Pediatric Readiness in the Emergency Department

Abstract

Note: This is a revision of the previous joint policy statement titled "Guidelines for Care of Children in the Emergency Department." Children have unique physical and psychosocial needs that are heightened in the setting of serious or life-threatening emergencies. The majority of ill and injured children are brought to community hospital emergency departments (EDs) by virtue of proximity. It is, therefore, imperative that all EDs have the appropriate resources (medications, equipment, policies, and education) and capable staff to provide effective emergency care for children. This policy statement outlines resources necessary for EDs to stand ready to care for children of all ages. These recommendations are consistent with the recommendations of the Institute of Medicine (now called the National Academy of Medicine) in its report "The Future of Emergency Care in the United States Health System." Although resources within emergency and trauma care systems vary locally, regionally, and nationally, it is essential that ED staff, administrators, and medical directors seek to meet or exceed these recommendations to ensure high-quality emergency care is available for all children. These updated recommendations are intended to serve as a resource for clinical and administrative leadership of EDs as they strive to improve their readiness for children of all ages. BACKGROUNDThe National Hospital Ambulatory Medical Care Survey reported that in 2014 there were approximately 5,000 EDs in the United States. Of the more than 141

Frequent emergency department use in the paediatric population: A systematic literature review

“…The American Academy of Paediatrics recently updated recommendations stressing the importance of ensuring that all EDs meet or exceed recommended appropriate resources for the care of children to include properly educated and capable staff 68 . Each ED setting should have an identified paediatric emergency care coordinator (PECC) that can be either a physician or nurse who promotes adequate infant and child emergency care and resuscitation skills for the rest of the healthcare providers and staff such as physician assistants (PAs), and advanced practice nurses (APRNs).…”

Incentives and barriers to pursuing pediatric emergency medicine fellowship: A cross‐sectional survey of emergency residents

“…Economically, it is infeasible for these EDs to employ a pediatrician or a pediatric emergency physician, as the pediatric volume alone is insufficient to support a physician who can only take care of children. Emergency‐trained pediatric emergency physicians are able to lead pediatric readiness efforts, research, quality improvement, and continuing educational programs in general and community EDs while working without clinical limitations based on patient age 14‐16 …”

Evaluation of the 2020 Pediatric Emergency Physician Workforce in the US

“… 3 However, most of these patients are seen not in specialty (stand-alone) children’s hospitals but in general EDs with variable pediatric capabilities 4 and limited pediatric readiness. 5 , 6 , 7 , 8 , 9 Most emergent care for pediatric patients in the US is also provided by emergency physicians (EPs) without specialized training in pediatric emergency medicine (EM). 10 , 11 Although the emergent care of pediatric patients is well within the scope of practice for physicians with training and board certification in general EM, children and adolescents have different clinical needs (compared with adults) and some EPs have decreased comfort caring for this population.…”