Or recently I had one that was we I didn't know anything. We were supposed to be going to a scene, and then we got diverted to the hospital and still didn't know anything. And as we were coming in on short final, meaning we were about to land, like literally, skids were almost on the deck. They said, You're going for a pediatric uh carverse e-bike. That's all we had. And that was literally a moment before we were about to land and walk into this ER. And I walk into that ER, not knowing what to expect, and they're doing CPR on this patient. So, like, and that quick, like you have to be able to snap in and do we we had no information, and we were able to walk into that room and start doing what we needed to do. And it's all based off of that experience and education and preparation that has all occurred up to that point.

SPEAKER_02 22:00

Wow. It's wow, that's amazing.

SPEAKER_01 22:02

No, I I think like the route you've taken is probably the best route you probably could. You have gotten to experience and learn so many different facets that it's like set you up to be successful in your role now. Like it's that's amazing.

SPEAKER_00 22:16

Yeah. Yeah. And I I say that, right? So if you look at my resume on paper, it may look like um that I hopped around right. That I hopped around. But if you sit back and look at it, it's everything everything was a forward progression. I knew where I wanted to go, and everything was a forward progression. Now, was I at some places for a short time? Yes. Did I give them a hundred percent that entire time I was there? Absolutely.

SPEAKER_03 22:47

Okay. Right.

SPEAKER_00 22:48

So like that is, you know, it may come off as being stepping stones, but it was it did get me to where I needed to be, but I also I also committed to that role in that, and I didn't look at it as like I'm using you, right? It was I'm absorbing and getting everything out of this that I can.

SPEAKER_02 23:10

Absolutely. And then I'm moving on.

SPEAKER_00 23:12

Yeah.

SPEAKER_02 23:13

And there's absolutely nothing wrong with that at all. I think it's actually great. Honestly, I wish I had done that. You know? Yeah.

SPEAKER_01 23:22

I mean, seriously, but so let's um kind of go into where you're at these days with um, you have the Blakery content, you have um reducing the fucker vector podcast. So um we'll we'll get to that in a second, but like let's go back and talk about the pediatric stuff. That was one of the things like I was most excited about because I have an um trauma center that I'm at. So what I guess you said right, you were fearful kind of kids never really took care of them, and then just kind of went head first into learning everything you needed to know about them. Um, how was that experience and like what kind of advice do you have for others who may have may are maybe they're in situations like you where they have like Felicia?

SPEAKER_00 24:06

Yeah, it's so it all comes down to exposure. Okay. And I've said this many times that I've been accused of being a pediatric expert over and over, and I'm not an expert by any means, by any means, but I've been exposed to it more than the average person. And that builds my confidence, that makes me more comfortable. And that's all it comes down to is all about that exposure. So if you are not comfortable with something, dive in. That's how I became an educator. I was not good at public speaking. I was the kid, and I can still very vividly remember back to grade school, high school, that the teacher would be like, We're gonna go around the room and we're gonna do this. And like my throat would instantly clear up. I'm counting heads of like how many times, which what sentence am I gonna have? Right. I I hated it. And now I'm traveling, I've done more traveling already this year, speaking at national and international conferences in front of large groups. Then I, you know, it's incredible, but I overcame that by taking every instructor class I could and forcing myself to start teaching. And it's the same with pediatrics, is I it scared me to death. I was not comfortable. And I just fully dove in and started getting more and more exposure and and making my building my confidence and building that to overcome that fear. So it's any way that you can get exposed to it is going to be beneficial. It will not be a waste of time. If you're gonna be an ER nurse, it's going to set you up for success because we know that a majority of pediatric patients do not go to a pediatric hospital to start with, right? So if you're going to be, you know, if you're gonna be strictly ICU, then maybe not so much because you're gonna be a little bit more age specific there. Uh but you know, depending on what you want to do, you any exposure is not gonna hurt.

SPEAKER_02 26:11

I wish I had gotten myself more exposed. I came, I worked in an organization where the pediatric and the adult emergency rooms were separated. So I only did the adult side, and we didn't really do too much cross-training. Even many years ago, we would say we were gonna cross-train, and then it just kind of you might go over there for a shift, but not really get like in it.

