EMSC History
Since 1984, under the administration of the Health Resources and Services Administration, the federal EMSC Program has worked to ensure that no matter where a child lives, the health systems in their area provide high-quality, equitable pediatric emergency care.
Explore the history of pediatric emergency care and the EMSC Program
1960s & 1970s: Adult Emergency Care Improves, But Pediatric Care Lags Behind
In the 1960s, an EMS system for adults takes form, catalyzed in part by experiences from the Korean and Vietnam wars, which demonstrated survival rates of soldiers increased by stabilizing and transporting them to well-equipped trauma centers. While adult care improves, however, children's outcomes lag behind.
1966
Report Published on Deficiencies in U.S. Emergency Systems
The National Academies of Science publish a report, “Accidental Death and Disability: The Neglected Disease of Modern Society,” highlighting deficiencies in the nation’s emergency systems.[1] That same year, the National Highway Safety Bureau is created.[2]
1970
NHTSA Created
The National Highway Safety Bureau becomes the National Highway Transportation Safety Administration (NHTSA). Part of NHTSA’s mission is to develop an emergency medical services (EMS) system.[3]
1973
Emergency Medical Services Systems Act of 1973 Passed
Congress passes the EMS Systems Act of 1973, a program managed by the Health Resources and Services Administration (HRSA), to provide resources to state and local governments for implementing comprehensive EMS systems.[4]
1975–79
Gaps in Pediatric EMS Identified
EMS systems dramatically improve outcomes for adults. But children’s outcomes lag behind. Pediatric surgeons, pediatricians, and other groups begin to voice concerns.
1979
EMS Programs with Pediatric Focus Proposed
Calvin Sia, MD, president of the Hawaii Medical Association, urges members of the American Academy of Pediatrics (AAP) to develop multifaceted EMS programs to reduce death and disability in children.[5]
[1] https://doi.org/10.1016/j.cpem.2018.10.001
[2] https://doi.org/10.1016/j.cpem.2018.08.001
[3] https://doi.org/10.1016/j.cpem.2018.08.001
[4] http://dx.doi.org/10.1016/j.annemergmed.2014.09.018
[5] http://dx.doi.org/10.3928/19382359-20210316-01
1980s: Pediatric Emergency Care Picks Up Speed and the EMSC Program Begins
The advocacy of key individuals like Dr. Calvin Sia and organizations like the American Academy of Pediatrics (AAP) lead to funding of the EMSC Program by Congress. The program, administered by the Health Resources and Services Administration (HRSA), begins to fund states to improve their emergency care systems. Meanwhile, pediatric emergency medicine gains traction as a distinct and important field.
1981
Pediatric Emergency Medicine (PEM) Becomes a Section of the AAP
The AAP creates a section dedicated to pediatric emergency medicine.[1]
1983
Interspecialty Conference on Childhood Emergencies Held
The American College of Emergency Physicians (ACEP) hosts the Interspecialty Conference on Childhood Emergencies. As a direct result, ACEP and AAP form a joint task force for improving care for the pediatric patient.[2]
Senators Cosponsor Bill to Create the EMSC Program
Senator Daniel Inouye (D-HI) joins Dr. Sia’s crusade after learning about a staff member’s experience with inadequate emergency care for his young daughter. Senators Orrin Hatch (R-UT) and Lowell Weicker (R-CT) join in sponsoring legislation to create the Emergency Medical Services for Children (EMSC) Program.[3]
1984
Federal Funds for EMSC Authorized
U.S. Congress enacts legislation authorizing the use of federal funds for EMSC. Administered by the HRSA Maternal and Child Health Bureau (MCHB), the EMSC Program provides states with funding for demonstration projects to help improve emergency medical services for critically ill and injured children. Congress appropriates initial funds of $2 million.[4],[5]
First Advanced Pediatric Life Support Course Implemented
The first Advanced Pediatric Life Support (APLS) course from the AAP and ACEP is implemented. APLS, which is later published as a manual, serves as the standard resource for critical condition recognition and stabilization.[6]
1985
EMSC Grant Announcement Published
Congress appropriates initial funds for EMSC; first program grant announcements are published.
1986
First EMSC Grants Awarded to Four States
EMSC awards grants in Alabama, California, New York, and Oregon. New states and territories are awarded increasingly over the years. By 2014, the EMSC Program funded grants at least once in all U.S. states, territories, and jurisdictions – currently 57 total.[7]
First PEM Journal Published
The first journal devoted to PEM, Pediatric Emergency Care, is published.[8]
1987
First Pediatric Advanced Life Support Course Created
The first Pediatric Advanced Life Support (PALS) course is created and implemented by the AAP and the American Heart Association. PALS is the standard for resuscitation training for pediatric health care providers in the United States.[9]
1988
EMSC Reauthorizing Legislation Passed
U.S. Congress passes the first EMSC reauthorizing legislation.[10]
1989
PEM Course Made Available
The first national PEM course is introduced by the ACEP and AAP.[11] Previously, there were no standards for pediatric emergency care and pediatrics remained a minor area of focus in general emergency medicine. The PEM course created a path toward standardization of care.
