Policies, Procedures, Protocols

Any resources indicated with an asterisk (*) are pulled from the 2012 Toolkit and currently being updated (if needed). Check back frequently for updated content.

Illness and Injury Triage

• Emergency Severity Index (ESI): A Triage Tool for Emergency Department Care - Implementation Handbook (2020 Edition)
• SAMPLE Illness & Injury Triage Policy Template
• SAMPLE Hospital Policy: Emergency Department Triage of Patients
• SAMPLE Triage Process in the Emergency Department

AAP Related Statements:

• Clinical Report - Physicians Roles in Coordinating Care of Hospitalized Children
• Management of Pediatric Trauma
• Overcrowding Crisis in Our Nations EDs: Is Our Safety Net Unraveling
• Principles of Pediatric Patient Safety: Reducing Harm Due to Medical Care

ENA Related Statements:

• Triage Qualifications and Competency

Revised in 2020 by:

• Catherine Olson, MSN, RN

Pediatric Patient Assessment and Reassessment

AAP Statements

• Access to Optimal Emergency Care for Children
• Management of Pediatric Trauma
• Nonemergency Acute Care: When It’s Not the Medical Home
• Patient Safety in the Pediatric Emergency Care Setting
• Pediatric Mental Health Emergencies in the EMS System - Policy Statement
• Pediatric and Adolescent Mental Health Emergencies in the EMS System - Technical Report
• Pediatric Observation Units

ENA Statements

• Access to Quality Healthcare
• Early Recognition of Sepsis in the Pediatric Patient (2016)

Revised in 2020 by:

• Sally K. Snow, BSN, RN, CPEN, FAEN

Documentation of Vital Signs

• SAMPLE Measurement of Vital Signs in the Emergency Department

AAP Related Statements:

• Emergency Information Forms and Emergency Preparedness for Children With Special Health Care Needs*
• Patient Safety in the Pediatric Emergency Care Setting*
• Weighing Pediatric Patients in Kilograms

ENA Related Statements

• Non-Invasive Blood Pressure Measurement
• Non-invasive Temperature Measurement (2015)
• Weighing Pediatric Patients in Kilograms

ENA Clinical Practice Guideline

• Synopsis Non-Invasive Blood Pressure Measurement
• Synopsis Non-invasive Temperature Measurement

Tools

• Emergency Severity Index (ESI): A Triage Tool for Emergency Departments
• Pediatric Early Warning Scores (PEWS) in the Emergency Department
• The FLACC: a behavioral scale for scoring postoperative pain in young children
• National EMS Clinical Guidelines
• Wong-Baker FACES Pain Rating Scale in Pediatric Emergency Department Patients

Revised in 2020 by:

• Madeline Joseph, MD, FAAP, FACEP

Immunization Assessment

AAP Related Statements:

• Immunization Information Systems
• Increasing Immunization Coverage - Policy Statement

ENA Related Statements:

• Immunizations and the Responsibility of the Emergency Nurse

Revised in 2020 by:

• Joyce Li, MD, MPH
• Katherine Mandeville, MD, MS

Sedation and Analgesia

• Texas Children's Hospital Evidence Based Sedation Guideline
• Pediatric Procedural Sedation in the Emergency Department: Ketamine-Propofol
• Procedural Sedation Outside of the Operating Room Using Ketamine in 22,645 Children: A Report From the Pediatric Sedation Research Consortium

AAP Related Statements:

• Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures
• Drugs Used to Treat Pediatric Emergencies
• Trends in Outpatient Procedural Sedation: 2007–2018

ACEP Related Statements:

• Unscheduled Procedural Sedation: A Multidisciplinary Consensus Practice Guideline

ENA Related Statements:

• Needle-Related or Minor Procedural Pain in Pediatric Patients
• Pediatric Pain

Currently under revision by:

• Corrie Chumpitazi, MD, MS
• Huma Shaikh, MD

Consent

AAP Related Statements:

• Care of the Adolescent Sexual Assault Victim
• Consent by Proxy for Nonurgent Pediatric Care
• Consent for Emergency Medical Services for Children and Adolescents
• Religious Objections to Medical Care *

Currently under revision by:

• Marie M. Lozon, MD

Social and Behavioral Health Issues

• Critical Crossroads Toolkit
• Substance Abuse and Mental Health Services Administration (SAMHSA) Resources on Cultural Competency/Humility
• National Pediatric Readiness Project: Preparing the Emergency Department to Provide Psychosocial Support to Children and Families in A Disaster. This webinar, occurring on October 29, 2015, discussed short- and long-term effects of disaster on the psychological functioning, emotional adjustment, health, and developmental trajectory of children; identified key elements in the behavioral health domain essential to the provision of psychosocial support to children and families in the aftermath of disaster; and described practical ways to incorporate behavior health policies and practices into disaster plans and embed them into everyday practice.

