Gfeller Attends Concussion Summit at White House

My wife, Lisa, and I were invited to attend President Obama’s Healthy Kids & Safe Sports Concussion Summit at the White House today, May 29. We were invited for several reasons, including our passion, advocacy and commitment to making sports safer for all children. We lost our younger son, Matthew, after he sustained a traumatic brain injury during a high school football game in 2008.

We were honored to be included in the Concussion Summit and hope the President’s support will raise awareness about sports-related brain injuries and save the lives of injured children across the U.S. Critical injury to children is a deeply personal issue for us, and I recently made the difficult decision to leave the corporate world to become the executive director of the Childress Institute for Pediatric Trauma.

I thought I would take this opportunity to introduce myself and explain one of the Institute's projects as it relates to the President's Concussion Summit today. As you may know, the Childress Institute was founded in 2008 through the generosity of NASCAR team owner Richard Childress and his wife Judy. The Institute helps fund research and medical education to improve the treatment for critically injured children in the U.S., including an ongoing study to measure head impacts in youth football. Recently published results from that study found that in high school players a single season of football can produce brain MRI changes in the absence of a diagnosed concussion. The researchers demonstrated that these impact-related changes in the brain have a strong association with a post-season change in cognitive function.

More than 70 percent of the football players in the United States are under age 14, so more research is needed to study the effect of repeated blows to the head in young players. Many great organizations are working to prevent injuries, yet not all accidents can be prevented and traumatic injuries continue to account for more childhood deaths than all other causes combined.  

The Childress Institute hopes further results will allow equipment designers, researchers, and clinicians to prevent, mitigate, identify and treat injuries to help make football a safer activity for millions of children. Discoveries made from research like the one referenced above will help save the lives of injured children, and we are proud to be a part of this process.

Matthew’s legacy lives on in many ways and you can view more of our story here. On and off the football field, Matthew was frequently heard saying “I won’t let you down.” By honoring Matthew’s memory, we hope we are keeping his promise.

- Robert J. “Bob” Gfeller, Jr., executive director of the Childress Institute for Pediatric Trauma 

EMS Week - May 18-24

Each year, the federal Emergency Medical Services for Children (EMSC) Program partners with the American College of Emergency Physicians (ACEP) to celebrate Emergency Medical Services (EMS) Week. The Wednesday within the week-long celebration is designated as EMS for Children Day or EMSC Day. This year marks EMSC’s 30th anniversary and we are excited about our theme this year: “Then, Now, Imagine…Honoring the Past, Experiencing the Present, Visualizing the Future.” 

This year National EMS Week is May 18-24 and EMS for Children Day will be held May 21. It features hundreds of grassroots activities coast-to-coast. On Wednesday, local communities and medical personnel are encouraged to focus their EMS Week activities on raising public awareness about the need for specialized emergency care for children. 

For the last three decades, the Emergency Medical Services for Children Program has successfully raised awareness among healthcare professionals, EMS and emergency and trauma system planners, and the general public that children respond differently than adults – physically, emotionally, and psychologically – to illness or injury.

The EMSC Program’s initial efforts primarily focused on addressing easily identified gaps in the quality of pediatric care in both the pre-hospital and acute care setting. In the 1980s and 90s, work centered on pediatric EMS train­ing, establishing pediatric specific equipment lists, and the development of pediatric care guidelines. In 2001, the Program funded a pivotal grant to support the infrastructure for the Pediatric Emer­gency Care Applied Research Network (PECARN). PECARN for the first time, made it possible for large, multi-institutional studies to take place leading to the development of evidence based pediatric protocols.   Since 2006, the Program has focused on national performance measures, a set of goals for each state to work towards to assure more consistency in the emergency and trauma care of children across the nation.

Looking toward the future, EMSC aims to ensure all emergency departments (EDs) are ready to care for children through the implementation of the National Pediatric Readi­ness Project (Peds Ready), a national quality improvement initiative. A heightened focus is also being placed on pediatric regionalized systems of care and pre-hospital pediatric emergency care research.