[1] https://www.aap.org/en/community/aap-sections/emergency-medicine/about-soem/
[2]https://www.researchgate.net/publication/15462208_Pediatric_emergency_medicine_The_history_of_a_growing_discipline
[3] http://dx.doi.org/10.3928/19382359-20210316-01
[4] https://uscode.house.gov/statviewer.htm?volume=98&page=2856
[5] https://publications.aap.org/aapnews/article-abstract/35/7/7/7568/Emergency-Medical-Services-for-Children-Program?redirectedFrom=fulltext
[6] https://www.aap.org/en/learning/advanced-pediatric-life-support/
[7] https://publications.aap.org/aapnews/article-abstract/35/7/7/7568/Emergency-Medical-Services-for-Children-Program?redirectedFrom=fulltext
[8]https://www.researchgate.net/publication/15462208_Pediatric_emergency_medicine_The_history_of_a_growing_discipline
[9] https://cpr.heart.org/en/resources/history-of-cpr
[10] https://uscode.house.gov/statviewer.htm?volume=102&page=3112
[11] https://doi.org/10.3928/19382359-20210316-01
1990s: Early EMSC Growth
An increasing number of states receive funding and the program structure evolves to include two resource centers, a Family Advisory Network, and Targeted Issues Grants. In addition, the individual state grants are restructured as the State Partnership Program. The impact of state work accelerates with the release of foundational resources and introduction of state policies that codify EMSC priorities.
1991
EMSC Establishes Resource Centers
MCHB establishes the EMSC Resource Network, which includes the EMSC National Resource Center (NRC), located at Children’s National Medical Center in Washington, D.C., and the National EMSC Resource Alliance, located at Harbor UCLA Medical Center in Los Angeles, CA.[1] The role of the centers is to assist state grantees, promote awareness of the unique needs of children, and increase collaborations to improve pediatric emergency care.[2]
PEM Becomes Approved Subspecialty
PEM is approved by the American Board of Pediatrics (ABP) and American Board of Emergency Medicine (ABEM) as a subspecialty, thereby establishing national standards for the knowledge base and skills required of PEM specialists.[3]
First EMSC-Related State Legislation Passed
In anticipation of receiving EMSC funding, Illinois passes the first EMSC-related state legislation within their EMS Systems Act: “Pediatric Trauma” outlines next steps in improving pediatric emergency care that were enabled by the grant.[4] Since then, numerous EMSC-related state laws have helped codify the program at the state level.
First Targeted Issues Grant Awarded
California becomes the first state awarded an EMSC Targeted Issues (TI) grant, which were established to find new approaches to improving emergency care for children. Typically, the projects result in a new resource or tool or demonstrate efficacy of a particular strategy. This first TI grant focused on the statewide improvement of the pediatric capabilities of local and regional emergency and critical care systems.[5]
1992
First State-Level Office of EMSC is Established
New Jersey becomes the first state to establish an Office of EMSC within its state health department.[6]
1993
“Emergency Medical Services for Children” Report Released by Institute of Medicine
The Institute of Medicine (IOM), now the National Academies of Sciences, Engineering, and Medicine, releases a report detailing continued deficiencies in pediatric emergency care and the need for better data. This report underscores why emergency care for children must differ from that for adults and justifies future EMSC-led initiatives.[7]
Model EMSC Statute Published
Harvard Journal of Legislation publishes a model EMSC statute to encourage states to establish a Children’s Emergency Medical and Injury Prevention Systems Act. The act addresses EMSC standards and advisory panels.[8]
1994
Children with Special Health Care Needs Gain Focus
A national workgroup is formed to address the emergency care needs of children with special health care needs.[9]
1995
National EMSC Data Analysis Resource Center Created
To help address “the need for more and better data on the volume, nature, and outcomes of pediatric emergency care,” a major shortcoming identified in the IOM report, MCHB funds the National EMSC Data Analysis Resource Center (NEDARC), located at the University of Utah in Salt Lake City, UT.[10]
First Pediatric Emergency School Nurse Course Developed
University of Connecticut receives a TI grant to update its school nurse training program and host a national train-the-trainer course. This work that has been continued by Illinois EMSC, which created an instructor manual that continues to be used in many states. The course is designed to enhance the assessment, triaging and treatment skills of the school nurse when confronted with the acutely ill or injured student.[11]
1996
EMSC Partnership for Children Consortium Established