SPEAKER_03 26:37

Yeah.

SPEAKER_02 26:38

And that is probably one of my biggest regrets because I do have that fear when it comes. I have two children, but my kids are grown now. But I don't know, it's just different knowing that you have to put an ID. I don't know, I feel like that, even though I don't feel like that about adults. It's just so different. So it's the unknown that's the fear that sits in. Yeah, so and I can relate to what you're saying because three years ago I walked into education after being an ER nurse for adults for over 20 years. And that was scary for me. I'd never taught a class. I really didn't really like talking in front of people either, and that was scary. Like I talked with my friends, but not like a big group of people, like so, but diving in, it really, really did it's helped me definitely. So I can understand that was great advice as far as with doing the same when it comes to kids, you know.

SPEAKER_00 27:45

Yep. So there's a piece there that I talk about often is you know, we we discuss medication errors frequently, right? And they're they're significantly higher with our pediatric patients. Yes, yes, because everything's weight-based and all that, but the the what I would say occurs even more is the error by omission. And what I mean by that is that we are so uncomfortable with assessing and treating and managing these pediatric patients that they get under-treated because we're not comfortable giving that narcotic or pain medicine. So we're just not gonna do it. Like, yep, they're yeah, they seem okay, right? Or we're gonna delay this, or giving that treatment, or whatever it may be. Uh, it's because of our own insecurities and lack of confidence and comfort that they end up getting under-treated, undermanaged, and oftentimes discharged home and then have to come back, or you know, continue to be miserable. When if you would have just put that IV in and gave them some medication and treated them, they could have been well on their way, right? Um there or continue to get worse and worse and worse. Dr. Antebi talks about a case that he had that this occurred where they missed sepsis in this pediatric patient. And it was, it was, he just got bounced from provider to provider to provider. And ultimately, by the time this patient got to Dr. Antevi, he was beyond sick. And this patient ended up losing multiple extremities because of the need for the pressors, and all, you know, because they were so far behind, because kids compensate and compensate and compensate till they don't, right? So kids look great, and right, and and and that's one of the things I say all the time, right? Is kids compensate and compensate and compensate until they don't. And there's this, there's this statement out there that you know, once they fall, they just abruptly fall off this cliff. And once they fall off that cliff, it's hard to get them back, right? But and I I believe that completely, but what I would argue is that there are signs that entire way leading up to it, and we overlook them, we miss them because kids compensate so well that we're not looking at that. Oh, their heart rate's up a little bit, right? Yeah, oh, they're a little tachyptic, but kids breathe fast and they tolerate higher heart rates, right? That's a kid.

SPEAKER_01 30:35

They're crying. Yeah, lots of and yeah, you can definitely like push off those things if you're not used to seeing them and and it's not something that's okay. Yeah, so absolutely, yeah. Yeah. So I guess with that, like what made you start the Blakery content and what made you kind of start your podcast? Because I'm gonna be pediatric education.

SPEAKER_00 30:59

Yeah, it it was one of those things that as I started growing in pediatrics, I felt like there was a need for this. And I've for a long time I thought about doing it, and I was just like, I know if I do this, it will be successful. Like I knew that, but I kept putting it off because I was like uh uncomfortable. And what are people gonna think? And what are they gonna say? And am I really gonna be a TikToker and doing this stuff? So I I bounced around. I mean, it was probably a couple years that I kicked that around. And then there was one day I'm scrolling through TikTok, and um, Alex Jabber of uh Emergency Resilience, she she does online like education coaching, but she also does, she has a phenomenal death notification course of how to talk to the families around death and explaining that and all that. And she had a video and she was like, she's like, Listen, just do it. She's like, if you are even remotely thinking about doing online education and content, she's like, you are a subject matter expert, you know the information, and if you're even thinking about it, just do it, just post the first video. And she's like, it's not gonna go anywhere, it's not gonna get right, it's probably gonna suck. However, just post the first video and build from there because once you get that out there, you can build from there. That day I went and recorded the first video and posted it. And three days later, that video had over 135,000 views and I gained over 3,000 followers. What was that first video about? Uh pediatric ventilation, how to properly ventilate with an ambu bag on a pediatric patient.

