2014 EMSC Program News

Arkansas EMSC Releases Exertional Heat Illness Project (04/11/2014)

Arkansas EMSC and the Arkansas Department of Health partnered with the Kory Stringer Institute at the University of Connecticut, Life Touch Media Productions, the Arkansas Department of Education, and many other key stakeholders to create Cool Down First as part of the Exertional Heat Illness Project.

Exertional heat illness is 100% preventable with the proper preparation and care of those that may suffer from it. The goal of the project is to be a resource to parents, schools, coaches, emergency medical personnel, and any others who may face this issue. Every public, private, and charter school in Arkansas will receive informational packets and Cool Down First DVDs. Additionally, every EMS agency in Arkansas will receive the same materials.

Texas EMSC to Host Webinar on Next Steps in Pediatric Readiness (04/11/2014)

Texas EMSC will host the webinar "Next Steps in Pediatric Readiness: Is It Time for Pediatric Facility Categorization in Texas?" at 9:00 am (Eastern) on Thursday, April 17 and again at 12 noon (Eastern) on Monday, April 28. Join the webinar to learn:

  • how Texas data from the National Pediatric Readiness Project supports the development of a pediatric facility categorization program;

  • what pediatric facility categorization is and how it can ensure quality emergency care for children in Texas; and

  • how pediatric facility categorization is currently being implemented in other states and regions and how those models can be used to develop a similar program in Texas.

To register, please email Sam Vance, Texas EMSC program manager, and include your first and last name, email address, job title, company, and date of webinar you choose to attend. Participants will receive a confirmation email two to three days prior to the webinar with login information.

Targeted Issue Grantee Publishes on Termination of Resuscitation in the Pediatric Out-of-Hospital Setting (04/10/2014)

EMSC Targeted Issue (TI) Grantee Mary Fallat, MD, at the University of Louisville Research Foundation published findings from her TI project "Compassionate Options for Pediatric Emergency Medical Services (COPE)" in the April issue of Pediatrics.

The aim of this study was to determine if the current protocols for out-of-hospital termination of resuscitation in adults with cardiopulmonary arrest are appropriate for pediatric victims. Despite growing acceptance of the termination of resuscitation when there is no expectation of a good outcome, pediatric patients are not considered in these out-of-hospital protocols.

In a systematic literature review utilizing PubMed and Medline, the study researchers determined 27 articles were appropriate for this study. Of the 1,114 patients who suffered a traumatic cardiopulmonary arrest out-of-hospital, 5.4% (60 patients) survived to hospital discharge. Of these 60 patients, outcome data was available for 51. The outcome data indicated that 29 suffered neurologic devastation and were severely disabled or in a vegetative state, three had moderate disability, and 19 had "good" or full neurologic recovery.

Researchers concluded that resuscitation should be initiated and continued until the patient arrives to the appropriate care facility. If the patient has arrested, resuscitation has exceeded 30 minutes, and the nearest facility is greater than 30 minutes away, parents and caregivers should be involved in the decision making process of determining whether to discontinue resuscitation.

March 2014 Issue of Clinical Pediatric Emergency Medicine Focuses on EMSC (04/01/2014)

The March 2014 issue of Clinical Pediatric Emergency Medicine focuses on Emergency Medical Services for Children (EMSC). The issue features 15 publications written by EMSC champions, including Program grantees and State Partnership advisory committee members.

Congratulations to all authors and the EMSC Program on this outstanding achievement!

EMSC Presents at John Templeton Jr. Pediatric Trauma Conference (03/28/2014)

EMSC Grantees Nathan Kuppermann, MD, MPH, and Randall Burd, MD, PhD, and the EMSC National Resource Center's Diana Fendya, MSN (R), RN, presented at the 14th Annual John Templeton Jr. Pediatric Trauma Conference held March 7 and 8, in Philadelphia, PA. This educational conference is a collaborative venture of Children's Hospital of Pittsburgh, St. Christopher's Hospital for Children, and the Children's Hospital of Philadelphia.