MCHB establishes the EMSC Partnership for Children Consortium to promote collaboration between national organizations, including the AAP, ACEP, the National Association of EMTs (NAEMT), National Association of State EMS Directors (now the National Association of State EMS Officials), the American Trauma Society, and the Ambulatory Pediatric Association. The partnerships enable the program to broaden its impact. [12]
Minimum Pediatric Prehospital Equipment Guidelines Approved
In recognition that EMS providers at all levels must have the appropriate equipment and supplies to optimize prehospital delivery of care, Minimum Pediatric Prehospital Equipment Guidelines are developed and approved by American College of Surgeons (ACS), National Association of EMS Physicians (NAEMSP), AAP, ACEP, and an EMSC stakeholder group.[13]
1997
State Partnership Program Introduced
State Partnership Program grants are introduced to help states continue to improve, refine, and integrate pediatric care within the state EMS system.[14]
EMSC Regions Form
Eight EMSC regions are formalized to support collaboration among State Partnership grantees.[15]
1998
First National Congress on Childhood Emergencies Event Held
MCHB sponsors the National Congress on Childhood Emergencies, a historic gathering of stakeholders across the country. During the event, HRSA announces its first National Heroes Awards to honor those who excel in improving children’s emergency care, including Dr. Sia.[16]
Interagency Committee on Emergency Medical Research Created
The Interagency Committee on Emergency Medical Research is created to improve the quality and quantity of EMSC research and to foster collaboration between federal agencies including HRSA, the Agency for Health Care Research and Quality, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health (NIH), among others.
“Emergency Guidelines for Schools” Published
Ohio EMSC publishes the first edition of “Emergency Guidelines for Schools.” The document provides guidelines for helping and ill or injured student when the school nurse is not available. It is later updated by other states; including, most recently, by Tennessee EMSC.[17]
1999
Family Advisory Network Created
Recognizing that families are an invaluable resource in improving emergency care, the EMSC Family Advisory Network (FAN) is formed. FAN representatives impart a consumer’s perspective and serve as community allies to support patient- and family-centered care across the continuum.[18]
First Model of Standards for EDs Approved for Pediatrics Published
California publishes the first standards for emergency departments (EDs) approved for pediatrics, also known as EDAPs. The standards are an early model for pediatric readiness.[19]
[1] https://www.sciencedirect.com/science/article/abs/pii/S1522840106000024
[2] https://doi.org/10.3928/19382359-20210316-01
[3]https://www.researchgate.net/publication/15462208_Pediatric_emergency_medicine_The_history_of_a_growing_discipline
[4] https://casetext.com/statute/illinois-compiled-statutes/regulation/chapter-210-health-facilities-and-regulation/act-50-emergency-medical-services-ems-systems-act/section-210-ilcs-503115-pediatric-trauma
[5] https://files.eric.ed.gov/fulltext/ED373869.pdf
[6] https://www.sciencedirect.com/science/article/abs/pii/S1522840106000024
[7] https://nap.nationalacademies.org/catalog/2137/emergency-medical-services-for-children
[8] https://harvardjol.com/wp-content/uploads/sites/17/2023/02/30HarvJonLegis331.pdf
[9] http://www.columbia.edu/itc/hs/medical/residency/peds/new_compeds_site/pdfs_new/def_spl_needs.pdf
[10] https://doi.org/10.1016/j.cpem.2006.01.001
[11] https://www.luriechildrens.org/en/emergency-medical-services-for-children/education/school-nurses/
[12] https://journals.healio.com/doi/10.3928/19382359-20210316-01
[13] https://doi.org/10.3928/19382359-20210316-01
[14] https://emscimprovement.center/programs/partnerships/
[15] https://media.emscimprovement.center/documents/EMSC_Regions_Map.pdf
[16] https://journals.lww.com/pec-online/Citation/1998/02000/Research_Abstracts_for_the_First_National_Congress.22.aspx
[17] https://www.luriechildrens.org/globalassets/documents/emsc/resourcesguidelines/guidelines-tool-and-other-resources/practice-guidelinestools/emergencyguidelinesforschools.pdf
[18] https://emscimprovement.center/programs/partnerships/family-advisory-network/
[19] https://pubmed.ncbi.nlm.nih.gov/10920160/
2000s: Gaining National Traction & Growing the Research Base
Collaborations increase with federal agencies and national organizations. In addition, the EMSC Program introduces the Pediatric Emergency Care Applied Research Network (PECARN) and begins to grow the basis of evidence for improved pediatric emergency care. At the state level, performance measures are established to track progress.
2000
Healthy People 2010 Released by HHS
The Department of Health and Human Services (HHS) releases Healthy People 2010, a national health promotion and disease prevention initiative that includes two EMSC-related objectives.[1]
EMSC-Related Multi-Agency Program Announcement Made
Multi-agency program announcement made in NIH Guide for Grants and Contracts, outlining research needs for EMSC.
