Are we prepared for injured kids?

How many of you are parents, aunts, uncles or grandparents with children around you?

We all know that illnesses and injuries are going to happen even with the best prevention and care. The CDC reports that North Carolina has higher than average death rates for injured children. Patient-related injury accounts for the highest death rate among children birth to 19 years old in North Carolina. Currently, there are only 124 pediatric intensive care beds in the state to care for those children and very few of them are vendor specialized pediatric intensive care beds. Therefore, there are very few special care beds for children in the state with dedicated physicians and nurses to take care of those patients. 

To help explain the issue from the medical professional’s perspective, we wanted to share a few numbers and ask some questions.

• What percentage of EMS calls involve kids?  5%
• What percentage of medical education time is typically devoted to trauma for children? LESS THAN 5%

The critically-injured pediatric patient produces more anxiety in caregivers because there is a lack of preparedness. We have found that when medical personnel are properly trained, children’s lives are saved. Unfortunately, budget cuts and financial restrictions result in many hospitals, EMS agencies and medical caregivers focusing on general training for continuing education instead of specialized courses for treating critically injured children.

• How comfortable would you feel caring for a child in an emergency?

The bottom line is that we all feel unprepared to care for injured kids because we don't care for them that often. When an emergency occurs, there is no time to travel long distances for care. We have to trust that the people caring for our children are prepared and know the best way to save and care for them, but more can be done to help support and prepare these first responders and emergency care providers. That is why we deliver evidence-based care for providers at all levels – from EMTs to nurses and physicians.

• How many of you watch reality TV?
• How many of you have been on a plane before? 

Simulation is reality-based learning – training in situations that are very close to reality. The aviation industry has used simulation technology for years by using flight simulation for pilot’s initial and ongoing training.  Experience shows you will react the way you are trained.

Simulators make learning fun and interactive. In recent years technology has allowed us to take advanced patient simulation into the classroom. Now we can go to the smaller hospitals, the EMS agencies, or the classroom and take this simulation technology to the student, instead of making them come to a simulation center.

Using advanced simulators in the classroom definitely benefits the student – whether that student is a paramedic, nurse or doctor – by giving them the chance to practice caring for a child and performing life-saving skills before they have to do it on a real patient. The pediatric trauma course supports critical thinking skills and gives access to the different equipment a medical professional might use when caring for a patient, whether it’s a ventilator or the different medications used.

We work hard behind the scenes to make sure your child receives the right care at the right time and gets to the right place for treatment. We hope you will learn more and share how we can all improve care for all injured children in the U.S.

- Dr. Dennis Taylor is an acute care nurse practitioner that works at a Level I trauma center in North Carolina, and has been a paramedic for over 30 years

- Gail Kluttz has been a nurse for 24 years and is the regional trauma systems nurse coordinator at a Level I Trauma Center in North Carolina

- Dale Hill works as the regional trauma outreach coordinator at a Level I trauma center in North Carolina and has been a Paramedic for more than 25 years, working in the pre-hospital, hospital and academic settings

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