Policy/Position Statements

Recommended Essential Equipment for Basic Life Support and Advanced Life Support Ground Ambulances 2020: A Joint Position Statement

Abstract: In continued support of establishing and maintaining a foundation for standards of care, our organizations remain committed to periodic review and revision of this position statement. This latest revision was created based on a structured review of the National Model EMS Clinical Guidelines Version 2.2 in order to identify the equipment items necessary to deliver the care defined by those guidelines. In addition, in order to ensure congruity with national definitions of provider scope of practice, the list is differentiated into BLS and ALS levels of service utilizing the National Scope of Practice-defined levels of Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT) as BLS, and Advanced EMT (AEMT) and Paramedic as ALS. Equipment items listed within each category were cross-checked against recommended scopes of practice for each level in order to ensure they were appropriately dichotomized to BLS or ALS levels of care. Some items may be considered optional at the local level as determined by agency-defined scope of practice and applicable clinical guidelines. In addition to the items included in this position statement our organizations agree that all EMS service programs should carry equipment and supplies in quantities as determined by the medical director and appropriate to the agency’s level of care and available certified EMS personnel and as established in the agency’s approved protocols.

Revised January 2021

Offers guidance for out-of-hospital medical direction and the intervener physician.

Revised January 2016

The American College of Emergency Physicians (ACEP), the National Association of EMS Physicians (NAEMSP), and the National Association of EMS Educators (NAEMSE) believe that changing technology, advances in research, and changing health care delivery systems, require the active involvement of knowledgeable, identifiable, and responsible physician medical directors in the provision of emergency medical services (EMS) education programs, including initial and continuing education programs.

Approved September 2016

A joint statement by the American College of Emergency Physicians (ACEP), the National Association of EMS Physicians (NAEMSP), and the National Association of State EMS Officials (NASEMSO).

Approved October 2016 (ACEP)

ACEP believes emergency physicians, as leaders in EMS, have a pivotal role in the integration of emergency medical services for children (EMSC). Emergency physicians impact the EMS-EMSC continuum in important ways as outlined in this policy statement.

Approved February 2018

ACEP considers EMS a practice of medicine requiring physician oversight, reaffirms its commitment to physician medical director leadership in EMS, and supports the principles outlined in this policy statement.

Approved October 2017

Abstract: Parental consent generally is required for the medical evaluation and treatment of minor children. However, children and adolescents might require evaluation of and treatment for emergency medical conditions in situations in which a parent or legal guardian is not available to provide consent or conditions under which an adolescent patient might possess the legal authority to provide consent. In general, a medical screening examination and any medical care necessary and likely to prevent imminent and significant harm to the pediatric patient with an emergency medical condition should not be withheld or delayed because of problems obtaining consent. The purpose of this policy statement is to provide guidance in those situations in which parental consent is not readily available, in which parental consent is not necessary, or in which parental refusal of consent places a child at risk of significant harm.

Pediatrics 2011;128:427–433

Reaffirmed 2020–Free access

NAEMSP position statement affirming that pediatric patients have unique needs that every EMS program must ensure are appropriately and reasonably met. NAEMSP believes that if the EMS medical director does not inherently possess knowledge and experience in pediatric-related EMS healthcare needs, they should engage with stakeholders that can provide EMS-appropriate guidance related to pediatric EMS healthcare needs. An EMS Pediatric Emergency Care Coordinator or an EMS System Pediatric Advisory Committee can augment and advise the EMS medical director(s) for the system or for individual EMS programs.

October 6, 2016. Taylor & Francis login needed to access full resource.

Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of all Children. In this policy statement, ACEP, the AAP, and the ENA recommend methods to Improve Entry Into the Emergency Care System, Pediatric Prehospital Care, and Emergency Department Care for Children and Adolescents.

Pediatrics (2021) 147 (5): e2021050787

Free access

This multiorganizational literature review was undertaken to provide an evidence base for determining whether recommendations for out-of-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospital termination of resuscitation for adult traumatic cardiopulmonary arrest when there is no expectation of a good outcome, children are routinely excluded from state termination-of-resuscitation protocols. The decision to withhold resuscitative efforts in a child under specific circumstances (decapitation or dependent lividity, rigor mortis, etc) is reasonable. If there is any doubt as to the circumstances or timing of the traumatic cardiopulmonary arrest, under the current status of limiting termination of resuscitation in the field to persons older than 18 years in most states, resuscitation should be initiated and continued until arrival to the appropriate facility. If the patient has arrested, resuscitation has already exceeded 30 minutes, and the nearest facility is more than 30 minutes away, involvement of parents and family of these children in the decision-making process with assistance and guidance from medical professionals should be considered as part of an emphasis on family-centered care because the evidence suggests that either death or a poor outcome is inevitable.

Pediatrics 2014;133:e1104–e1116

Free access

This clinical report is a revision of “Preparing for Pediatric Emergencies: Drugs to Consider.” It updates the list, indications, and dosages of medications used to treat pediatric emergencies in the prehospital, pediatric clinic, and emergency department settings. Although it is not an all-inclusive list of medications that may be used in all emergencies, this resource will be helpful when treating a vast majority of pediatric medical emergencies. Dosage recommendations are consistent with current emergency references such as the Advanced Pediatric Life Support and Pediatric Advanced Life Support textbooks and American Heart Association resuscitation guidelines.

The National Association of EMS Physicians and the then National Association of State EMS Directors (now National Association of State EMS Officials) created a position statement on emergency medical vehicle use of lights and siren in 1994. This document updates and replaces this previous statement and is now a joint position statement

February 2022

Resource availability and pediatric readiness across EMS agencies are variable. Providing high-quality EMS care to children requires an infrastructure designed to support the care of pediatric patients and their families. Therefore, it is important that EMS physicians, administrators, and EMS personnel collaborate with pediatric acute care experts to optimize EMS care through the development of care models to minimize morbidity and mortality in children as a result of illness and injuries.

Approved January 2019