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Emergency Medical Services for Children

About EMSC

Background

Early EMS systems were designed to provide rapid intervention for sudden cardiac arrest in adults and rapid transport for motor vehicle crash victims. The was limited recognition that children required specialized care. Pediatricians and pediatric surgeons, identifying poor outcomes among children receiving emergency medical care, became advocates on behalf of their patients. They sought to obtain for children the same positive results that EMS had achieved for adults.

In the late 1970s, Calvin Sia, M.D., president of the Hawaii Medical Association, urged members of the American Academy of Pediatrics to develop multifaceted EMS programs that would decrease illness and death in children. Dr. Sia worked with US Senator Daniel Inouye (D-HI) and his staff assistant, Patrick DeLeon, Ph.D., to generate legislation for an initiative on pediatric emergency medical services for children.

In 1984, Senators Orrin Hatch (R-UT) and Lowell Weicker (R-CT) joined Senator Inouye in sponsoring the first EMSC legislation. C. Everett Koop, M.D., then Surgeon General of the United States, strongly supported this measure, as did the American Academy of Pediatrics.

The Emergency Medical Services for Children (EMSC) program was established with the passage of the legislation in 1984. Two years later, Alabama, California, New York, and Oregon became the first recipients of Federal grant money specifically earmarked to improve pediatric emergency medical services.

Since then, grants have helped all 50 States, plus the District of Columbia, the Commonwealth of the Northern Mariana Islands, American Samoa, US Virgin Islands, Guam, and Puerto Rico.

In 1990, HRSA-MCHB funded the Institute of Medicine (IOM) to conduct a study of pediatric emergency medical services. The IOM study report, which was released in July 1993, details the nature, extent, and outcomes of pediatric illness and trauma emergencies; describes the current state of pediatric emergency care; identifies the data and standards needed for surveillance and evaluation of EMSC services; and provides policy recommendations to promote the development of better systems of care.

The vision for EMSC is a system that works perfectly for all children, everywhere, but is needed less frequently as both illness and injury prevention reduce the number of life-threatening emergencies.

Accomplishments

Since its establishment in 1984, the EMSC program has improved the availability of child-appropriate equipment in ambulances and emergency departments. Through grants to States and territories, it has supported hundreds of programs to prevent injuries, and has provided thousands of hours of training to EMTs, paramedics and other emergency medical care providers.

EMSC Program support has led to legislation mandating EMSC programs in several states, and to educational materials covering every aspect of pediatric emergency care. Most important, EMSC efforts are saving kids' lives.

Although EMSC has made great progress over the years, much remains to be done to ensure children receive optimal medical care.

Grants

EMSC grants fund States and U.S. Territories to improve existing emergency medical services (EMS) systems and to develop and evaluate improved procedures and protocols for treating children. The EMSC program is the only federal program that focuses specifically on improving the quality of children’s emergency care. All States, U.S. Territories, and the District of Columbia have received federal funding. Currently, only State governments and accredited schools of medicine are eligible to receive EMSC grants.

Targeted Issue grants are intended to address specific needs or concerns that transcend state boundaries. Typically the projects result in a new product or resource or the demonstration of the effectiveness of a model system component or service of value to the nation. Funding for Targeted Issue grants are up to $200,000 per year. Project periods are for three years.

Network Development Demonstration Project Cooperative Agreement demonstrates the value of an infrastructure or network designed to be the platform from which to conduct investigations on the efficacy of treatments, transport, and care responses including those preceding the arrival of children to hospital emergency departments. Creation of this infrastructure will help overcome present difficulties in assessing efficacy and quality of care and ensuring accountability in State EMSC programs that derive from the relatively small incidence rates of pediatric emergency events and the lack of a current mechanism to pool sites and treatment experiences. Once established, the infrastructure can also be utilized as a means to conduct observational and randomized studies on a variety of issues related to EMSC, including processes involved in transferring research results to treatment settings. Projects were approved for a 3-year period, with average yearly awards of $700,000 in total costs.

Central Data Management Coordinating Center provides Pediatric Emergency Care Applied Research Network (PECARN) Regional NODES with data services including collection, management, guidelines for analysis and a central repository for PECARN generated data. Approximately $615,000 per fiscal year is available to support one CDMCC Cooperative Agreement.

State Partnership grants solidify the integration of a pediatric focus within the state EMS system, the only eligible applicant is the State EMS agency, unless the State specifically requests and designates another State entity. States receive as much as $115,000 per year, for as many as three years.

EMSC Partnership for Children Stakeholder Group The Partnership (PFC) Stakeholder Group was formed in 2003. The group is a collaborative of diverse organizations and EMSC Program grantees convened to improve the emergency medical care of children through the exchange of knowledge, development of partnerships, and provision of input and counsel to the EMSC Program. The PFC Stakeholder Group is composed of representatives from two U.S. Government agencies (the National Highway Traffic Safety Administration Emergency Medical Services Division and the Indian Health Service), seven EMSC grantees and the following 20 national organizations:

Ambulatory Pediatric Association (not a U.S. Government Web site)

American Academy of Pediatrics (not a U.S. Government Web site)

American College of Emergency Physicians (not a U.S. Government Web site)

American College of Osteopathic Emergency Physicians (not a U.S. Government Web site)

American College of Surgeons (not a U.S. Government Web site)

American Pediatric Surgical Association (not a U.S. Government Web site)

American Trauma Society (not a U.S. Government Web site)

America's Health Insurance Plans(not a U.S. Government Web site)

Emergency Nurses Association (not a U.S. Government Web site)

Family Voices (not a U.S. Government Web site)

National Association of Children’s Hospitals and Related Institutions (not a U.S. Government Web site)

National Association of EMS Physicians (not a U.S. Government Web site)