TABLE 1

Integration of Pediatric Components Into EMS Systems

Medical oversight
 Ensure pediatric representation in EMS planning, operations, and oversight as outlined in the NAEMSP position statement “Physician Oversight of Pediatric Care in EMS”
 Provide direct and indirect medical oversight that integrates pediatric-specific elements into the global EMS system
Operations
 Include pediatric-specific guidance and expertise in the development and improvement of EMS operations
 Have pediatric-specific equipment and supplies available and ensure that prehospital providers are competent in their use
 Develop processes for evaluating pediatric-specific psychomotor and cognitive competencies of prehospital providers
 Have policies that ensure the safe transport of children and families in emergency vehicles
 Collaborate with outpatient and hospital-based pediatric experts, especially those in EDs
 Facilitate destination determination of patients by weighing the risks and benefits of transport to a higher level of care
 Collaborate with local EDs to promote basic pediatric readiness of all facilities
 Include considerations for care of children and families in emergency preparedness planning and exercises, including family repatriation, in time of disasters
 Provide situational awareness to caregivers by encouraging providers to designate a person to narrate and preempt actions to the bystander on the scene, using lay terms to communicate with patients and families, and allowing bystanders to maintain a line of sight with the child as long as they are not interfering with patient care
Education
 Ensure that prehospital providers receive periodic pediatric-specific education
 Ensure pediatric assessment and recognition of respiratory distress or failure, cardiac failure, and shock
 Competency in neonatal and pediatric resuscitation
 Ensure updated psychomotor skills and practice in pediatric airway management (focusing on basic airway management) and venous and intraosseous placement and access
 Provide education tools to improve proper pain and wt assessment and pain management
Research, data management, and QI
 Implement practices to reduce pediatric medication errors
 Include pediatric-specific measures in QI and quality assurance processes
 Submit data to a statewide database that is compliant with the most recent version of the NEMSIS and work with local hospitals to track pediatric patient-centered outcomes across the continuum of care
  • Adapted from National Association of Emergency Medical Services Physicians. Physician oversight of pediatric care in emergency medical services. Prehosp Emerg Care. 2017;21(1):88 and Ayub EM, Sampayo EM, Shah MI, Doughty CB. Prehospital providers’ perceptions on providing patient and family centered care. Prehosp Emerg Care. 2017;21(2):233–241.