SPEAKER_02 33:08

Yeah, yes.

SPEAKER_00 33:09

And I was like, wait a minute, this wasn't supposed to go anywhere. Nobody was supposed to see this.

SPEAKER_02 33:15

Look at that.

SPEAKER_00 33:16

And it was, you know, it was just that confirmation of concept, right? And it it reassured me that everything that I had been thinking for years was accurate and that there was a need for this and there was an interest. And I think the fact obviously the helmet and flight suit is a sales pit, right? Like people are engaged, and and this was an eight, eight-minute TikTok video, right? It and it still it still took off. And but I start the video out with do you get nervous when you have to ventilate a pediatric patient? And then I'm like, so do I. Let's talk about it, right? As like as the pediatric professional, I still get nervous too. Right. But let's let's talk about it. And how do we reduce that discomfort a little bit? And it all comes down to preparation and increasing your confidence level by training and doing the things. And it's just taken off from there. And the podcast itself was never really intended. It was just one of those, you know, it was like an afterthought of what if I interview high-level pediatric providers across the country. And I don't even know if still to this day, like the actual point is the podcast itself and people sitting down and listening to the whole podcast. But the information having that discussion and dialogue with those high-level pediatric providers, and then being able to break those down into the smaller clips and videos and be able to push those out and get that information out there. Of again, not just me talking, but you know, my first guest was Dr. Antevi of the Hantevi system, who is phenomenal in the pediatric world. And the second one was Patricia Frost, who is doing pediatric disaster preparedness on the national level. Uh, the one that comes out tomorrow is with Dr. Uh Tracy, who is big on TikTok, doing she's a pediatrician and doing just breaking down myths on TikTok for new parents and that kind of stuff. So that was the whole plan just to get high-level pediatric providers and share their like what's important to them right now in pediatric care and what are their thoughts and and going through that. So that's how the podcast kind of came about. And um, yeah, it's been a uh whirlwind for sure. That's awesome.

SPEAKER_01 35:48

How long has it been? I I didn't go back to the beginning, but obviously.

SPEAKER_00 35:53

Yeah, I uh I mean just like middle of last year, I think. Like, yeah, like it hasn't been, it has not been long at all.

SPEAKER_01 36:04

So did you ever think kind of content creation and you know what you're kind of doing now was part of your plan ever?

SPEAKER_00 36:14

I I think a little bit. There there was that point where I was like, I really enjoy the education and spreading awareness and breaking down, making people feel more comfortable pediatrics. Um and I I think I always plan on being a YouTuber and doing YouTube videos and that kind of stuff, but then TikTok came around and like it just it just it was so much easier to just do and and share and get up and running. And so I went that route, and um it's been crazy ever since.

SPEAKER_01 36:47

That's that's amazing. That's awesome. Yeah, I mean, just for somebody who's started out a little, hasn't had your success, but like I love being able to share education too. I think the more that people have the opportunity to find education in the ways that they like to consume it, the better off they're going to be if they can get little tidbits from TikTok that's gonna help them be more prepared to take care of patients and like all for it. Like, I I'm I'm all for everybody like you know, getting that information because we're living in a different generation than we should with those ladies and those little.

SPEAKER_02 37:26

I was like looking at that video, I'm like, my goodness, it was great.

SPEAKER_01 37:32

What do you kind of um are making about the the pediatric readiness push that's kind of going on nationwide right now? I'm sure it's probably you're very excited about it.

