September 2022

Pediatric Champions

September is Pain Awareness Month!

For acutely ill and injured children, pain has short-term consequences (pain and distress for the child, caregivers, and providers; prolonged procedure time; slower healing) and long-term consequences (increased sensitivity to pain; avoidance of health care settings; anxiety and stress).

To help providers in emergency settings assess and manage pain in children, the Emergency Medical Services for Children Innovation and Improvement Center, has released a new Pediatric Education and Advocacy Kit (PEAK) on pain.

PEAK: Pain includes bottom-line recommendations on both pain treatment and procedural pain; a five-part podcast series; how-to videos; and more! All resources are free and open access. View the resources.

2022 Alaska EMS Survey Results

To better understand the EMS system’s ability to care for pediatric patients, the EMS for Children Program conducts a national survey of EMS agencies, every January - March. The following are the 2022 Alaska results of this quality improvement effort.

Pediatric Emergency Care Coordination

The Alaska EMS performance measure survey data showed that 41.1% of the Alaska, State Licensed/ 911-responding agencies reported that they have a designated Pediatric Emergency Care Coordinator. On initial and renewal applications for State EMS Agency Licensing, it is strongly recommended that EMS agency administrators designate a PECC.

A study of the readiness of hospital emergency departments (EDs) to care for children has shown that EDs are more prepared to care for children when there is a Pediatric Emergency Care Coordinator (PECC) who is responsible for championing & making recommendations for policies, training, & resources pertinent to the emergency care of children.¹

While this study was conducted in EDs, the 2020 joint policy statement,² Pediatric Readiness in EMS Systems,  states the importance of EMS physicians, administrators, & personnel to collaborate with pediatric acute care experts to optimize EMS care for children to improve outcomes. In further support of the importance of EMS agency PECCs, a recent study “found that the availability of a PECC in an agency is associated with increased frequency of pediatric psychomotor skills evaluations.”³

The Pediatric Emergency Care Coordinator (PECC) is a member of the EMS agency and is familiar with the day-to-day operations and needs at the agency.

Designated individuals who coordinate pediatric activities for a region can serve as the PECC for one or more individual EMS agencies within that region or community.

This individual need not be dedicated solely to this role and could be personnel already in place with a special interest in children who assumes this role as part of their existing duties.

Top Five (5) PECC Duties Reported:

Use of Pediatric-Specific Equipment

The processes & frequency of skill-checking evaluations for EMS providers has long been established as important for the maintenance of skills when treating patients for improved patient outcomes.^4-6 Miller's Model of Clinical Competence provides a framework for clinical evaluation that theorizes that competency for clinical skills can be demonstrated for EMS through a combination of skill stations, case scenarios & simulations, & real-life field observations with a frequency of at least twice a year.

The Alaska EMS performance measure survey data showed that 33.9% of the Alaska, State Licensed/ 911-responding agencies scored a 6 or higher when asked about their agencies pediatric processes & frequency of skill-checking evaluations for their providers. Click here and go to page 35 to see how the skill-checking points were calculated.

Use of Pediatric-Specific Equipment Matrix:

Let's Get PedsReady!

Check out the Prehospital Pediatric Readiness Checklist & Toolkit and get PedsReady!

The two-page checklist is based on the 2020 joint policy statement, “Pediatric Readiness in Emergency Medical Services Systems,” of the American Academy of Pediatrics, American College of Emergency Physicians, Emergency Nurses Association, National Association of Emergency Medical Services Physicians, and National Association of Emergency Medical Technicians. 

The toolkit provides more than 80 resources to help agencies address gaps in pediatric readiness and has been curated by a comprehensive team of stakeholders. The resources align with the checklist and the joint policy statement.

Attention EMS Agency Administrators and PECCs, this is an annual EMSC survey  and participation is important. Please make sure to keep your contact information updated within the Alaska EMS License Management System. Next survey will be January - March 2023. Thank you! 

National Pediatric Readiness Project

The National Pediatric Readiness Project is a multi-phase quality improvement initiative to ensure that all EMS agencies and emergency departments have the right equipment, supplies, medications and training to provide high-quality emergency care for children. Every Child. Every Day. Pediatric Readiness is addressing system-level issues—policies, protocol and agreements, and not penalizing individual people or teams—that truly reduces morbidity and mortality for ill and injured children.