State-by-State Trauma Systems Needs Survey Conducted
EMSC, NHTSA, and the Office of Rural Health Policy conduct a state-by-state trauma systems needs survey to characterize the current structure and viability of state trauma systems in the United States. The survey results in the development of a national group on trauma and EMS systems, inclusive of rural communities.
Providing Family-Centered Prehospital Care Guidelines Published
EMSC funding helps support a foundational NAEMT publication: “Guidelines for Providing Family-Centered Prehospital Care.”[2]
2001
PECARN Cooperative Agreement Created
EMSC funds four cooperative agreements to form the Pediatric Emergency Care Applied Research Network (PECARN), the first-ever federally funded, multi-institutional network for research in pediatric emergency medicine.[3]
Care of Children in the ED Guidelines for Preparedness Released
AAP and ACEP release “Care of Children in the Emergency Department Guidelines for Preparedness.” This document is the first set of national guidelines outlining necessary resources to ensure that children receive quality emergency care.[4]
National EMS for Children Day Established
“National EMS for Children Day” is established as part of National EMS Week, which is presented by ACEP in partnership with the NAEMT. EMSC Day is now celebrated annually on the third Wednesday of May.[5]
2002
EMSC Data Center Cooperative Agreement Awarded
The EMSC Data Coordinating Center, which supports data collection and management, quality assurance, statistical analysis, and more for PECARN, is established at the University of Utah.
EMSC National Public Information and Education (PIE) Campaign
HHS adopts the EMSC theme, “The Right Care When It Counts,” as the focus of its annual observance of Child Health Month in October. The centerpiece of the celebration is a three-year campaign to engage families in understanding the unique needs of children in emergencies.
2003
First National Assessment of EDs Conducted
Under a grant from the EMSC Program, an assessment is conducted to determine U.S. hospitals’ compliance with AAP and ACEP’s 2001 “Care of Children in the Emergency Department: Guidelines for Preparedness.” Results revealed that most hospitals were unaware of the national guidelines and few hospitals had all of the equipment and essential care policies listed.[6]
2005
“Twenty Years of Emergency Medical Services for Children” Published
“Twenty Years of Emergency Medical Services for Children: A Cause for Celebration and a Call for Action” is published in Pediatrics, outlining the importance and impact of the EMSC Program.[7]
2006
“Future of Emergency Care” Series Released by IOM
IOM releases the “Future of Emergency Care,” a series of reports that includes “Emergency Care for Children: Growing Pains” and highlights ongoing gaps in pediatric emergency care as well strategies to address them – including the adoption of pediatric champions in emergency settings, also known as pediatric emergency care coordinators (PECCs).[8]
Tribal EMS Program Focus
Outcomes from EMSC State Partnership Programs working with Tribal EMS Programs are presented at the annual EMSC Grantee Meeting.
EMSC Performance Measures Roll Out
To track EMSC’s impact and in accordance with the Government Performance and Results Act, the EMSC State Partnership Program’s first set of performance measures are rolled out. The performance measures include: 1) The degree to which the state has ensured the operational capacity to provide pediatric emergency care, 2) The adoption of requirements by the state for pediatric emergency education for the license renewal of basic and advanced life support providers, and 3) The degree to which the state has established permanence of EMSC in the state.
2007
PECARN Dexamethasone Trial Published
PECARN completes its first major trial looking at the use of dexamethasone for the treatment of infant bronchiolitis and publishes a study in the New England Journal of Medicine.[9]
2008
EMSC Research Applications Released by NIH
The NIH releases a special program announcement inviting applications for EMSC research; this first-ever multi-agency program funding opportunity announcement aims to expand and improve EMSC research.[10]
2009
Ambulance Equipment Guidelines Updated; Checklist Created
“Minimum Pediatric Prehospital Equipment Guidelines” are updated to “Equipment for Ambulances,” which includes recommendations for both pediatric and adult patients.[11] The guidelines are subsequently updated in 2014 and 2020 (“Recommended Essential Equipment for Basic Life Support and Advanced Life Support Ground Ambulances”). A corresponding checklist is also created.
“Guidelines for Care of Children in the Emergency Department” Released
“Care of Children in the Emergency Department Guidelines for Preparedness" is updated to a Joint Policy Statement: “Guidelines for Care of Children in the Emergency Department.” Authored by AAP, ACEP, and ENA, it is endorsed by over 17 organizations, including ACS, NAEMSP, NAEMT, NASEMSO, and others. This statement offers recommendations for essential equipment, medications, personnel training, and key policies necessary for optimal pediatric emergency care.[12]
State Partnership Program Performance Measures Refined
The first set of performance measures are refined to further demonstrate the results of State Partnership Program funding. Additional measures include pediatric medical direction, equipment on patient care units, training for prehospital providers, trauma and medical recognition programs, interfacility transfer, and adopting program priorities in state policy.