SPEAKER_00 37:42

Yes. Yeah, it's it absolutely. So I sit on the uh EMS for children board at the state level in my state, and you know, there's things that we've been talking about there for a while, and it's it's coming about. And with the results of the new survey that came out, uh so I played a very instrumental role in getting agencies within my area to fill that survey out. Like I was literally like picking up the phone and saying, Chief, like please fill this out. And what can I do to support you to fill this out? It's very easy, right? Like I was I was cold calling fire chiefs all over the state and trying to get more and more people. And I'm like, listen, like this is how we're gonna generate funding. Like, we need this information. So uh I was excited to see those results come out. Uh, I think what was pretty awesome is the organization that I work for saw those results come out and came to me and was like, Did you see this? And I was like, Yeah, yeah, I was a I was a part of that. And they're like, We need to do this. And I was like, Yeah, yeah, we do. And I actually just recently got moved into, I got taken out of um some of my clinical time, is getting moved into a non-clinical. I'm actually becoming the PEC, so the per pediatric emergency care coordinator for my agency, but then also all of the EMS agencies that fall under us for med control. I am now going to start working towards getting them pediatric ready and designating pecs at all of those departments and working with them to roll out pediatric education, all because of those results in that study that came out, which is absolutely much needed, right? And so I'm pretty excited about that opportunity.

SPEAKER_01 39:42

That's all yeah. No, in the area you work, does your system have like smaller satellite hospitals where they really need this and can benefit from this?

SPEAKER_00 39:53

Yeah, absolutely. Even our main hospital will benefit from it. It is a pediatric trauma center, but still they don't see a ton.

unknown 40:04

Okay.

SPEAKER_00 40:04

So, and then the satellites even less. And then yeah. Yeah. So uh yeah, it'll absolutely be beneficial. And I sat down on Monday, I had an office day and was like literally just starting to build this from the ground up and start creating, like, I was able to send the director and my manager, like, all right, you know, questions of like what are they expecting? Right. And then, but then then there was another page of like, here's what I already have planned in my head. Here's what I plan to do. Does this align with, you know, and go from there?

SPEAKER_02 40:41

Right. Yeah.

SPEAKER_00 40:42

Yeah. And I and I think they're looking to me to build it into what I want it to be based off of my background and experience, which is exciting.

SPEAKER_01 40:52

That's no, that's very exciting. Obviously, with the new legislation and all of this, it's it's very exciting to see like you talked about statistics, right? A lot of families and kids go to facilities that are not pediatric centers. Yes. Exactly. So just to see that push towards taking better care of our kids is is such a win. It's it really is. I'm very, very excited about you.

SPEAKER_00 41:17

So step that back again, right? So I'm I always tend to lead more towards the EMS side of it, right? So again, EMS, they're responding to everything. It it they don't get to like, oh, this is a pediatric call, send that unit or send that nurse or whatever. Right. It's that call comes in and they respond to it. So, and we also know that statistically for EMS on national, about six to thirteen percent of their call volume is pediatrics. And for some agencies, that call that volume is closer to one percent. Yeah. So they're seeing very few pediatric kids patients on a monthly basis. So, but when that call comes in for a pediatric patient, that family expects them to show up and be ready to care for their child in the same way that they would care for that adult patient. So, one of the things that we're moving towards here in this state, and a lot of states are doing this now, where they've started doing the pediatric readiness recognition for emergency departments, similar to a STEMI center or stroke center. They're now doing that for pediatrics, but then they're also doing that for EMS agencies as well, where there's an EMS agency pediatric readiness recognition. And there's, you know, there's the ED survey of pediatric readiness, but there's also the pre-hospital readiness survey where they're doing the exact same thing and evaluating all that. And the numbers are, I mean, they speak for themselves. Like the EMS just doesn't do enough of it. And there's it clearly shows having a PEC impacts that. Is I will be creating PECs at all of these agencies and then working with them to support them and look at their equipment and provide training and QA and QI and all that stuff.

SPEAKER_01 43:23

That's that's awesome. I, you know, I'm just very excited about that. But I did want to touch on like a couple more things just before we, you know, are at the end of our time. Um, you know, Panatakus talked earlier about your, you know, your passion for family-centered care. Do you want to kind of go into that and kind of tell us about that?