The 2021 National Pediatric Readiness Project assessment included questions for hospital EDs around: infrastructure, administration and coordination of care for children, personnel, pediatric-specific policies, equipment, and resources.

After hospitals submitted their responses online they immediately received: 

A pediatric readiness score for their ED (range from 0 – 100)

The average pediatric readiness score of EDs of similar pediatric volume

The average pediatric readiness score of all participating ED’s to use as a benchmark

A Gap Report specific to their ED to target efforts for pediatric readiness improvement.

The dynamic nature of quality improvement for EDs on a local and national level requires the involvement of hospital leadership, healthcare administrators, and ED personnel who demonstrate commitment to their communities by improving pediatric readiness.

2021 Alaska Assessment Results

The 2021 Assessment period resulted in 21 of 23 Alaskan hospitals participating (91%). Alaska received a pediatric readiness score of 66. The assessment data showed the following opportunities exist (but not limited to) in Alaska hospitals for improving pediatric readiness: Supporting the pediatric emergency care coordination in EDs by designating a Pediatric Emergency Care Coordinator. Ensuring hospital disaster preparedness policies and plans include the needs of children.

Improve Pediatric Disaster Preparedness

In disaster planning and preparation, children present a particular challenge. The physiological, psychosocial, and emotional needs of children are unique and complex, and they are often heightened when disasters strike (National Commission on Children and Disasters, 2010). Unfortunately, children are frequently involved when a disaster occurs. It is essential that hospital disaster policies include and plan for these distinctively vulnerable patients.

Essential Pediatric Domains and Considerations for Hospital’s Disaster Policies

This checklist is an update to the original 2014 checklist and seeks to expand its utility. It is intended as a tool to help hospital administrators and leadership incorporate essential pediatric considerations into existing hospital disaster policies.

CALL TO ACTION!

This is a CALL TO ACTION for everyone to be involved in helping to improve quality of care for ill or injured children in an emergency.

Explore the ED Toolkit and Checklist to get PedsReady!

Pediatric Facility Recognition

An Alaska EMSC program that recognizes hospitals that are prepared with the appropriate pediatric equipment, supplies, medications, protocols, training, and processes they are better able to provide children who are acutely ill or injured with the best quality emergency care. If your facility is interested in improving your pediatric readiness and would like to make steps towards a pediatric facility recognition please contact Alaska EMSC now!

Congratulations to the recently recognized/ renewed Alaska  Pediatric Emergency Care Facilities!

Providence Alaska Medical Center, Sept. 2021
Fairbanks Memorial Hospital, Nov. 2021

1. Gausche-Hill, M., Ely, M., Schmuhl, P., Telford, R., Remick, K. E., Edgerton, E. A., & Olson, L. M. (2015). A National Assessment of Pediatric Readiness of Emergency Departments. JAMA Pediatrics, 169(6), 527–534.
2. Moore, B., Shah, M. I., Owusu-Ansah, S., Gross, T., Brown, K., Gausche-Hill, M., Remick, K., Adelgais, K., Lyng, J., Rappaport, L., & Snow, S. (2020). Pediatric Readiness in Emergency Medical Services Systems. Prehospital Emergency Care, 24(2), 175-179.
3. Hewes, H. A., Ely, M., Richards, R., Shah, M. I., Busch, S., Pilkey, D., Dixon Hert, K., & Olson, L. M. (2018). Ready for Children: Assessing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Seƫng. Prehospital Emergency Care, DOI: p10.1080/10903127.2018.1542472
4. Lammers, R. L., Byrwa, M. J., Fales, W. D., & Hale, R. A. (2009). Simulation-based Assessment of Paramedic Resuscitation Skills. Prehospital Emergency Care, 13(3), 345–356.
5. Su, E., Schmidt, T. A., Mann, N. C., & Zechnich, A. D. (2000). A Randomized Controlled Trial to Assess Decay in Acquired Knowledge Among Paramedics Completing a Pediatric Resuscitation Course. Academic Emergency Medicine, 7(7), 779-786.
6. Miller GE. The Assessment of Clinical Skills/Competence/Performance. Acad Med 1990;65:S63-67.
7. National EMS for Children Data Analysis Resource Center (NEDARC). EMS for Children Performance Measures: Implementation Manual for State Partnership Grantees. Salt Lake City, UT: NEDARC; 2017.

The Alaska Emergency Medical Services for Children Program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award (H3MC06688) with 0 percent financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.