Pediatric Protocols and Guidelines Resources

State prehospital protocols & guidelines for pediatric medical and traumatic conditions.

Reference card from New York EMSC (March 2003)

Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emer- gency medical experience and can have a lasting effect on a child’s and family’s reaction to current and future medical care. A systematic approach to pain management and anxiolysis, including staff education and protocol development, can provide comfort to children in the emergency setting and improve staff and family satisfaction. Pediatrics 2012;130:e1391–e1405

(focus on emergency departments, but some valuable information for prehospital, too)

The purpose of this document is to provide healthcare professionals with key facts and recommendations for treating pain in children. This summary was co-produced by the pain content advisors for TREKK, Dr. Samina Ali of the Stollery Children’s Hospital, Dr. Naveen Poonai of the London Health Sciences Centre (LHSC): Children’s Hospital, Dr. Amy Drendel of the Medical College of Wisconsin, and content advisor for EIIC Dr. Corrie Chumpitazi of Baylor College of Medicine and uses the best available knowledge, at the time of publication.

June 2023

EIIC: Pediatric Status Epilepticus Algorithm

The American College of Surgeons (ACS) Field Trauma Triage Guidelines (FTTG), for use by clinicians nationwide, provide evidence-based criteria in making care and transport decisions for patients with traumatic injuries in the prehospital setting.

This is a sample ED policy, but includes prehospital references:

How EMS providers can gather data to report to ED: Sections III.D.13. and, V.B.2.)

This toolkit provides practical information about the development and use of evidence-based guidelines for prehospital care, and addresses the implementation of guidelines related to any clinical or operational topic relevant to EMS. Resources contained herein include tips on education of EMS personnel as part of guideline implementation and methods for evaluating whether a guideline was successfully implemented and improved patient care. Additional resources on the evaluation of EBG implementation are included.

These guidelines are based on the most current and comprehensive review of resuscitation science, systems, protocols, and education.

Guidelines include Neonatal Resuscitation, Pediatric Basic Life Support, Pediatric Advanced Life Support, and Pediatric Special Circumstances of Resuscitation.

These guidelines are intended to facilitate the creation of state and local EMS system clinical guidelines, protocols, or operating procedures. System medical directors and other leaders are invited to harvest content as will be useful. These guidelines are either evidence-based or consensus-based and have been formatted for use by field EMS professionals.

Pediatric information is integrated throughout the document.

Pediatric-specific guidelines start on page 144 (BRUE, Bronchiolitis, Croup, Neonatal Reususcitation, Childbirth).

Additional pediatric-specific information includes: Pediatric Vitals/GCS (page 16); Pediatric Glasgow Coma Scale (page 17); Pediatric Syncope & Presyncope (page 26).

Guidelines of interest: Patient Refusals --> Special Considerations - Minors (page 24); Abuse & Maltreatment (page 55).

This model protocol incorporates elements of an evidence-based guideline for prehospital analgesia in trauma and evidence-based guidelines for prehospital pain management created using the National Prehospital Evidence-Based Guideline Model Process.

This guide is designed to help EMS personnel and first responders safely and effectively manage suspected or confirmed measles cases.

Example guidelines/protocols from state EMS offices & local EMS agencies.

(Last updated: December 18, 2025)

The Pediatric Decision Tree (PDTree) is an evidence-based guideline to suggest the type of pediatric hospital which can meet a child’s definitive needs. The PDTree defines four levels of pediatric care; designated trauma/burn centers, comprehensive pediatric facility (with pediatric ICU and surgical services), regional pediatric facility (with pediatric inpatient care or 24/7 pediatric specialists in the ED) and local pediatric ready facility.

PowerPoint presentation by Dr. Manish Shah.

Objectives:
1) To provide an overview of the past, present and future of national prehospital evidence-based guideline (EBG) development
2) To describe critical considerations in developing, implementing and assessing outcomes for prehospital guidelines
3) To define how prehospital guidelines relate to pediatric readiness in emergency departments

The purpose of this website is to promote openness, discussion and collaboration among system directors in the development of EMS protocols, with the goal to help improve all EMS protocols to the current state of the science using evidence-based medicine.

The list of available protocols is a work in progress.

No pediatric-specific document, would need to access each state/agency guideline to find pediatric resources.

Prehospital Evidence Based Practice (PEP) is a collaborative effort of Canadian and international EMS clinicians (paramedics, physicians, nurses and other allied health professionals). PEP is sponsored and managed by the Dalhousie University Department of Emergency Medicine Division of EMS, and Emergency Health Services Nova Scotia.

Click on "Open Resource" and scroll down to "Pediatric" in the alphabetized list.

Topics include: Advanced Airway Management, Airway Emergency; Allergic Reaction; Altered Mental State; Burns; Cardiac Arrest & Arrhythmia; Environmental Emergency; Respiratory Distress; Shock; Trauma; Perinatal Care.