SPEAKER_00 43:42

Yeah. So uh thank you for bringing that back up. I think that so often we look at family members as being difficult or intrusive or but what we have to understand is that they are not just anxious bystanders. They are part of that care contiguum. We have to include them. We have to communicate to them. We have to reassure them. We need to explain to them what we're doing, why we're doing it. Oftentimes in pediatrics, right? And sometimes in adults. Obviously, honestly, like I started to fall in love with the family center care while working in the PicU, but where I really fell into it was working adult ICU, end-of-life conversations and terminal weans and doing that stuff and having families go from I want everything done to deciding to not do everything to terminal wean and walk out of that ICU feeling comfortable and smiling and knowing that their family member is now comfortable and no longer struggling and that they didn't have to make that decision, but they were basing that decision off of the wants that they knew that their family member wanted. Right. So they were putting that decision back on their family member and having those conversations and supporting those people. And I say oftentimes one of the most frequent and most critical skills that I provide is just holding someone's hand or giving them a hug and including them in that. So, you know, bringing that back to the pediatric world is like those parents, they know that patient better than anyone else. They know the triggers, they know, right? So they're a huge resource and we have to include them in there. And I think oftentimes it comes back to we're not confident, we're not comfortable, so we're not going to communicate and we're going to be standoffish and we're just going to do the things that we and we don't want anyone to see what we're doing because we're not sure that we're doing it correctly. Right. And so we have to incorporate them in there. One of the things that I do that really changes the game is when I first walk into a room for a pediatric patient, the very first thing I do is look at mom and dad. I make eye contact and I say, hey, my name's Christopher. I'm one of the nurses with the flight team. We're here to get your child to wherever we're taking them. Okay. I always tell them, I said, listen, right now, your child is my priority. I'm going to go over, I'm going to assess some things. I'm going to put them on our monitor. We're going to look at some things. I'm going to get some information. We're going to do what we need to do immediately. And we're going to get out of here pretty quickly. This is all going to move very fast. And then once I do all that, I will circle back and I will have a conversation with you. Do you have any immediate questions for me right now that's going to impact my care? And oftentimes they're like, nope, do what you need to do. Right.

SPEAKER_02 47:03

Exactly.

SPEAKER_00 47:04

And that only took seconds.

SPEAKER_02 47:06

Yeah.

SPEAKER_00 47:06

And in that moment, they went from, right? Because oftentimes you walk in and they're irritated because they've been waiting for a long time or their kids sick, right? And what I do right there is within seconds, I say, I see you, I hear you. However, your child is more important to me right now. But I'm coming back to you. But I am going to come back to you and we're going to address all the things. But right now, I want to make sure that your kid is good and do anything that I need to do. And then we'll circle back. And oftentimes, like you can see their whole demeanor change of nope, no, you do you do what you need to do. And they feel heard, they feel seen. And that's is such a huge piece as being a parent, is you just want to be heard and feel like your child is a priority.

SPEAKER_01 47:58

Right. That's amazing. Like you're right. I feel like that's huge and so under like stated, but it's like such an impactful thing for families and patients, like when they are in that situation.

SPEAKER_00 48:10

Yeah. And and as care providers, right, we see the worst of the worst.

SPEAKER_03 48:15

Yes.

SPEAKER_00 48:15

So when we walk into a not so sick patient and the family is hovering, and this and that, and it's, you know, it's 6 30 p.m. on a Tuesday, and we're ready to, you know.

SPEAKER_03 48:30

Get up out of there.