PECARN Traumatic Brain Injury Prediction Rule Study Released
A PECARN study of 42,000 children with blunt head trauma leads to a clinical prediction rule for emergency neuroimaging, thus reducing unnecessary scans and radiation exposure.[13]
Ninth Region Forms
EMSC forms a ninth region, the Pacific Islands EMSC Region (PIER).[14]
[1] https://www.cdc.gov/nchs/healthy_people/hp2010.htm
[2] http://paemsc.org/wp-content/uploads/2017/02/guidelines-for-providing-family-centered-care-NAEMT.pdf
[3] https://pecarn.org/
[4] https://publications.aap.org/pediatrics/article-abstract/107/4/777/63516/Care-of-Children-in-the-Emergency-Department?redirectedFrom=fulltext
[5] https://www.airmedicaljournal.com/article/S1067-991X(01)70035-1/pdf
[6] https://pubmed.ncbi.nlm.nih.gov/18055671/
[7] https://publications.aap.org/pediatrics/article-abstract/115/4/1089/67608/Twenty-Years-of-Emergency-Medical-Services-for?redirectedFrom=fulltext
[8] https://nap.nationalacademies.org/read/11655/chapter/1
[9] https://www.nejm.org/doi/full/10.1056/nejmoa071255
[10] https://grants.nih.gov/grants/guide/pa-files/PA-12-142.html
[11] https://doi.org/10.1542/peds.2009-1094
[12] https://publications.aap.org/pediatrics/article/124/4/1233/71861/Joint-Policy-Statement-Guidelines-for-Care-of
[13] https://pubmed.ncbi.nlm.nih.gov/19758692/
[14] https://pier.uhtasi.org/
2010s: The Evolution of Pediatric Readiness
The concept of pediatric readiness takes hold in the form of two flagship projects: The National Pediatric Readiness Project for EDs and the National Prehospital Pediatric Readiness Project for EMS agencies. As part of that work, the EMSC Program begins to incorporate quality improvement through the creation of the EMSC Innovation & Improvement Center.
2011
EMSC Expands PECARN
EMSC expands PECARN by awarding six new cooperative agreements.[1]
2012
State Partnership Regionalization of Care Grants Funded
EMSC funds six State Partnership Regionalization of Care (SPROC) grants, an initiative to develop and implement regionalized systems of care that encompass the sharing of resources and improving access to pediatric healthcare services in tribal, territorial, insular, and rural areas.[2]
National Pediatric Readiness Project Created
In partnership with AAP, ACEP, and ENA, the EMSC Program establishes the National Pediatric Readiness Project (NPRP), a multiphase quality improvement (QI) initiative to ensure all EDs are prepared for children. The first phase of the NPRP is a national assessment of hospital EDs to help identify gaps based on the “Joint Guidelines on the Care of Children in the ED.”[3]
NEDARC and DCC combine
NEDARC and the DCC combine as one center: the EMSC Data Center.[4]
2013
First NPRP National Assessment Conducted; Toolkit Finalized
More than 4,000 EDs participate in the NPRP assessment – a response rate of more than 82%. In late 2013, EMSC, AAP, ACEP, and ENA initiate phase two of the NPRP: the development of strategies and resources to engage EDs in QI activities, including the creation of the NPRP toolkit, which offers resources for addressing gaps identified by the assessment.[5]
Six Prehospital Care TI Grants Funded
EMSC funds six new TI grants on pediatric prehospital care, representing one of the largest investments, $5.4 million over three years, in pediatric prehospital research. [6]
PECARN Publishes CT Scan Tool
PECARN publishes a clinical prediction tool that helps clinicians identify which children with abdominal injuries do not need a CT scan.
2014
EMSC Turns 30
EMSC celebrates 30 years with the slogan: “Then, Now, Imagine... Honoring the Past, Experiencing the Present, Visualizing the Future.” To commemorate the occasion, “Emergency Medical Services for Children: Thirty Years of Advancing High-Quality Emergency Care for Children” is published in Pediatric Emergency Care.[7]
Pediatric Disaster Guidelines for Hospitals Published
The NRC publishes “Essential Pediatric Domains and Considerations for Every Hospital’s Disaster Preparedness Policies,” which is later updated in 2022.[8]
EMSC Funding Reaches Entire United States
With the awarding of a State Partnership Program grant to American Samoa,[9] all 50 states, territories, and jurisdictions have received EMSC grant funding at some point in time.
