National organizations unite on pediatric readiness

Last week, the Health Resources and Services Administration’s (HRSA) Emergency Medical Services for Children (EMSC) program and five national organizations joined together to draw attention to pediatric readiness. “Pediatric readiness” is defined as having the necessary infrastructure to meet the needs of ill and injured children in an emergency.

The collaboration took the form of two webinars held as part of National Emergency Medical Services (EMS) Week and EMSC Day, which fell on May 19. The “Pediatric Readiness: Every Child, Every Day” event on EMSC Day covered pediatric readiness across the care continuum, including the National Pediatric Readiness Project (NPRP), a multiphase effort to assess and improve care for children in emergency care settings. The following day, "This is EMS: Caring for Our Children," focused on pediatric readiness in prehospital settings specifically, including the National Prehospital Pediatric Readiness Project (PPRP).

The webinars were coordinated by the EMSC Innovation and Improvement Center (EIIC) and hosted by the American College of Emergency Physicians (ACEP) in partnership with the American Academy of Pediatrics (AAP), the Emergency Nurses Association (ENA), the National Association of State EMS Officials (NASEMSO), and the American College of Surgeons (ACS) Committee on Trauma.

Taking pediatric readiness to the next level

The May 19 webinar was attended by more than 360 people. Introductory remarks were given by Michael Warren, MD, MPH, FAAP, Associate Administrator, Maternal and Child Health Bureau, HRSA, which funds and administers the EMSC Program.

“All of you show up for work every day with your passion, your expertise, and your commitment to advancing care for children who are injured--and that is why this program works and why we’re moving ahead as a country,” said Dr. Warren.

Dr. Warren discussed EMSC’s progress to date, including various quality improvement collaboratives, research advances, and the two readiness projects. He also highlighted opportunities for improvement, such as the fact that unintentional injury is still the leading cause of death for children in the United States.

His remarks were followed by a panel discussion of leadership from the participating organizations:

• Lee Savio Beers, MD, FAAP, President of AAP
• Ron Kraus, MSN, RN, EMT, CEN, ACNS-BC, TCRN, President of ENA
• Avery Nathens, MD, PhD, FACS, Medical Director, Trauma Quality Programs, ACS
• Mark S. Rosenberg, DO, MBA, FACEP, President of ACEP
• Kyle Thornton, EMT-P, MS, President of NASEMSO

Marianne Gauche-Hill, MD, FAAP, FACEP, FAEMS, Co-Director of the NPRP and Medical Director for the Los Angeles County EMS Agency, served as moderator.

Panelists each discussed the ways in which their organizations are tackling pediatric readiness, ranging from developing policy recommendations to supporting the role of pediatric emergency care coordinators (PECCs). They also discussed how webinar attendees could get more involved, including by joining pediatric emergency-specific workgroups, like AAP’s Section on Emergency Medicine or NASEMSO’s pediatric council.

At one point, Kraus, of the ENA, compared pediatric readiness as being as essential in emergency departments as having a defibrillator. “We would never open the doors if we didn’t have a defibrillator -- [pediatric readiness] needs to be as common as taking care of someone with a myocardial event. ”

Highlighting the necessity of collaboration, Dr. Rosenberg of ACEP added: “If we all step forward with our organizations and their expertise, we’re going to move this to the level we need.”

Gauche-Hill reminded attendees to complete the NPRP assessment, open now through July 31, by visiting www.pedsready.org. She also highlighted the PECC Workforce Development Collaborative, which is currently enrolling participants.

Collaborating to improve prehospital readiness

More than 200 individuals attended the prehospital-focused webinar held the next day, which was also EMS Week’s “Save-a-Life Day.”

Kathleen Adelgais, MD, MPH/MSPH, Co-Lead of the EIIC Prehospital Domain, introduced the event’s speakers, who represented the numerous stakeholders involved in the National Prehospital Pediatric Readiness Project (PPRP). The prehospital project, which parallels the National Pediatric Readiness Project, is set to launch a national assessment of EMS agencies in 2024.

A key step in the evolution of the PPRP has been the development of two foundational documents: a Joint Policy Statement and a Technical Report. The lead authors of these documents--Brian Moore, MD, FAAP, Professor of Emergency Medicine at the University of New Mexico, Manish Shah, MD, MS, Associate Professor at Baylor College of Medicine, and Sylvia Owusu-Ansah, MD, MPH, FAAP, Assistant Professor of Pediatrics and Emergency Medicine at the Children's Hospital of Pittsburgh--offered a behind-the-scenes glimpse into the process of developing both.

“The collaboration was all worth it for the final product,” said Dr. Moore, describing the culmination of 120 revisions. Both documents can be found here.

The PPRP has also released a checklist and toolkit, which are now available on the EIIC website. Dr. Shah described the development of the two-page EMS Agency Checklist, and Melissa Winger, the Family Advisory Network representative from Minnesota, shared details of the process behind creating the Prehospital Pediatric Readiness Toolkit. The toolkit features more than 80 resources.

Jeffrey L. Jarvis, MD, MS, EMT-P, FACEP, FAEMS, Medical Director for the Williamson County EMS system and Marble Falls Area and an emergency physician at Baylor Scott and White Hospital, located in Texas, summed up the importance--and difficulty--of providing quality care for children thus:

“One of the challenges when dealing with pediatric patients, however, is that compared with adults, we just don’t see that many of them. That infrequency is a good thing … but the downside, the double-edge of that, is that the infrequency means that we don’t have the experience and frequently overlook things.”

He emphasized the need for systematic evaluation of readiness and the vital importance of PECCs. Captain Steve Maselli, EMS Supervisor for the Walton Fire Protection District, then gave a personal perspective on being a PECC: “The PECC role has been a huge positive for us and other agencies within the state of Kentucky.”

During the Q&A portion of the event, many extended their thanks to EMS practitioners in light of EMS Week and asked how to get involved. As one key opportunity, Dr. Adelgais encouraged EMS practitioners to enroll in the upcoming PECC Workforce Development Collaborative.