SPEAKER_00 48:32

Yeah. Get up out of there and do right. And and we walk in, and this family is just a lot. They're a lot because no one has communicated to them. No one has explained to them the plan. No one has explained to them what's going on with their child. And as soon as you can break that down, they're like, okay, all right. I I had one family, I tell this story often, is it was a pediatric trauma, and we get there, and this patient was intubated. Uh, the family was not there yet, and we're in the room doing the things. We're about ready to get up out of there and transport this patient. And the nurse says, Mom is in the hallway. So I look at my partner and I say, I'm gonna go out and talk to mom quick. I'll be right back. I go out to mom and she's standing out in the hallway by herself with that 10,000 yard stare of her brain was making up every worst case scenario because she had not seen her child. She was not there when this happened. She was at work and got the call. So I go out and I, first thing, I'm like, hey, I'm Christopher, one of the flight nurses, you know, one of the nurses with the flight team. We're gonna get your child up to the pediatric center. Here's what's going on, right? And I said uh they did put a breathing tube in. They not because she was not breathing on her own, but because we wanted to take that workload off of her. So she is sedated right now to keep her comfortable and allow us to treat her without jeopardizing that. But again, she was breathing, but we are breathing for her now because we gave her medications to take over for that. You're gonna see some bruising and some swelling on her face. She has an obvious fracture of her leg and some bruising on her uh abrasions on her body. I said, but when you get in there, I said, you're more than welcome to come in, give hugs and kisses, and uh we're gonna get out of here pretty quickly. Do you have any questions for me? And as soon as I started talking, you could see her lock in. She started reading my name tag and was paying attention to every word that came out of my mouth. She came in, gave hugs and kisses, and we left. We fly this patient to the pediatric center, drop them off, give report, do handoff, and we're out doing like cleaning up our stuff and we're getting ready to leave. And I see mom showed up and she's standing in the hall by herself again. Just you could see she had that look again. So I walked over and I said, Hey, mom. I said, the flight went, it was completely uneventful, went great. Um, I said, I know this room, this trauma bay, looks overwhelming. There's a lot of people in there, there's a lot of things going on. I said, This is what it looks like when every patient comes into this room. What they want to do is make sure they find look at everything and make sure they're not missing anything. And I told her, I said, I have personally worked with most of the people in this room. You guys are in good hands. And she gave me a giant hug and we left. The next morning, I'm scrolling through Facebook as I do. I'm doom scrolling, and it's picture after it's this child, this child, this child. Here we ended up being close friends of close friends. And this mom read my name tag, and she was able to reach out to me, and she said, I knew in that moment I was going to find you when this was over. And we got to meet up, and she, you know, the the kiddo did fantastic and got to come out to the airbase and climb in the helicopter and do all the things. But what that mom told me, she goes, she goes, and this will live with me forever. She goes, You were the only person that talked to me. She goes, you brought comfort when I couldn't even breathe. Right. And I was like, I was so taken back because I was like, all I did was talk to you in plain English. Like I just, I just explained to you what was happening, what was going on, what was going to happen. And that was the most impactful thing that could have happened to her that day. And I'm thankful that I got to play that role. And it's moments like that that make me continue to realize how important family-centered care is.

SPEAKER_03 52:47

Absolutely.

SPEAKER_00 52:48

And if if we all incorporate that into and understand that, yes, it's just a Tuesday to us, but this is the worst day for most people that we encounter.

SPEAKER_03 52:58

Absolutely.

SPEAKER_00 52:59

Regardless of how severe it is.

SPEAKER_01 53:02

Yeah. I guess the other portion kind of of this communication thing, that's a great story. And I kind of wanted to end on that, but like I do have one more kind of question to this is what kind of tips and tricks do you have for people taking care of pediatric patients as far as communicating with them about procedures or communicating, like you did a great job, obviously, of communicating with the family about what's going on. But do you have any tips and tricks for anybody listening about how to communicate with the actual pediatric patient?

SPEAKER_00 53:32

Just be honest. Never ever lie to a pediatric patient. If it's gonna hurt, tell them it's gonna hurt.

SPEAKER_02 53:40

That's what child likes to be it.

SPEAKER_00 53:42

Yeah. Um the the cool, calm, collected uh demeanor of just of allow them to sense your peace, right? Which is hard to do when you're not feeling confident.

SPEAKER_02 53:56

Right.