2015
Pediatric Readiness Results Published
Results from the first NPRP assessment are published in JAMA Pediatrics, indicating an average pediatric readiness score of 69 for participating hospital emergency departments (on a scale of 0-100).[10]
PECARN Expanded to Prehospital Research
PECARN expands to include prehospital research for the first time and adds six EMS affiliates.
PECARN Therapeutic Hypothermia Trial Published
PECARN teams up with the NICHD Collaborative Pediatric Critical Care Research Network and completes two trials to evaluate whether regulating body temperature improves outcomes for children after cardiac arrest, both in and out of the hospital. The studies are published in 2015[11] and 2017[12] in the New England Journal of Medicine.
2016
EMSC Innovation and Improvement Center Established
EMSC establishes and awards a grant to create the EMSC Innovation and Improvement Center (EIIC), which is focused on accelerating the impact of the EMSC Program through quality improvement science and builds off the work of the NRC.[13]
Facility Recognition Collaborative Kicks Off
The EIIC holds the Facility Recognition Collaborative to assist states in creating programs that recognize EDs that are ready to care for children in emergencies. By the end of the collaborative, five states prepare to launch a program and eight states report progress toward implementation.[14]
New TI Grants Funded
Five TI grants are awarded to help translate research into practice.[15]
2017
New Performance Measures Roll Out
Due to the success and retirement of earlier performance measures, EMSC creates three new prehospital-focused performance measures and updates other measures for State Partnership Programs. [16]
2018
Two Collaboratives Launched
EIIC launches the Pediatric Readiness QI Collaborative (PRQC) and the Pediatric Emergency Care Coordinator (PECC) Learning Collaborative engaging EMSC grantees and hundreds of hospital and prehospital clinicians in improving emergency care.[17]
“Pediatric Readiness in the Emergency Department” Joint Policy Statement Released (PR)
The 2009 joint policy statement “Guidelines for Care of Children in the Emergency Department” is updated by the APP, ACP, and ENA to “Pediatric Readiness in the Emergency Department.”[18]
Advancement of PEM Knowledge
NEDARC, in collaboration with other EMSC team members, contributes to the body of knowledge in PEM with four key publications in 2018: 1) Assessing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting; 2) Getting More Performance Out of Performance Measures; 3) Improving response to an establishment survey through the use of web-push data collection methods; 4) Assessing Infrastructure to Care for Pediatric Patients in the Prehospital Setting. Pediatric Emergency Care..[19],[20],[21],[22]
EMSC Highlighted in Clinical Pediatric Emergency Medicine
The EMSC issue of Clinical Pediatric Emergency Medicine is published. The special issue includes multiple EMSC-focused research articles.[23]
PECARN Publishes Two Key Studies
PECARN publishes results of a study that demonstrates, contrary to common practice, that clinicians may safely individualize fluid hydration for children with diabetic ketoacidosis (DKA) without fear of causing brain injury.[24] They also publish a landmark study that proves probiotics do not improve the severity or length of viral acute gastroenteritis.[25]
2019
EMSC Program Reauthorized
“Emergency Medical Services for Children Program Reauthorization Act of 2019” H.R. 776 is passed, reauthorizing the EMSC Program to continue its work.[26]
National Prehospital Pediatric Readiness Project Steering Committee Convenes
Key national organizations unite to drive pediatric improvements in prehospital EMS systems through the National Prehospital Pediatric Readiness Project (PPRP) , which parallels the NPRP and aims to launch an assessment of EMS agencies in 2024.[27]
Study Finds Fourfold Lower Rate of Mortality Associated with ED Pediatric Readiness
“Emergency Department Pediatric Readiness and Mortality in Critically Ill Children” is published, which for the first time quantifies the impact of pediatric readiness on outcomes nationally using data from the 2013 assessment.[28]