AAP Related Statements:

• Pediatric Mental Health Emergencies in the Emergency Medical Services System
• Pediatric and Adolescent Mental Health Emergencies in the EMS System

ENA Related Statements:

• Cultural Diversity and Gender Inclusivity in the Emergency Care Setting
• Tips for Providing Safe Structure for Pediatric Behavioral Health Patients-Infographic

Currently under revision by:

• Thomas Chun, MD, MPH
• Susan Duffy, MD MPH
• Lorah Ludwig, MA

Physical or Chemical Restraint of Patients

AAP Related Statements:

• Facilities and Equipment for the Care of Pediatric Patients in a Community Hospital
• Pediatric and Adolescent Mental Health Emergencies in the Emergency Medical Services System
• Evaluation and Management of Children and Adolescents With Acute Mental Health or Behavioral Problems. Part I: Common Clinical Challenges of Patients With Mental Health and/or Behavioral Emergencies
• Executive Summary: Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms

NAEMSP Related Statements:

• Patient Restraint in Emergency Medical Services Systems

State Protocol Example:

• State of Connecticut Emergency Medical Services Protocol version 2020

Revised in 2020 by:

• Steven C. Rogers, MD, MS-CTR
• Danielle Belanger, RN

Child Maltreatment

• SAMPLE Child Maltreatment Policy Template *
• Understanding Medical Findings in Child Sexual Abuse: An Update For 2018

AAP Related Statements:

• Care of the Adolescent after Sexual Assault
• The Evaluation of Suspected Child Physical Abuse
• Child Sex Trafficking and Commercial Sexual Exploitation: Health Care Needs of Victims

ENA Related Statements:

• Care of Prepubescent Pediatric Sexual Abuse Patients in the Emergency Care Setting
• Human Trafficking Awareness in the Emergency Care Setting

Currently under revision by:

• Julia Magana, MD
• Katherine Snyder, MD

Death of the Child in the ED

AAP Related Statements:

• Death of a Child in the ED
• Death of a Child in the ED - Technical Report
• Supporting the Family After the Death of a Child

Revised in 2020 by:

• Joan Shook, MD, MBA

Do Not Resuscitate (DNR) Orders

• SAMPLE DNR: End of Life Issues in the ED Policy Template
• Pediatric Death in the ED: Communicating News, Administrative Duties, Care Initiatives

AAP Related Statements:

• Do-Not-Resuscitate Orders for Pediatric Patients Who Require Anesthesia and Surgery
• Guidelines on Forgoing Life-Sustaining Medical Treatment

Revised in 2020 by:

• Mary E. Fallat, MD

Family/Guardian Presence (family-centered care)

• SAMPLE Family Presence during Invasive Procedure and Resuscitation
• Pediatric Trauma: Communication with Families

AAP Related Statements:

• Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information
• Patient- and Family-Centered Care and the Role of the Emergency Physician Providing Care to a Child in the ED
• Patient- and Family-Centered Care of Children in the ED
• Supporting the Family After the Death of a Child

ENA Related Statements:

• Clinical Practice Guideline: Family Presence During Invasive Procedures and Resuscitation
• Patient-and Family-Centered Care for Children in the Emergency Department: A Self-Assessment Tool
• Resuscitative Decisions in the Emergency Care Setting

Revised in 2020 by:

• Karen J. O'Connell, MD, MEd, FAAP

Communication with Primary Care Provider

• SAMPLE Statement on Partnering with Primary Community Pediatricians

AAP Related Statements:

• Care Coordination in the Medical Home: Integrating Health and Related Systems of Care for Children With Special Health Care Needs
• Health Information Technology and the Medical Home
• The Medical Home

Revised in 2020 by:

• Joyce Li, MD, MPH
• Katherine Mandeville, MD, MS

Medical Imaging

• SAMPLE Imaging and Radiology Policy Template
• ACR Appropriateness Criteria Suspected Physical Abuse—Child

AAP Related Statements:

• Radiation Risk to Children From Computed Tomography
• Children With Minor Blunt Head Trauma Presenting to the Emergency Department

Revised in 2020 by:

• Nathan Kuppermann, MD, MPH
• Julia Magana, MD

Children with Special Healthcare Needs (CSHCN)

Content coming soon!

Section in creation by:

• Marie Y Mann, MD, MPH, FAAP

Telehealth and Telecommunications

• SAMPLE: Telehealth Consult Workflow
• Telemedicine Graphic
• Physical Exam Tips
• Telehealth Etiquette Checklist
• NTRC 2019 Contact Sheet
• TRAC Telehealth Implementation Checklist

Section created by:

• James Marcin, MD, MPH