SPEAKER_00 53:56

And uh, but allow them to feel that because they are gonna sense that, they're gonna pick up on that. But it is communicate everything and give them give them little wins and little decisions, right? And and and tell them this happened. Do you want this color or this color? Or do you want me to tell you everything? Or would you rather me just go? Do you want me to count down? It has to happen. It's gonna suck, it's gonna pinch. And as soon as it's done, mom and dad can pick you up, or I get you a popsicle, or whatever that may be. But never ever lie to them. Talk through everything that they want you to talk through, avoid the big words and you know, make funny faces at them and try to, you know, another thing is if they have a teddy bear, be like, Do you want me to do this to your teddy bear first? Can I listen to your teddy bear? Can I, you know, can I show you what this is gonna look like? I had a kid that one of the when I was first getting, I just got accepted to get hired at the pediatric center and I was still running 911. And I was still very unsure, but we got called out for an unruly, I believe it was a five-year-old, unruly five-year-old. And I I, you know, the whole way there, I was like, sounds like this kid needs a spanking, right? Right, right. And I and I get there and I'm talking to social work and the adoptive parents, and they're like, This is the worst kid I've ever dealt with. He's like turning over furniture at the doctor's office, like he's aggressive, like doing all these things. And as they're talking to me, this five-year-old kid comes out, like dressed in the coolest clothes ever, comes out and stands there with his hands in his pockets, like, you know, and just eyeballs me and looks me up and down and just gives me that look of like, you don't have a chance. And I was like, Okay, sir, okay. And he went back in his room and I finished, you know, talking to them, and I they were like, he has to go. So I I I walked in his room and and I'm talking to him, and I said, Listen, I said, uh, I said, I tried to get the story of what was going on. He wasn't really talking, and I I just told him, I said, listen, I said, and then finally he he goes, they lied to me. They lied to me, they and I forget exactly what it was, they told him, but and I and I just looked at him, I said, Listen, I said, I will not lie to you. I promise you that. I said, you are leaving here with me. You have to go to the hospital. There is not a choice. The choice is, do you walk out of here like a big boy, or do I carry you out of here? Because at this point, there is no option. But those are the choices. And the social worker, the parent came in and was like huddling, and they're like, he's never gonna walk out of here, and blah, you know, I was like, go. I said, go. And I shooed them out and I continued to talk with him a little bit. And he was like, he's like, I'll walk out. I said, okay, but here's the rule. I said, if you're gonna walk out there, I said, you're gonna hold my hand, you're not even gonna look at them, you're not gonna, or I said, you're not gonna talk to them, you're not gonna acknowledge them. We're gonna walk right past them and we're gonna go out to the ambulance and I'm gonna get you out of here. And he goes, Okay. And he hopped up, he held my hand, he walked out of there. And I swear to you, as we walked past those, those two people, he, he gave them that look of like, F you, I'm out of here. He didn't say a word, he did not say a word, but he walked out to that and we got to the door, and and I was like, and I said, Do you want me to get the door or you want to get the door? He's like, I'll get it, and opened the door, and we went out and we got to the ambulance, and we had the best ride to the hospital. And we were talking, you know, I was like, What do you want to be when you grow up? And he was like, I think I want to be a football player. And then he goes, he goes, either a football player or maybe a counselor. He goes, because I he goes, I could help other kids because I know what medications work and which ones don't. And I might be able to help other kids with that. And I was like, sir, I think that would be a great option for you. And we had yeah, and we had the funnest ride to the hospital, and like I dropped him off, and I literally was like, okay, I think I can do this. I think I can do pediatrics. Right.

SPEAKER_02 58:37

Because most definitely.

SPEAKER_00 58:39

Right. It was just that like final confirmation, and and that's how it's been ever since. Is like when you can give them the space to be them, right? And and honest, open, honest communication. We had we had a family that brought a kid in for surgery and told them they were going for a birthday party.

SPEAKER_03 58:59

No, we can't do that.

SPEAKER_00 59:01

And they show up at the hospital and have to have surgery. It's no, we can't do that. Yeah, it's just open, honest communication. Tell them it's gonna suck if it's gonna suck, but give them the choice, let them make what choices they can.

SPEAKER_01 59:17

Yeah, that's true.

SPEAKER_00 59:18

That was a really long-winded answer to that.

SPEAKER_01 59:20

But I felt like I love it because I do feel like, especially if people have never really had the chance to take care of kids, like they don't really know how to communicate with kids. And that's like a huge thing is to be able to like, you know, like I said, give them the choices and kind of rewards and all of those like little things. So I I did think it was important to touch on it. I I like your stories.