“Critical Crossroads: Pediatric Mental Health Care in the Emergency Department” Published
Catalyzed by the growing pediatric mental health care crisis, MCHB publishes a resource toolkit, “Critical Crossroads: Pediatric Mental Health Care in the Emergency Department.”[29]
Pediatric Disaster Care Centers of Excellence Funded
The Office of the Administration for Strategic Preparedness and Response (ASPR) awards $16 million to create two Pediatric Disaster Care Centers of Excellence as pilot projects to improve regional disaster response capabilities: the Eastern Great Lakes Pediatric Consortium for Disaster Response (now known as Region V for Kids) and the Western Region Alliance for Pediatric Emergency Management (WRAP-EM). The Centers of Excellence work closely with EMSC.[30]
PECARN Publishes Landmark Research on Febrile Infants and Status Epilepticus
PECARN publishes a series of articles that change the way emergency medicine evaluates febrile infants and informs the AAP Clinical Practice Guideline for the Evaluation and Management of Well-Appearing Febrile Infants 8-60 Days Old. The also publish a critical study that found no significant difference between key medication options for status epilepticus, which allows clinicians to use the option that is safest and easily available.[31],[32]
[1] https://pecarn.org/wp-content/uploads/2021/02/PECARNNewsletterWinter2011CDMCC.pdf
[2] https://emscimprovement.center/programs/sproc/
[3] https://emscimprovement.center/domains/pediatric-readiness-project/
[4] https://doi.org/10.1097/PEC.0000000000000333
[5] https://jamanetwork.com/journals/jamapediatrics/fullarticle/2214165
[6] https://www.hmpgloballearningnetwork.com/site/emsworld/article/12213717/emsc-targeted-issues-projects-leading-pediatric-prehospital-research
[7] https://journals.lww.com/pec-online/Abstract/2015/02000/Emergency_Medical_Services_for_Children__Thirty.17.aspx
[8]https://emscimprovement.center/education-and-resources/toolkits/pediatric-disaster-preparedness-toolbox/
[9] https://emscimprovement.center/programs/grants/144/american-samoa-state-partnership-20140301-american-samoa-emsc-state-partnership-grant/
[10] https://jamanetwork.com/journals/jamapediatrics/fullarticle/2214165
[11] https://www.cpccrn.org/documents/2015_PMID25913022_Moler.pdf
[12] https://www.cpccrn.org/documents/2017_PMID28118559_Moler.pdf
[13] https://emscimprovement.center/
[14] https://emscimprovement.center/collaboratives/facility-recognition-collaborative/
[15] https://media.emscimprovement.center/documents/TI_Fact_Sheet_2016-2019_Final.pdf
[16]https://www.nedarc.org/performancemeasures/documents/EMS%20Perf%20Measures%20Manual%20Web_0217.pdf
[17] https://emscimprovement.center/collaboratives/all/
[18] https://publications.aap.org/pediatrics/article/142/5/e20182459/38608/Pediatric-Readiness-in-the-Emergency-Department
[19] https://www.tandfonline.com/doi/full/10.1080/10903127.2018.1542472
[20] https://www.sciencedirect.com/science/article/abs/pii/S1522840118300624?via%3Dihub
[21] https://www.tandfonline.com/doi/full/10.1080/08898480.2018.1477386
[22] https://pubmed.ncbi.nlm.nih.gov/30489489/
[23] https://www.sciencedirect.com/journal/clinical-pediatric-emergency-medicine/vol/19/issue/3
[24] https://www.nejm.org/doi/10.1056/NEJMoa1716816
[25] https://bmjopen.bmj.com/content/7/9/e018115.long
[26] https://www.congress.gov/bill/116th-congress/house-bill/776
[27] https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-readiness/
[28] https://publications.aap.org/pediatrics/article/144/3/e20190568/76984/Emergency-Department-Pediatric-Readiness-and
[29] https://media.emscimprovement.center/documents/critical-crossroads-tool.pdf
[30] https://www.phe.gov/Preparedness/responders/ndms/Pages/PDCCOE.aspx
[31] https://www.nejm.org/doi/10.1056/NEJMoa1905795?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
[32] https://pubmed.ncbi.nlm.nih.gov/30776077/
2020s: Preparing for Everyday Emergencies & Disasters
Pediatric readiness initiatives continue to reach new heights. Catalyzed in part by the COVID-19 pandemic, there is an increased focus on the intersection of emergency care and disaster preparedness for children. Congress funds the Pediatric Pandemic Network as part of the EMSC Branch within HRSA.
