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Emergency Medical Services for Children Program

What does the EMSC program address?

The mission of the EMSC program is to reduce child and youth mortality and morbidity sustained due to severe illness or trauma. The EMSC Program aims to ensure that state of the art emergency medical care for the ill and injured child or adolescent; pediatric service is well integrated into an emergency medical service system backed by optimal resources; and that entire spectrum of emergency services, including primary prevention of illness and injury, acute care, and rehabilitation, is provided to children and adolescents as well as adults, no matter where they live, attend school or travel. Who do you reach?

The EMSC program has in past and present, funded and supported pediatric emergency care improvement initiatives/projects in every State and U.S. Territory to expand and improve emergency care for children who need treatment for life threatening illnesses or injuries.

How do you reach them?

State Partnership Grants (SP): In response to the Institute of Medicine’s (IOM) Report “Growing Pains,” and in partnership with EMS-professionals from across the country, the federal EMSC Program implemented baseline performance measures to address the gaps in healthcare identified in the IOM Report. Based on ongoing assessments conducted by the EMSC State Partnership grantees, the EMSC Program has been able to complete the only national assessment of pediatric pre-hospital emergency care in the nation. EMSC performance measure data has been collected from thousands of EMS agencies and hospital’s to assess the:

• Access to medical direction for EMS providers treating and transporting pediatric patients
• Appropriate pediatric equipment and supplies on ambulances to treat children; and
• Availability of inter-facility transfer agreements and guidelines (processes) designed to expedite the transfer of pediatric patients to the most appropriate facility.

Additionally, Program Partners in the states and territories focus efforts to assure that:

• Basic and Advance Life Support Providers receive pediatric education to maintain competencies necessary to treat pediatric patients;
• EMS Providers are trained to transport and transfer children to the most appropriate medical facility that has been officially recognized to be equipped and prepared to treat and stabilize pediatric patients during medical emergencies and traumatic incidences;
• There is sufficient oversight and dedicated personnel managing the program;
• An Advisory Committee meets regularly to support program personnel and to guide project activities;
• The state/territorial EMS Board has pediatric representation; and
• Mandates are in place to assure pediatric medical direction is available 24/7; EMS providers receive pediatric education continuously; ambulances are equipped with pediatric equipment and supplies; hospitals with emergency departments are ready to treat and stabilize pediatric patients are they have agreements and guidelines to expedite the safe and efficient transport and transfer of children to the right care.

Funding is available to each State and U.S. Territory through the State Partnership grant mechanism. Under these partnership grantees, federal funding if available is awarded annually.

Targeted Issue Grants (TI): TI Grants are awarded to eligible applicants to help address issues of national significance that extend beyond State boundaries. Typically, these grants result in new products or resources, or show the feasibility of new methods, policies, or practices.

Examples of products and resources developed:

• A national educational curriculum teaching EMT’s and paramedics how to treat pediatric emergencies. The Program called Pediatric Education for Prehospital Providers (PEPP) was originally developed with a TI grant and is now regularly updated and promoted through the American Academy of Pediatrics.
• Performance measures defining quality metrics for treating children in the emergency department.
• A pain management curriculum in the prehospital setting.
• Training curriculum teaching emergency care providers how to care for children with special health care needs.
• Training curriculum for school nurses to prepare for emergencies.
• Facial recognition software that can be used by hospitals to reunify parents and children during a disaster.

Studies conducted by TI grantees have resulted in new knowledge regarding:

• How to manage respiratory arrest in children in the prehospital setting.
• How to manage cervical spine injuries in children in the prehospital setting.
• Genetic markers for fever in children.
• Injury prevention strategies in children.

