Emergency Medical Services for Children Program
The national Emergency Medical Services for Children (EMSC) Program works in communities around the country to improve the quality of pediatric medical care, with the goal of reducing childhood morbidity and mortality that results from severe illness or trauma. This federal initiative evolved out of a growing recognition that children have unique needs in emergency situations, which often vary from those of adults due to physiological, developmental and psychological differences.
The program is federally funded to expand and improve emergency medical services for children in each state. Grant funding has supported improvements such as:
- Adding child-appropriate equipment in ambulances and emergency departments
- Supporting programs to prevent pediatric injuries
- Providing training to emergency medical technicians (EMTs), paramedics and other emergency medical care providers
- Developing educational materials to cover every aspect of pediatric emergency care
Emergency Medical Services for Children Program at Children’s National
Children’s serves as the hub of the District of Columbia’s EMSC program (EMSC-DC), in collaboration with the D.C. Department of Health, D.C. Fire and Emergency Medical Services (FEMS), D.C. Hospital Association and D.C. Office of Emergency Management.
Through this partnership, we are leveraging the expertise and data of the Children’s Emergency Department teams with our local emergency response system to provide improvements in pediatric medical care. In addition, our proximity to policy makers, related advocacy groups and national organizations improves our local program outcomes.
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Making Emergency Care Better
Children's National staff and our partners in the Emergency Medical Services for Children Program provide free training to other health care providers who want to better their skills when giving emergency care to young patients.
What We Are Achieving
Establishing Children’s National as a Level One Pediatric Trauma Center
As a Level One Pediatric Trauma Center designated by the D.C. government and the American College of Surgeons, Children’s National is uniquely positioned to handle injured patients who are victims of trauma. This designation, along with D.C. Fire and Emergency Medical Services’ protocols, define which patients should be transported to Children’s, creating a standardized system for care for such patients in D.C.
Expanding Access to Simulation Training
Children’s National Emergency Medicine Specialist Pavan Zaveri, M.D., is developing a new simulation course for three District of Columbia hospitals with emergency departments to improve care for children. The course, known as Improving Pediatric Acute Care through Simulation (iPACTS), will train health care providers on how to administer medication and use pediatric medical equipment to improve outcomes and survival for acutely ill and injured infants and children. The work will connect adult community emergency departments with care at Children’s National, aiming to reduce infant morbidity and mortality through higher standards of pediatric emergency care.
Visiting Firehouses and Equipping Local Ambulances
The EMSC Program has advocated ensuring that our D.C. Fire and Emergency Medical Services (FEMS) ambulances are all prepared to handle pediatric trauma. Children’s National emergency department physicians visit firehouses to check and see if they have pediatric versions of their equipment. While there, we describe how children aren’t just simply tiny adults and require equipment that is specialized to their size. We encourage firehouses and D.C. FEMS to make sure equipment such as correct needle gauges, pediatric c-collars for immobilization, pediatric papoose boards, pediatric defibrillator pads and other emergency equipment suitable for children is available on ambulances.
Training Our Peers on the Use of Pediatric Equipment
Pediatric emergency medicine physicians at Children’s National, who are either board certified or board eligible pediatric emergency medicine specialists or fellows in training, are available to train peers on the use of pediatric medical equipment. These specialists stay up-to-date on D.C. Fire and Emergency Medical Services (FEMS) protocols and work to improve the quality of education to D.C. FEMS health care providers. Our D.C. FEMS peers also participate in pediatric rotations at the Children’s National Emergency Department, with our Emergency Department staff accompanying them on grand rounds as they visit patients in their care.
Building Recognition for Hospitals Handling Pediatric Emergencies
Children’s National staff continue to advocate at the local government level for a voluntary process of recognition for hospitals that stabilize or manage pediatric patients in Washington, D.C. As part of this effort, our team and partners at the D.C. Department of Health and its Health Emergency Preparedness and Response Administration have proposed legislation that would incorporate pediatric expertise in a cabinet-level position in D.C. government, as well as coordinate agencies to recognize pediatric health care facilities.
Tracking Local Hospital Transfer Guidelines and Agreements
Whether an emergency department has interfacility transfer agreements and guidelines with other area emergency departments or hospitals is one key factor in making sure patients are getting the best care possible, wherever they seek it. The latest survey of local emergency departments by the EMSC-DC program found that 63 percent of area hospitals have transfer agreements (compared with 69 percent nationally) and that 88 percent of area hospitals have transfer guidelines (compared with 76 percent nationally). Having these benchmarks helps us track progress and make improvements to the local emergency health care system.
Improving Data Reporting to Advance Care
The EMSC-DC Program has guided D.C. Fire and Emergency Medical Services to submit 911 call data to the National EMS Information System to improve data reporting. For example, by analyzing 911 call data, EMSC leadership can identify areas that have a high number of calls and can station more ambulances in those areas – and potentially add training for pediatric emergencies in those areas if trends indicate such a need. In doing so, the region is able to efficiently collect data on health emergencies and analyze the performance of the local health care system, leading to better care across all D.C. hospitals and less strain on emergency departments in cases where emergency care may not be needed.