The EMSC Program’s partners are extensive and extremely critical to the program. EMS week is a very special time for u because the program's goal is to address the entire continuum of emergency care, from the pre-hospital care given by EMS providers to pediatric critical care in the hospital setting to pediatric rehabilitation, as well as injury prevention. Having great partners like ACEP, AAP, ACS, NAEMT, NAEMSO, ENA, and STN helps us address pediatric emergency care where ever it may be taking place.

We have celebrated EMS for Children Day for the last 12 years realizing the important role that EMS providers play in the care of injured children. This is a perfect opportunity for states, the general public and other organizations to say thank you to those who reach our children first when injury occurs.

To honor EMSC’s achievements and learn more about EMSC Day, please visit http://emscnrc.org/Events/EMSC_Day.aspx. There are celebration and appreciation ideas for EMS and health care professionals, as well as fact sheets for the general public. There is also artwork for sharing on social media and some child activity sheets. Supporters can share a proclamation with governors and regional legislature to proclaim EMS Week.

-       Diana Fendya, Trauma Acute Care Specialist at the Emergency Medical Services for Children National Resource Center

Pediatric Trauma Society

The Pediatric Trauma Society (PTSA) started with a group of surgeons and nurses dedicated to pediatrics sitting around a few years ago saying to each other, "We keep talking about the need to create a group dedicated to injured children. We keep telling the same people, and it doesn't seem like the people who are supposed to be listening are listening, and wouldn't it be great if …?" Then, one of my surgical colleagues from Boston, David Mooney, said, “We're going to make this happen."

He marshaled together a group of people, found some support, found a little bit of money, and said, "We're going to do it this time. We're really going to incorporate ourselves, and we're going to become the Pediatric Trauma Society."

We started with a relatively small group of people and it grew pretty quickly. We now have about 500 members who actually pay dues, which is pretty impressive. We started actively organizing in 2011 and formally incorporated in 2012.

What's important about the Pediatric Trauma Society is that pediatric trauma is not only the number one killer of kids, but trauma in children is different than trauma in adults and it needs further development and discussion. It involves a large number of professionals over a broad spectrum of care. In order to prevent kids from getting injured, to treat the kids who are injured better, and to make sure that their long-term outcomes are as good as possible, all those people need to be talking to each other.

We have found that prior to the formation of the Pediatric Trauma Society, there were a lot of really interested people, but we tended to talk to ourselves. The trauma surgeons would talk to trauma surgeons, and the emergency medicine people would talk to each other, the critical care people would talk to each other, and the rehab people would talk to their group, and so on. None of those people were really talking to people outside their specialty about working together and improving as a whole team. What we ultimately envision is an organization and a forum where cross-specialty discussion can occur, so that we can get out of our individual comfort zones and really talk about a problem that is beyond our own individual areas of expertise.

The Childress Summit of the PTS was held a year ago, in April 2013. It was an amazing feeling to get all those people, who are representatives of all those different groups, in the same place. We realized we really are talking about the same problem, but just coming at it from different perspectives. It was cool to be able to share ideas, share frustrations, share the goals for the future, and then try to make this into a platform for improvement and best practices. It really felt like we defined a new field of medicine and that we are embarking on something new.

It's not that people haven't been interested in pediatric injury before, but it's the fact that we've broadened it out and said, "This is the full scope of pediatric injury and trauma is the problem.” We need to go about solving this problem from a lot of different directions, and wouldn't it be great if all these people talk to each other regularly? We are creating a broader network of colleagues that treat injured children around the United States.

Our website is www.PediatricTraumaSociety.com. It has information for members and nonmembers about issues of interest in pediatric trauma. With support from the Childress Institute for Pediatric Trauma in 2013, we were able to put together our first summit on pediatric trauma and that was really exciting.