Pediatric Emergency Care Applied Research Network (PECARN): the purpose of PECARN is to demonstrate the value of an infrastructure or network designed to be the platform from which to conduct investigations on the efficacy of treatments, transport, and care responses in emergency care settings including those preceding the arrival of children to hospital emergency departments. PECARN provides the leadership and infrastructure needed to promote multi-centered studies, support research collaboration among EMSC investigators and to encourage informational exchanges between EMSC investigators and providers. PECARN conducts meaningful and rigorous multi-institutional research into the prevention and management of acute illnesses and injuries in children across the continuum of emergency medicine health care. PECARN works with diverse demographic populations and across varied geographical regions to promote the health of children in all phases of care. The PECARN network consists of multiple Emergency Departments across the nation which represent academic, community, urban, rural, general, and children’s hospitals. The entire network serves approximately one (1) million acutely ill and injured children every year. The PECARN network has published numerous peer reviewed articles that focus is on improving pediatric emergency care nationwide.

What are the programs future goals?

Future EMSC programs goals are:

• To develop effective and sustainable training methods to improve pediatric knowledge among EMS providers
• To assure that program grantees address improvements in pediatric care provided by emergency medical services (EMS) providers in the pre-hospital setting
• To identify evidence-based triage protocols and hospital designation choice of acutely ill or injured children
• To evaluate the health outcomes of pre-hospital pediatrice care
• To develop modules of regionalization and telemedicine that allow for timely transfers or care delivery to criticclly ill or injured children in rural settins where specialty care is not readily available

Do you have any special partnerships?

The EMSC program has long learned that achievement of goals and priorities could not happen without the involvement of people from many walks of life or without the cooperation from other federal agencies and national organizations. The EMSC program has established ongoing partnerships through interagency agreements with multiple federal agencies:

• The Office of EMS located within the National Highway Traffic Safety Administration (NHTSA)
• the Centers for Disease Control and Prevention (CDC)
• the Indian Health Services (IHS)
• Agency for Healthcare Research and Quality (AHRQ).
• National Institutes of Health (NIH)

The EMSC program is also involved with several federal collaborative. The Federal Interagency Committee on EMS (FICMES), National Emergency Medical Services Advisory Committee NEMSAC and the Interagency Committee on EMSC Research (ICER) who’s main focus are to improve collaborative efforts for the improvement regarding the quality and quantity of EMSC research. The EMSC program has established partnerships with diverse national organizations that look to the improvement of emergency medical care of children through the exchange of knowledge and collaboration. These partnerships include but are not limited to: Academic Pediatric Association, American Academy of Family Physicians, American Academy of Pediatrics, American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American college of Surgeons, American Heart Association, American Pediatric Surgical Association, American Public Health Association, Emergency Nurses Association, Family Voices, National Association of EMS Physicians, National Association of Emergency Medical Technicians, National Association of EMS Educators, National Association of School Nurses, National Association of Social Workers, National Association of State EMS Officials, National PTA, National Registry of Emergency Medical Technicians, SAFE KIDS Worldwide, the American Trauma Society and the Society of Trauma Nurses.

Do we have resources we would like to make available?

The EMSC program supports two resource centers:

• The EMSC National Resource Center (NRC) located in Washington DC at Children’s National Medical Center whose main purpose is to maintain the EMSC’s professional partnerships, dissemination of national information, and support a special collaboration with the Family Advisory Network (FAN). In 1999, the NRC worked with the state partnership grantee program manager to recruit a family representative within their state and territory to be the voice of the consumers. These special partnerships locally and nationally assured that the EMSC program remained connected with the healthcare needs of the community and led the program manager to ties within the community to other family-focused programs. http://childrensnational.org/EMSC
• The National EMSC Data Analysis Resource Center (NEDARC) located in Salt Lake City, Utah whose main focus is to assist all grantees in data collection, analysis and desimination that focuses on the improvement of pediatric emergency care. ; www.nedarc.org

More information on PECARN can be found at www.pecarn.org. The PECARN network also has technical support available through the Central Data Management Coordinating Center. More information can be found at www.pecarn.org/coordinatingCenter

Administrations EMS website: www.hrsa.gov/ems Office of EMS website: www.ems.gov