Presentations included:

  • "Development of an Evidence-based Abdominal Imaging Algorithm" and "Indications for Head CT in the Pediatric Trauma Patient" (Kuppermann)

  • "Assessing and Improving Team Performance During Pediatric Trauma Resuscitation" and " Challenging Cases in Pediatric Trauma" (Burd

  • "Trauma Care Begins with the ABCDE, but Don't Forget the Ws': Who, What, Where and When to Transfer" (Fendya)

Comparison of Decision Rules Highlights Results of Former PECARN Study (03/27/2014)

A recent publication in Annals of Emergency Medicine compared two clinical decision rules and clinician practice to the Pediatric Emergency Care Applied Research Network (PECARN) Traumatic Brain Injury (TBI) prediction rules (published in Lancet 2009) to evaluate diagnostic accuracy for identifying clinically important traumatic brain injuries in children with minor head trauma presenting to the emergency department. This study concluded that only physician practice and the PECARN TBI prediction rules identified all clinically important TBIs.

Alabama EMSC to Host EMS Pediatric Respiratory Emergencies Webcast (03/13/2014)

The Alabama EMSC program along with the Alabama Department of Public Health will host the webcast EMS Pediatric Respiratory Emergencies from 11:00 am – 12:30 pm (Eastern) on March 25, 2014. This webcast will provide education and awareness on pediatric respiratory difficulties as well as provide an overview of pediatric respiratory anatomy and physiology, emphasize airway support and management, demonstrate some of the most common airway problems, and use clinical experience to explain how common pediatric respiratory issues can be better assessed.

New York EMSC and NYSDOH Revise Pediatric Hospital Regulations (02/28/2014)

The New York State Department of Health (NYSDOH) and its EMSC program have revised the minimum operating standards for all hospitals in regards to the pediatric patient. The hospital codes and regulations were revised to include quality improvement activities, staffing qualifications/competencies, appropriately-sized equipment and building infrastructure, and policies and procedures all centered around the pediatric patient; the obvious goal being to ensure hospitals are treating the patients they are qualified and prepared to treat, and if not, to transfer the patient(s) to an appropriate facility.

The sections of the New York code that were revised include: Admission and Discharge, Quality Assurance, Surgical, Outpatient, Anesthesia, Respiratory, Radiology, Pharmaceutical, and Emergency Services. A new section on Pediatric Intensive Care Units was also added.

California EMSC to Host Educational Forum at CFEDWest 2014 Conference and Expo (02/28/2014)

On Monday, May 19, California EMSC is partnering for the second year with the California Fire EMS and Disaster West (CFEDWest) to host the pre-conference educational forum "Get Ready with Kids" at the 2014 CFEDWest Conference and Expo in Palm Springs, CA. This forum will explore current issues and practices in providing emergency care to children.

EMSC Grantees Publish on Program Manager Survey on Education of Prehospital Providers (02/27/2014)

EMSC Grantees Manish Shah, MD, and Karen Belli recently published a study in Prehospital Emergency Care aimed to examine the content and number of hours of pediatric-specific education that prehospital providers receive during initial certification and recertification. The study also aimed to identify barriers to implementing specific requirements for pediatric education of prehospital providers.

Electronic surveys were sent to 55 EMSC State Partnership grant program managers to inquire about the certification and recertification processes of prehospital providers and barriers to receiving pediatric training in each jurisdiction. Based on a 91% response rate, results indicate that specified pediatric education hours exist in more states and territories for recertification than initial certification. Barriers to enhancing pediatric education include: limitations in funding, time, instructors, and accessibility. The study suggests modifying statewide policies on prehospital education and increasing hands-on training to help overcome identified barriers.

