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

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.


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]


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]


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]


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.


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

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.


Pediatric Emergency Medicine (PEM) Becomes a Section of the AAP

The AAP creates a section dedicated to pediatric emergency medicine.[1]


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]


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]


EMSC Grant Announcement Published

Congress appropriates initial funds for EMSC; first program grant announcements are published.


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]


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]


EMSC Reauthorizing Legislation Passed

U.S. Congress passes the first EMSC reauthorizing legislation.[10]


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/


[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


[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

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.


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]


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]


“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]


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]


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]


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]


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]


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]


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


[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/

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.


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]


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]


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.


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]


“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]


“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.


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]


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]


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/

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.



EMSC expands PECARN by awarding six new cooperative agreements.[1]


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]


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.


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.


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.


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]


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]


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]


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


[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


[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/

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.


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]


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]


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.