Equipment, Supplies & Medications Guide

To ensure emergency care staff have ready and easy access to safe and reliable pediatric equipment, supplies, and medications when needed.

PWDC - Equipment, Supplies & Medications

This flow diagram is designed to help one think about how to break down this focus area into small steps. The questions in this flow diagram align with the environmental scan worksheet in the next section. Consider the primary drivers of an equipment program as you review the following process map:

  1. Funding
  2. Communication
  3. Resources/Tools/Technology
  4. Policies/Procedures
  5. Education

Consideration of the anatomical, physiological, and developmental needs of children is an important factor in planning for pediatric emergencies, both in- and out-of-hospital. The idea that children are not small versions of adults has been widely used when discussing pediatric emergency needs, and is an important consideration when stocking equipment, supplies, and medications. Pediatric patients require weight-based dosing and properly sized equipment. Providers should have access to the appropriate equipment, supplies, and medications to properly manage any sick or injured child.

While there are many articles to reference on the importance of stocking equipment, supplies, and medications for pediatric patients, the groundwork was laid in the 1993 Institute of Medicine (now National Academy of Medicine) Emergency Medicine for Children report. This report recognized that the appropriate tools are needed to “enable {emergency care providers} to use their training and skills successfully.” The report further recommends “that all hospital EDs and EMS systems maintain at least a minimal level of essential equipment and that consistency in these requirements is appropriately balanced with the flexibility needed in special circumstances. If these materials are used infrequently, they must be monitored on a regular basis so that they do not deteriorate or become outmoded.”

Following additional recommendations from the report that hospital emergency departments and emergency response and transport vehicles have available and maintain equipment and supplies appropriate for the emergency care of children, the EMS for Children Program has supported essential equipment recommendations for both EMS agencies and emergency departments (EDs). Past assessments of both EMS agencies and EDs have shown that over 90% of those surveyed stock nationally recommended pediatric equipment, supplies, and medications. Acknowledging this, the intent of this focus area is not to “count widgets” but to help you create processes to ensure individuals involved in patient care know where and how to access well-functioning pediatric equipment, supplies, and medications. This includes:

  • recommendations for procurement of supplies,
  • how to maintain up to date and complete inventory 24/7,
  • best practices for organization of supplies,
  • strategies to collaborate with other organizations to lessen the burden/cost,
  • recommendations for orientation of staff to access the supplies, and
  • processes to evaluate, select, and update supplies.

This Guide can assist PECCs in communicating to EMS and ED leadership the critical importance of ensuring pediatric equipment, supplies, and medications are readily available to frontline practitioners as outlined in national guidelines. These simple steps will help all practitioners to provide high-quality care to pediatric patients.

Testimonials

“Our pediatric first-in bags were just not up to par at all. It was a big orange bag with everything just shoved in it, old, expired stuff and nothing was organized appropriately. So, I was able to get him to order three Broselow-type of bags. I was able to pull equipment in every one of the colors that corresponded to the Broselow tape, just to make it easier for crews when working with pediatric patients. One provider will identify what color to use and then you just pull out the pouch that you need and everything you need should be right in there for them. So that was the biggest pediatric change that I've done since becoming a PEC coordinator. I think it's definitely improved our organization and professionalism on a scene. When trying to find something to help treat a pediatric patient, at least we know where it is and how to get it without having to ruffle through the mess of that previous bag.”

“{when we purchased new pediatric restraints} we did a hands-on demonstration. Each group member had to be signed off before they were installed in the trucks.”

“Just holding the equipment and tools, touching them, and being familiar with the [location]—it helps build that muscle memory.”

See key drivers and change strategies below.

While equipment needs and requirements will vary depending on a variety of factors (e.g., EMS provider licensure and certification levels, rural vs. urban hospital setting, geography, etc.), having essential equipment, supplies, and medications for the unique needs of children is essential to optimize the delivery of pediatric patient care.

Cross-Cutting Change Strategies

1.1. Connect with your EMSC Program Manager to enquire about resources available to help keep some items stocked (contact information can be found here).

1.2. Determine if your regional healthcare or disaster coalition(s) can assist with supply gaps.

1.3. Work within your local system to create equipment exchange programs or group purchasing cooperatives (additional prehospital and hospital examples included below).

Prehospital Change Strategies

1.4. Develop relationships with regional or urban transport services to create an agency-central repository of replacement supplies.