EMSC EMS Performance Measure Reassessment Response Rate Exceeds 82% Nationwide (02/27/2014)

On June 1, 2013, the Maternal and Child Health Bureau began conducting a reassessment of Emergency Medical Services for Children (EMSC) performance measures 71, 72, and 73. Each state is required to participate in the re-assessment and has a three-month window to collect the data. That three-month window was determined by each State Partnership grantee as long as it fell between June 1, 2013, and February 28, 2014. The current response rate is 82.3% nationwide! Congratulations!

New Mexico SPROC Releases Module on Emergency Management of DKA in Children (02/14/2014)

New Mexico's EMSC State Partnership Regionalization of Care (SPROC) project released a new module on emergency management of diabetic ketoacidosis (DKA). In the module scenario, Chelsea, a 16-year-old known Type 1 diabetic, presents to the pediatric emergency department in diabetic ketoacidosis. This emergency scenario, filmed at the University of New Mexico Health Sciences Center Medical Training Center, visually instructs medical personnel in the emergency treatment of a pediatric patient in diabetic ketoacidosis. The module also includes an interview with a pediatric endocrinologist who discusses key points and treatment highlights of pediatric diabetic ketoacidosis.

Former TI Grantee Publishes on Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis (02/14/2014)

Former Targeted Issue (TI) Grantee Richard Lammers, MD, published "Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis" in the January/March 2014 issue of Prehospital Emergency Care. This article aimed to identify underlying causes of prehospital medication errors that were observed during a simulated pediatric anaphylaxis reaction.

A standardized scenario and child mannequin were used in a mobile simulation lab to identify common and clinically significant medication errors and underlying causes of those errors during the treatment of a five-year old patient with anaphylaxis by prehospital providers. Study subjects included licensed emergency medicine technicians, specialists, and paramedics who worked as either a two- or four-person EMS crew.

Subjects participated in a 20-minute simulation using their own equipment and medication. The investigators utilized a checklist-based scoring protocol to identify errors.

A total of 142 providers participated in 62 simulation sessions. Ninety-five percent of crews gave epinephrine; 46% delivered the correct dose with the appropriate concentration. Twenty percent gave a dose that was more than five times the correct dose and 14% bolused epinephrine intravenously. Among the 55 crews who administered diphenhydramine, four delivered the correct dose.

The eight underlying causes of errors were as follows: faulty reasoning, faulty recall of medication dosages, weight estimation errors, problematic references, calculation errors, dose estimation, communication errors, and medication delivery errors.

PECARN Publishes on Validation of TBI Prediction Rules (02/13/2014)

Pediatric Emergency Care Applied Research Network (PECARN) Principal Investigator Lise Nigrovic, MD, and colleagues published "Pediatric Emergency Care Applied Research Network Head Injury Clinical Prediction Rules Are Reliable in Practice" in the January 2014 issue of Archives of Disease in Childhood. This cross-sectional study aimed to evaluate the performance of the PECARN Traumatic Brain Injury (TBI) prediction rules in an external patient population.

Study subjects included children who presented to one of two pediatric emergency departments (ED) in Boston, MA, and Padua, Italy, within 24 hours of a minor blunt head trauma and had a Glasgow Coma Scale equal to or greater than 14. Pediatric emergency and general pediatric attendings, pediatric emergency medicine fellows, and senior residents completed all study forms in the prospective cohorts, and a senior researcher conducted a standard medical chart review and chart abstraction for the retrospective cohort.

A total of 2,750 children presented to the EDs with 2,439 being enrolled in the study. Fifteen percent (373) of study participants had a computed tomography (CT) performed, 3% (69) had traumatic findings on the CT, and 0.8% (19) had a clinically important TBI. None of the children with a clinically important TBI were classified as very low risk by the PECARN TBI prediction rules. This study concluded that the PECARN TBI prediction rules accurately identified children at very low risk for clinically significant TBI.