Our first annual meeting of the Pediatric Trauma Society will be November 14 and 15, 2014, at the Renaissance Blackstone in Chicago. Our goal is for the annual meeting to be a forum where members can present their best research work. Our members are interested in the whole spectrum of pediatric trauma teams, including doctors and nurses, social workers, emergency medicine practitioners, and surgeons.

We are very interested in people submitting their work. The abstract submission process is open, so we invite everyone to submit their best work for presentation. We also plan to have sessions with invited panelists, and time to review the guidelines we’ve been developing. We encourage networking between members to discuss similar issues and concerns, and how are we going to advance the field.

The core of our mission is to improve the care of injured children. We want to do that through the spectrum of care. We are very interested in supporting research in pediatric trauma and providing a place for that research to be presented and disseminated.

We are also interested in presenting best practices, so that in doing the groundwork to figure out what those best practices are, validate those best practices, and then disseminate them. Using venues such as the national meetings, our website, and electronic media, we're hopeful that the information will reach everyone who takes care of injured children and help them find the best way to take care of those children.

- Dr.Barbara Gaines, President of the Pediatric Trauma Society, Associate Professor of Surgery at the University of Pittsburgh, and the Director of Trauma and Injury Prevention at the Children's Hospital of Pittsburgh at UPMC

Kids and Cars: Automotive Injuries

As a parent, I know the worries about keeping a child safe. From their first trip home from the hospital to the simple act of crossing the street, to be a parent is to worry. Did I buy the right car seat? Are they looking both ways? And some day, will I make clear the responsibilities that come with the privilege of driving?

At the National Highway Traffic Safety Administration, we work to help parents keep their kids safe across every stage of a child’s development: from the infant and the toddler all the way up to the teenager just learning to drive. We want them to have the tools and knowledge they need to stay safe and hope they will never, ever, have to see the inside of a trauma center.

Yet we lose nearly 10,000 children each year due to traumatic injury, a large percentage of whom suffered due to motor vehicle crashes.

In 2012, roughly one-in-ten people killed in traffic fatalities were under the age of 18. That year alone, we lost 2,980 children and young people to injuries in traffic crashes that were completely preventable.

That is why we are doing more at NHTSA to keep our kids safe from harm.

We’ve been working hard to better protect a vehicle’s most vulnerable occupants—infants and toddlers—by improving standards for child seats. NHTSA is taking a significant step forward in the protection of children by proposing upgrades to the federal motor vehicle safety standard for child restraint systems.

The proposed upgrades would include the first ever side impact crash test for car seats sold in the U.S. that are designed for children weighing up to 40 pounds. The tests would use both an existing 12-month-old child crash test dummy, and a newly-developed side impact dummy representing a 3-year-old.

Parents, guardians and care providers can search for current vehicle and child seat safety recalls and find where they can get help installing child car seats at Safercar.gov and through our Safercar app, which is available for iPhone and for Android devices.

On the other end of the child development spectrum, NHTSA is working to help families discuss safety with their young driver through our 5 to Drive campaign.

5 to Drive is about getting parents and guardians to engage in an ongoing discussion with teens about safe driving. And it needs to happen right now because we’re losing too many young people in crashes that are 100 percent preventable.

•          Motor vehicle crashes are the number one killer of 14- to 18-year-olds

•          In 2011, more than 2,300 people were killed in crashes involving a teen (14 to 18) driver

•          Nearly 60 percent of those killed were teen drivers and teen passengers

Despite the dangers to our young people, a recent survey reported that only 25 percent of parents had a driving safety discussion with their young driver. If we’re to save lives, that discussion has to start today with the help of 5 to Drive.

I appreciate the hard work of the women and men of the Childress Institute, your advocacy on behalf of the health and safety of young people, and for the opportunity to discuss these issues and advances in automotive safety. Together, as partners in protecting children, Childress and NHTSA can help to save lives, and to ensure that all children have the opportunity to grow up healthy and happy, and to fulfill their enormous potential.

by David Friedman, Acting Administrator, NHTSA