2020
“Pediatric Readiness in Emergency Medical Services Systems” Published
A joint policy statement, “Pediatric Readiness in Emergency Medical Services Systems,” is published in the January 2020 Pediatrics by AAP, ACEP, ENA, NAEMSP, and NAEMT alongside a technical report by AAP. The documents help form the basis for the work of the PPRP.[1]
EMSC Scholars and Fellows Program Launches
The EIIC launches two opportunities to engage future leaders in the EMSC space: the EMSC Scholars Program and the EMSC Fellows Program.[2]
First Pediatric Emergency and Advocacy Kit Released
The EIIC Knowledge Management Domain release its first Pediatric Emergency and Advocacy Kit (PEAK), a collection of both original and curated resources on an area of clinical focus.[3]
Pediatric Disaster Preparedness Quality Collaborative Launched
EIIC partners with the Eastern Great Lakes Pediatric Consortium for Disaster Response to hold a Pediatric Disaster Preparedness Quality Collaborative.[4]
PECARN Develops Novel Suicide Screening Tool
PECARN publishes a novel teen suicide screening tool that can improve detection of mental health needs of teenagers.[5]
2021
Second NPRP Assessment Yields 71% Response
Despite the ongoing demands of navigating the COVID-19 pandemic, the NPRP launches its second national assessment of hospital emergency departments, which yields a 71% response rate.[6]
PPRP Creates Checklist & Toolkit
The PPRP develops and releases an official Checklist & Toolkit for EMS agencies.[7]
Two Collaboratives Launch
EIIC launches a six-month long Telehealth Collaborative; the 10-month long PECC Workforce Development Collaborative kicks off later in the year.[8],[9]
Pediatric Readiness to Be Included in Trauma Verification Standards
The American College of Surgeons announces new pediatric standards for all verified trauma centers, including a standard based on the NPRP. Standards go into effect in 2023. [10]
HRSA EMSC Branch Expands with Establishment of Pediatric Pandemic Network
HRSA awards a $48 million grant over five years to five children’s hospitals to establish the Center for Pediatric Everyday Readiness–Pediatric Pandemic Network (PPN). The network resides within the EMSC branch of MCHB alongside the EMSC Program. The goal of the network is to improve the nation’s ability to meet the needs of children during disasters and global health threats—in part by improving everyday pediatric readiness. The network brings together the expertise of the children’s hospitals with the work of EIIC and the two ASPR Pediatric Disaster Care Centers of Excellence. This program is a Special Project of Regional and National Significance (SPRANS), authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act).[11]
2022
EMSC Data Center Awarded
The University of Utah’s cooperative agreement is funded again. Its two components, NEDARC and the Data Coordinating Center, are now formally known as the EMSC Data Center.
PPN Expands to 10 Hub Sites
HRSA awards an additional $29 million over five years to five children’s hospitals, expanding the PPN to 10 total hub sites.[12]
Research Demonstrates Long-Term Impact of Readiness
Research funded through a TI grant demonstrates that high pediatric readiness reduces mortality in injured children at trauma centers out to one year by 30%.
[1] https://www.phe.gov/Preparedness/responders/ndms/Pages/PDCCOE.aspx
[2] https://emscimprovement.center/about/scholars-fellows/
[3] https://emscimprovement.center/education-and-resources/peak/
[4] https://emscimprovement.center/collaboratives/pediatric-disaster-preparedness-quality-collaborative/
[5] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2775993
[6] https://emscimprovement.center/news/nprp-assessment-achieves-71-response-rate/#:~:text=NPRP%20assessment%20achieves%2071%25%20response%20rate!
[7] https://emscimprovement.center/news/press-release-new-pediatric-checklist-and-toolkit-available-for-ems-agencies/
[8] https://emscimprovement.center/collaboratives/telehealth/
[9] https://emscimprovement.center/collaboratives/pwdc/
[10] https://emscimprovement.center/news/raising-the-bar-for-pediatric-trauma-care-pulse/
[11] https://mchb.hrsa.gov/programs-impact/pediatric-pandemic
[12] https://mchb.hrsa.gov/programs-impact/pediatric-pandemic
Further reading
Explore a selection of articles about the history of pediatric emergency care and the history of the EMSC Program.
- "Advances in Pediatric Emergency Medical Service Systems," Pediatric Emergencies, 1991
- "Pediatric Emergency Medicine: The History of a Growing Discipline," Pediatric Emergencies, 1995
- "Twenty years of Emergency Medical Services for Children," Pediatrics, 2005
- "The Emergency Medical Services for Children Program: Accomplishments and Contributions,"Clinical Pediatric Emergency Medicine, 2006
- "The Pediatric Emergency Care Applied Research Network: Progress and Update"Clinical Pediatric Emergency Medicine, 2003
- "The Pediatric Emergency Care Applied Research Network (PECARN): Rationale, Development, and First Steps," Academic Emergency Medicine, 2008
- "Quality Improvement in Pediatric Emergency Medicine," Academic Pediatrics, 2013
- "A Tale of Two Populations: Addressing Pediatric Needs in the Continuum of Emergency Care," Annals of Emergency Medicine, 2014
- "The Little Program That Could: Saving Emergency Medical Services for Children," Clinical Pediatric Emergency Medicine, 2014
- "Emergency Medical Services for Children Thirty Years of Advancing High-Quality Emergency Care for Children," Pediatric Emergency Care, 2015
- "Redefining Ladd's path," Journal of Pediatric Surgery, 2016
- "Access to High Pediatric-Readiness Emergency Care in the United States,"Journal of Pediatrics, 2017
- "EMSC Special Issue," Clinical Pediatric Emergency Medicine, 2018 (Multiple articles)
- "Hear Our Voice: Every Child, Every Day; Pediatric Emergency Care Services in the United States," Clinical Pediatric Emergency Medicine, 2020
- "The Origins and Evolution of Emergency Medical Services for Children," Pediatric Annals, 2021