Pediatric Equipment Guidelines Toolbox

• It is imperative that prehospital emergency care providers, emergency department (ED) personnel, and office-based pediatricians/physicians have the appropriate equipment and supplies if they are to provide proper care for ill and injured children. Without the necessary medical equipment, healthcare professionals are limited in the quality of care they can provide to our nation’s children.

Many national organizations and government agencies have tackled this issue by developing essential and recommended equipment and supply list for inclusion inBLS and ALS ambulances, EDs, and physician offices. The following toolbox identifies the most recent guidelines, resources, position papers, and journal articles on pediatric equipment guidelines.

HEALTHCARE PROVIDER RESOURCES

American Academy of Pediatrics, Committee on Pediatric Emergency Medicine

• Policy Statement: Pediatric Care Recommendations for Freestanding Urgent Care Facilities. Table 1 of this statement provides a list of recommended Office Emergency Equipment and Supplies for pediatric patients seen in freestanding urgent care facilities. (Accessed December 2008)

• Guidelines for Preparedness of Emergency Departments that Care for Children: A Call to Action. This is a joint statement by the AAP and the American College of Emergency Physicians (ACEP). It replaces a previous equipment guidelines document created in 1995 that was retired in 2004. (Accessed December 2008)

• Emergency Readiness of Pediatric Offices. This report presents findings from Periodic Survey #27, which explored the state of readiness for common emergencies of office-based pediatric practices. Initiated by the Committee on Pediatric Emergency Medicine, it includes a listing of the availability of the equipment/medications necessary to handle emergencies. (Accessed December 2008)

• Facilities and Equipment for the Care of Pediatric Patients in a Community Hospital. Many children who require hospitalization are admitted to community hospitals that are more accessible for families and to their primary care physicians, but vary substantially in their pediatric resources. The intent of this clinical report is to provide basic guidelines for furnishing and equipping a pediatric area in a community hospital. (Accessed December 2008)

• Care of Children in the Emergency Department: Guidelines for Preparedness. Table 2 of this document, titled “Guidelines for Equipment and Supplies for Use on Pediatric Patients in the ED,” lists essential equipment for preparedness for pediatric patients in an emergency department setting. This document has been reviewed by and is supported in concept by the following organizations: Ambulatory Pediatric Association, American Association of Poison Control Centers, American College of Surgeons, American Hospital Association, American Medical Association, American Pediatric Surgical Association, American Trauma Society, Brain Injury Association Inc, Emergency Nurses Association, Joint Commission on Accreditation of Healthcare Organizations, National Association of Children's Hospitals and Related Institutions, National Association of Emergency Medical Technicians, National Association of EMS Physicians, National Association of School Nurses, National Association of State Emergency Medical Services Directors, National Committee for Quality Assurance, and the Society for Academic Emergency Medicine. It was approved by ACEP Board of Directors September 2000 and the American Academy of Pediatrics Board of Directors December 2000. (Accessed December 2008)

American College of Surgeons (ACS)

• Equipment for Ambulances. This document provides a list of equipment that the ACS believes to be necessary on all ambulances in order to provide sufficient patient care in the pre-hospital setting.  (Accessed December 2008)

Florida Emergency Medical Services for Children (EMSC)

• Guidelines for Pediatric Equipment Inventories in EMS Disaster Response Trailers. Developed by the Florida Emergency Medical Services for Children (EMSC) project, this list offers guidelines for essential pediatric equipment to be stocked in EMS Disaster Response trailers. (2004)

• Hospital Pediatric Equipment Inventories for Disaster Response. Created by the Florida Emergency Medical Services for Children (EMSC) project, this list is a compilation of key pediatric equipment and supplies hospitals should stock to ensure adequate emergency disaster response resources for children. (2004)

• K.I.D. (Kids in Disasters) Kit. A product of the Florida Emergency Medical Services for Children (EMSC) project, the Kit provides child- and family-centered materials addressing disaster triage, the Broselow-Luten principles of color-coding children, tools for responding to incidents involving agents of chemical warfare, and several other aspects of pediatric disaster planning and preparedness – with some materials also available in Spanish. (2007)

National Association of School Nurses (NASN)

• Preparing for School Emergencies. This position statement from the NASN outlines both the levels of care providers and the necessary equipment needed to provide emergency care to children in a school setting. (Accessed December 2008)

National EMSC Data Analysis Resource Center (NEDARC)

• Pediatric Equipment Data Collection Form for ALS Ambulances. Developed by NEDARC, this survey template was designed to assist EMSC State Partnership grantees in the gathering of data for performance measure 66b regarding the availability of essential pediatric equipment on BLS and ALS ambulances. The equipment list may be altered so that it reflects only those items of equipment that fall within their scope of practice and that they are authorized to use. (Accessed December 2008)

Armstrong Medical Industries Inc.

• Broselow_®/Hinkle Pediatric Resuscitation System. The Broselow_®/Hinkle System is a color-coded system designed to supply all the information and equipment needed to perform a pediatric emergency resuscitation. It includes the Broselow Pediatric Emergency Tape. This length-based resuscitation tape has a reference at each color bar on the tape to inform the healthcare provider of equipment sizes to perform emergency resuscitation on a child. A reference at each weight zone on the tape shows pre-calculated medication dosages. Designated resuscitation equipment is contained in corresponding, color-coded equipment pouches included in the following product. The most current Tape is Version 2007A, and complies with the Joint Commission of Healthcare Organizations (JCAHO) National Patient Safety Goal 3B.  (Accessed December 2008)

EXAMPLE PRACTICES

Illinois Emergency Medical Services for Children

• Pediatric Prehospital Equipment Recommendations. This document contains two lists that identify pediatric equipment items recommended for inclusion on basic or advanced life support ambulances. The equipment is classified as essential or desirable. (Accessed December 2008)

• Required Pediatric Equipment and Recommended Pediatric Kit. Developed by the Equipment, Transport and Treatment Guideline Committee of the Emergency Medical Services for Children Project, this document identifies the pediatric equipment required by Wisconsin legislation (Trans 309) for BLS and ALS ambulances, and lists the equipment and supplies to be included in a recommended pediatric response kit. The recommended pediatric kit is intended to supplement the required equipment. Prehospital emergency care providers are encouraged to carry pediatric equipment as a separate kit to provide organization and easy access. (Accessed December 2008)

• Recommended Guidelines for Physician Offices, Clinics, and Urgent Care Centers for Pediatric Emergency Preparedness. Children with life-threatening emergencies are commonly brought to physician offices, clinics, and urgent care centers for treatment. One 1996 study identified that 82 percent of pediatric practices experience at least one such emergency monthly. Effectively initiating treatment for pediatric emergencies requires early recognition, management skills, equipment, medications, and effective hospital transport. An Emergency Medical Services for Children subcommittee developed the following recommendations for equipment, medications, and training. To facilitate rapid selection of equipment, the subcommittee also developed a reference for pediatric equipment based on weight and age. (Accessed December 2008)

FAMILY AND CAREGIVER RESOURCES

Center for Anaphylactic Support

• EpiPen is a registered trademark for the most commonly used auto injector of epinephrine (adrenaline), used to treat anaphylactic shock. This device can save the life of a child who is having a severe allergic reaction. This web site provides a video on how to use it. (Access December 2008)

Emergency Medical Services for Children National Resource Center

• How to Prevent and Handle Childhood Emergencies: A Handbook for Parents and People Who Care for Children . This handbook can prepare you to help a child if an emergency does occur. It provides information about children of all ages, from newborns to teens. The publication includes a checklist of resources for families to keep on hand in the event of a medical emergency. (Accessed December 2008)