Preliminary Agenda Now Available for 2014 EMSC Program Meeting (02/13/2014)

The preliminary agenda and logistics fact sheet are now available for the 2014 Emergency Medical Services for Children Program being held Tuesday, July 29 through Friday, August 1, 2014, at the Renaissance Arlington Capital View Hotel in Arlington, Virginia. The theme for this year's meeting is: "Emergency Medical Services for Children: Then, Now, Imagine; Honoring the Past, Experiencing the Present, Visualizing the Future."

Online registration will open on March 3, 2014. Attendees will be responsible for making their own hotel reservation by contacting the hotel directly or by using the hotel's online reservation system. Attendees should not call the Renaissance Arlington Capital View Hotel until they receive an identification code that is specific to this year's meeting. That code will be released when registration opens on March 3. Additional details about the meeting will be forthcoming.

HHS Seeks Nominations for New National Advisory Committee on Children and Disasters (02/07/2014)

The needs of children in disasters will be the focus of a new advisory committee of the U.S. Department of Health and Human Services (HHS). The National Advisory Committee on Children and Disasters (NACCD) will provide expert advice and consultation to the HHS Secretary on comprehensive planning and policies to meet the needs of children before, during, and after a disaster or public health emergency. Nominations are being accepted from non-federal health care professionals and representatives from state, tribal, territorial, or local health departments with expertise in pediatric disaster planning, preparedness, response, or recovery. The submission deadline for nominations is February 14, 2014. For more information and instructions on how to apply, visit www.phe.gov/naccd.

Texas EMSC is Accepting Nominations for EMSC Crew of the Year Award (01/31/2014)

In honor of EMSC Day 2014 and the 30th Anniversary of the EMSC Program, the Texas EMSC State Partnership program is now accepting nominations for the Sixth Annual EMSC Crew of the Year Award. This award is granted to an EMS crew or station who has displayed outstanding care for a child in an emergency medical or trauma event, demonstrated exceptional effort in the development of pediatric training or quality improvement programs, or was instrumental in planning and conducting creative injury prevention programs.

To submit a nomination for the EMSC Crew of the Year, please send the following information to EMSC Program Manager Sam Vance by February 7, 2014 at Samuel.Vance@bcm.edu

  1. Names and titles of crew members

  2. Agency or organization with contact information

  3. A brief (500 words or less) description of the event or program and why you feel this crew deserves special honor and recognition

  4. Your contact information (will not be disclosed without your permission)

Arkansas EMSC Holds Successful Simulation Event (01/31/2014)

Arkansas EMSC held a simulation event on Wednesday, January 22, which took place in an elementary school. Simulation dolls were utilized to help prepare emergency medical personnel in the community for child emergencies.

Charlotte, Houston and Milwaukee Prehospital (CHaMP) Research Node Center (RNC) Releases a New Research Lecture (01/30/2014)

The 2013 Targeted Issue Grantee CHaMP Research Node Center released its second research lecture titled "Developing a Research Question." Produced by E. Brooke Lerner, PhD, at the Medical College of Wisconsin, this video is the second installment of the CHaMP node's EMS Research Education video series. The series aims to assist healthcare professionals in designing EMS-based research and engaging with the CHaMP network. The presentation examines the origin of research ideas and provides a step-by-step tutorial on developing a high-quality research question. Topics covered include: what makes a good research question, identifying a suitable research question's key components, and the construction of a research question using the PICO method.

Alaska EMSC Welcomes New Program Manage (01/18/2014)

Alaska EMSC welcomes its new program manager, Marna Lee Schwartz , MD, FAAP. Dr. Schwartz is a Board-certified primary care pediatrician with additional training in evaluation of child abuse and neglect, neurodevelopmental delays/autism, and fetal alcohol syndrome. She has spent the last six years doing full-time clinical work at a large primary care clinic in Juneau working with general and special needs pediatric patients. Dr. Schwartz also provides pediatric coverage for the emergency department, labor and delivery, and inpatient care (general and pediatric intensive care unit) at Bartlett Regional Hospital. The EMSC family would like to congratulate Dr. Schwartz on her new role!