1.5. Work with local hospitals and create a restocking agreement.

Hospital Change Strategies

1.6. Engage in shared purchasing models with hospitals in your region or network.

1.7. Develop an exchange program with a local pediatric center to replace supplies or equipment.

EMSC State Partnership Change Strategies

1.8. Connect with philanthropic organizations, who may be able to help with providing pediatric equipment or supplies.

1.9. Connect agencies struggling to maintain equipment for cost-sharing purposes.

Effectively communicate to the organization’s leadership the specific equipment needed.

Cross-Cutting Change Strategies

2.1. Sell the importance of having a robust equipment and supply process in place (e.g., create talking points or an elevator speech to use with leadership).

2.2. Use state/territory pediatric recognition programs that includes equipment requirements as an incentive for leadership to conform to national standards.

2.3. Identify potential safety events to promote equipment maintenance and replacement importance (e.g., pediatric jump kit missing an appropriately sized mask during a respiratory emergency).

2.4. Develop talking points that address the importance of having appropriate equipment and supplies to deliver high-quality, effective care.

2.5. Garner support and buy-in from front-line colleagues to adhere to policies and development of resources.

EMSC State Partnership Change Strategies

2.6. Develop talking points to advocate for equipment.

2.7. Advocate for state pediatric equipment and supplies standards.

Cross-Cutting Change Strategies

3.1. Establish a baseline inventory list.

3.2. Create a policy and procedure for daily equipment and medications checks (verify items not expired and still function).

3.3. Develop a process for reporting of equipment/supply failures.

3.4. Develop a process to introduce new, evaluate current, and retire old equipment and supplies.

3.5. Identify methods for restocking missing and expired items, to include map of location.

3.6. Identify an individual(s) to be responsible for regularly stocking of supplies and medications.

3.7. Develop a process to orient/education staff on equipment, supply, and medication location.

EMSC State Partnership Change Strategies

3.8. Integrate national equipment standards into facility and EMS recognition criteria.

Cross-Cutting Change Strategies

1.1. Create a locator map/list for pediatric supplies that aren’t stocked in the pediatric cart/bag (e.g., chest tube tray).

1.2. Ensure length-based tapes are available and accessible to staff.

1.3. Ensure a pediatric drug reference and formulary (e.g., binder, reference card) is readily available.

1.4. Consider a “Pediatric Comfort Kit” be included in your inventory list. This kit should include items to soothe, comfort and distract kids during an emergency.

1.5. Utilize reminder cards/posters for restocking between patient encounters (e.g., resuscitation packets that include reminder on bottom to restock equipment).

Prehospital Change Strategies

1.6. Have a pediatric bag prepared for quick and easy access to pediatric-sized equipment, supplies, and medications, include an equipment list on this bag. Replicate throughout the agency/system.

1.7. Stock devices for the safe transport of children in ambulances.

Hospital Change Strategies

1.8. Create a pediatric cart for quick and easy access to pediatric-sized equipment, supplies, and medications, include an equipment list on this cart.

EMSC State Partnership Change Strategies

1.9. Create infographic or host a webinar on the importance of pediatric equipment and supplies

1.10. Provide equipment checklists to EMS agencies & EDs

1.11. Identify external resources/tools to support EMS agencies & EDs.

Cross-Cutting Change Strategies

5.1. Automate tracking to monitor use for purchasing/restocking.

5.2. Identify a system to log and track equipment failures.

5.3. Use electronic checklist for daily equipment checks.

5.4. Identify an automated system which provides alerts when items are in low supply.

EMSC State Partnership Change Strategies

5.5. Create online networking opportunities/blogs for EDs/Agencies to discuss equipment challenges

Education strategies should focus on inclusion of pediatric components in training events (e.g., include scenarios where pediatric equipment, supplies, and medications would be needed).

Crosscutting Change Strategies

6.1. Design a pediatric equipment, supply, and medications scavenger hunt for both new employee orientation and yearly competency training (e.g., pre-shift scavenger hunts or safety huddles).

6.2. Provide just-in-time training for new equipment and supplies.

6.3. Team simulations should include scenarios where pediatric equipment, supplies, and medications are needed. Integrate all systems of care if possible (EMS, hospital, life flight).

EMSC State Partnership Change Strategies

6.4. Promote/host pediatric simulation sessions that integrate care hand-off between prehospital and hospital providers.

6.5. Host webinars on pediatric equipment/supplies, integrate into PECC training