Raising the bar for pediatric trauma care

More children die of injury each year than from all other causes combined. But only 57% of children across the United States live within 30 miles of a pediatric trauma center that can treat all pediatric injuries, regardless of severity.

To help bridge this gap, the American College of Surgeons (ACS) has announced new pediatric standards for all verified trauma centers, including a standard based on the National Pediatric Readiness Project, the flagship initiative of the Emergency Medical Services for Children (EMSC) Program. The project is jointly led by EMSC and the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association.

The new verification standards for both adult and pediatric trauma centers were announced during the 2021 ACS Trauma Quality Improvement Program (TQIP) annual conference, which featured a plenary session, “What to Expect When You’re Not Expecting Injured Children: Pediatric Readiness in Adult Trauma Centers,” on Nov. 16. The session was moderated by Aaron Jensen, MD, MEd, MS, Trauma Co-Lead for the EMSC Program’s Innovation and Improvement Center, and featured the following panelists:

• Kate Remick, MD, Co-Director of the EMSC Innovation and Improvement Center and the National Pediatric Readiness Project;
• Marianne Gausche-Hill, MD, FACEP, FAAP, Co-Director of the National Pediatric Readiness Project;
• Craig Newgard, MD, MPH, Principal Investigator for an EMSC Targeted Issues grant; and
• Aspen Di Ioli, RN, a pediatric emergency care coordinator (PECC) at Pomona Valley Hospital Medical Center.

“The new standard on pediatric readiness is the result of years of close collaboration between the EMSC Program and the ACS Committee on Trauma,” says Jensen. “We are grateful to the College for their recognition of the importance of pediatric readiness and are excited to help raise the bar for the initial post-injury care of children nationwide.”

The new pediatric readiness standard will require that all trauma centers participate in the National Pediatric Readiness Project assessment. Upon completing the assessment, participants receive a pediatric readiness score and gap report. If any gaps are identified, the new standard will require that trauma centers develop a plan to address them.

“The best way to prepare for the new pediatric standards is to identify a team member who can serve as a pediatric emergency care coordinator or PECC,” says Remick. “Research shows that having a PECC improves pediatric readiness scores by 16 points, and having a high pediatric readiness score is associated with as much as a four-fold lower rate of mortality in children.”

The standards are anticipated to be published in March 2022 in the seventh edition of “Resources for Optimal Care of the Injured Patient,” the guidebook for trauma center improvement and verification. To help trauma centers prepare for the new standard, the EMSC Innovation and Improvement Center is holding a Trauma Improvement Sprint during two half-day sessions on Feb. 23, 2022, and March 2, 2022, as part of its PECC Workforce Development Collaborative. A PECC can be any physician, nurse, or clinical team member; previous pediatric experience is not required.

“As a nurse in a mixed adult and pediatric ED, I would highly recommend joining the collaborative to improve pediatric care in your facility,” says Di Ioli. “I have learned something new at every session. It’s amazing to network with peds-specific nurses and hospitals and have access to their resources.”

Register for the sprint at https://bit.ly/TraumaImprovementSprint. To learn more about trauma center verification, visit https://www.facs.org. Learn more about pediatric readiness and access related resources and tools here.