Pediatric Emergency Care Coordinators in Emergency Medical Services

By Sam Vance and Rachael Alter

EMS responses for pediatric patients represent thirteen percent of total the EMS runs in the United States, but because call volume is highly variable across regions and across agencies, nearly 40% of all EMS agencies in the United States see fewer than thirteen pediatric patients per year on average.1,2 With EMS providers having limited pediatric focused education and infrequent encounters with children, particularly with the critically ill, there are gaps in patient care, patient safety, and clinical outcomes.3,4

To help address these gaps, the Institute of Medicine (IOM) released Emergency Care for Children: Growing Pains which specifically recommends that EMS agencies designate a pediatric emergency coordinator (PECC) to ensure that training and guidelines are available to field providers to maintain competence in the emergent care of children.5 This role is now commonly referred to as a PECC. The report suggests the individual(s) filling this role would serve as a resource to provide oversight to the care of children, to promote the integration of pediatric components into daily service delivery, as well as local and regional disaster planning, and to promote pediatric education throughout their EMS agency.5

Acting on the recommendations from that report, the Health Resources and Services Administration’s (HRSA) Emergency Medical Services for Children (EMSC) program has set as a performance measure for the EMSC State Partnership Program that 90% of all EMS agencies have a PECC by 2026. Based on responses from the 2017-2018 EMSC Program Survey, only 22.9% of EMS agencies currently have a PECC.

As such, the EMSC program is currently engaged in a national quality improvement collaborative designed to increase the number of prehospital PECCs across 9 states allowing new strategies for identifying, expanding the number of and training prehospital PECCs to be discovered. Resources developed from this collaborative will be made available nationally. The materials developed will assist other states and territories understand how best to help EMS agencies adopt these interventions according to their needs. For more information, click here.

References

1. Shah MN, Cushman JT, Davis CO, Bazarian JJ, Auinger P, Friedman B. The epidemiology of emergency medical services use by children: an analysis of the National Hospital Ambulatory Medical Care Survey. Prehosp Emerg Care. 2008; 12(3):269-76.
2. EMSC Innovation and Improvement Center (EIIC). NEDARC Data Collection Results for Performance Measures 02 and 03. EMSC Meeting Austin, Texas 2018. Available at: https://emscimprovement.center/categories/measurement/. Accessed 8.30.2018.
3. Ngo TL, Belli K, Shah M. EMSC Program Manager Survey on Education of Prehospital Providers. Prehospital Emergency Care. 2014; 18(3):424-8.
4. Remick K, Gross T, Adelgais K, Shah MI, Leonard JC, Gausche-Hill M. Resource document: Coordination of pediatric emergency care in EMS systems. Prehosp Emerg Care. 2017; 21(3):399-407.
5. Institute of Medicine. 2007. Emergency Care for Children: Growing Pains. Washington, DC: The National Academies Press. https://doi.org/10.17226/11655 .