New National Statement Sets Life-Saving Standards for Pediatric Readiness in Emergency Departments

A new joint statement released today outlines what every emergency department (ED) needs to be ready to care for kids—an effort that could save more than 2,100 children’s lives nationwide each year.

The joint statement, "Pediatric Readiness in the Emergency Department," was developed by professional societies representing emergency physicians, emergency nurses, pediatricians, and trauma surgeons. It spells out the critical steps EDs can take to be fully prepared for children in emergencies and is an update to recommendations previously released in 2018 and 2009.

“More than 80% of children who come to an ED go to a general community hospital, not a children’s hospital,” said Kate Remick, MD, lead author of the statement and co-director of the National Pediatric Readiness Project (NPRP). “Every ED should be fully prepared for kids, no matter how often they see them. These recommendations save lives.”

The statement informs the work of the NPRP, an initiative of the federal Emergency Medical Services for Children (EMSC) Program in collaboration with multidisciplinary organizations. The NPRP supports the nation’s more than 5,000 EDs in improving their Pediatric Readiness through self-assessments, benchmarking, checklists, quality dashboards, and other resources.

The Stakes Are High, But The Fixes Are Doable

Research shows that critically ill and injured children treated in EDs in the top 25% of readiness nationwide are up to 76% less likely to die compared to children treated in EDs in the lowest quartile. The cost needed to reach the top 25% is relatively low, between $4 to $48 per pediatric patient, depending on patient volume.

Many EDs face systemic challenges—workforce shortages, competing demands, and strained resources—that make it challenging to meet national standards. But the revised statement emphasizes that Pediatric Readiness is vital and achievable for all EDs, including freestanding EDs, rural emergency hospitals, and critical access hospitals.

What’s New in the 2025 Recommendations

Many recommendations remain the same, such as the importance of appointing both nurse and physician pediatric emergency care coordinators (PECCs) to lead readiness efforts within EDs. Updates largely expand on existing recommendations, including:

• Increased focus on pediatric-specific clinical practice guidelines and decision support tools for common pediatric conditions to standardize and optimize care;
• A list of pediatric-specific quality measures, including targeted measures by condition;
• New emphasis on the need for multidisciplinary review of all pediatric deaths and adverse events;
• A deeper focus on pediatric mental health, including universal suicide screening in teens;
• Reinforcement of the importance of immediately available, portable, weight-based pediatric resuscitation carts and use of medication dosage tools to avoid manual calculations; and
• Broader expectations for pediatric considerations in disaster preparedness.

To help EDs implement these recommendations, the statement includes a Pediatric Readiness Checklist. The statement also is accompanied by a technical report that outlines the scientific evidence supporting each recommendation.

2026 Readiness Assessment: A Chance to Improve

The new statement sets the stage for an upcoming nationwide NPRP Assessment period, slated to open on March 3, 2026. EDs will be assessed on a 100-point scale and receive a gap report identifying areas for improvement.

“The 2026 assessment is our chance to see where we stand—and where we can do better,” said Marianne Gausche-Hill, MD, co-director of the NPRP and a co-author of the statement. “By participating in the National Pediatric Readiness Project Assessment, you can identify what is needed for your ED to be fully ready to care for children.”

Hospitals can learn more by registering for a free webinar on Feb. 12 and can start preparing now using NPRP resources, including a toolkit and checklist, at pediatricreadiness.org.

About the National Pediatric Readiness Project (NPRP)

The National Pediatric Readiness Project is an initiative of the Department of Health and Human Services’ Health Resources and Services Administration’s Emergency Medical Services for Children Program with support from multidisciplinary organizations. The project empowers EDs to improve their “Pediatric Readiness” or capability to care for acutely ill and injured children. High levels of Pediatric Readiness are associated with a reduction in pediatric mortality in critically ill and injured children by as much as 76% and, nationwide, could save more than 2,100 children’s lives each year. Learn more at www.pediatricreadiness.org.