SPEAKER_02 59:42

I love your stories, but you actually make a good point on just knowing how to talk to people, period. Whether they're kids, whether they're adults, whether whether they are behavior, health it's just communicating you know, with people and stuff. And I do feel that you do see a world of a difference when you do that. You are 100%.

SPEAKER_01 1:00:06

Well, we also hate I always hate to like smash on the generation, but we are coming from a generation where it is different now. Like the communication's not happening as much face to face in person, and it's all like online and all of this stuff. So there is a deficit in communication in general right now. Because they have social anxiety.

unknown 1:00:28

Yeah.

SPEAKER_02 1:00:29

So they don't talk to people, they just go in and do things, and they don't, you know. We have to talk to people. We have to. We have we need to talk to the family members, we need to talk to the patients, you know.

SPEAKER_00 1:00:42

Yeah. I've started doing uh a lot more posts on LinkedIn about family-centered care and that communication piece. And the one that I just did the other day was like we lose families within the first 10 seconds. We lose their confidence, we lose their everything because we go in and we don't acknowledge them and we start doing work and you know, and and it's that piece that we met. Yep. Yeah. So yeah.

SPEAKER_01 1:01:10

This is this has honestly been amazing. Like I said, I was very excited to talk to you all about pediatrics, but I feel like you've brought some really good, really, really good points, like especially for ER nurses who, you know, uh there's always that struggle between pre-hospital world and um the hospital settings. So that was a great, like two mix centrics there, some tips and tricks about pediatric care, the insides of flight nursing. This has been it's been wonderful.

SPEAKER_02 1:01:36

It's been thank you so much.

SPEAKER_01 1:01:38

Like, yeah, you make anything else you wanna say or plug or you know, anything before we are.

SPEAKER_00 1:01:46

No, I think this has been fantastic. I think we hit on a lot of good points. I think, you know, just kind of touching base again there on what you just mentioned, that disconnect between pre-hospital and and ED, right? But so what I would challenge every ER nurse to think when EMS is calling them report and they're the one taking that call, is to think about the feelings that they feel when they call the ICU report. There you go. There you go. That's it. And you're like, why is this? Why are they asking me this question?

SPEAKER_02 1:02:19

Why they want me to put on their whole assessment? Right. Touche. Touche. I like that. I like that.

SPEAKER_00 1:02:25

I don't I don't know what their skin looks like, and I don't know what their urine output is, but they may have peed the bed, right? And you can weigh the sheet when I get up there, right? Like touche. It's true. Those are the things that like we are all function, but when you are working in the ICU, you then understand why they ask those questions. Yeah, yeah, you know, like their urine output, you're like, you're literally changing things every 45 minutes on that.

SPEAKER_03 1:02:52

Yeah.

SPEAKER_00 1:02:53

So it's just understanding everyone's world.

SPEAKER_01 1:02:55

It's right. That's that's true. But it's so true because we're all here, hopefully, right, to take care of the patient, and we are all doing in different ways, but the end goal is the same. And it, you know, we just gotta all be gracious to each other because we're all just trying our best to make sure our patients are getting good.

SPEAKER_00 1:03:14

That is one of the most things that I'm most thankful for is that I have walked in the pre-hospital shoes, the ER shoes, the ICU shoes, the flight shoes. So, like when I show up in all these different environments, I know what their intentions are, I know what their priorities are and all that.

SPEAKER_02 1:03:30

You have the entire picture. That's what we use.

SPEAKER_00 1:03:34

So, but thank you so much for having me. This this really has been a lot of fun. And uh, thank you so much.

SPEAKER_01 1:03:40

So, yeah, everybody, I will drop a social link in our um little description here. Please go check him out. He's been great. So if you want to see more of him, please check him out. Thank you, Christopher, and everybody will see you next time. Thanks again, Christopher.

SPEAKER_02 1:03:55

Yeah, have a good night.

SPEAKER_00 1:03:56

Absolutely. Thanks, you too.