Pediatric Protocols and Guidelines
Protocols and guidelines for providing emergency care to children are especially important to prehospital and hospital clinicians who treat children infrequently yet need to keep their knowledge and skills up to date. Massachusetts EMSC aims to have in place statewide standards of care at every level of the EMS system so that all practitioners will be able to respond appropriately when caring for an injured or very sick child.
Effective March 1 2010, certain MA EMS Statewide Treatment Protocols include pre-hospital treatment for adrenal insufficiency/adrenal crisis. Paramedic ambulances in the state must stock either Solu-Cortef or Solu-Medrol. Massachusetts is only the second state in the nation to fully implement these standards.
Prehospital Protocols
Section 5 of the Massachusetts statewide treatment protocols covers protocols for pediatric emergencies. Each protocol includes instructions for Basic Level EMTs, Intermediate EMTs and Paramedics. These protocols are developed under the auspices of the Office of Emergency Medical Services (OEMS) at the Department of Public Health.
Guidelines for EMTs and Paramedics: Transport Safety
The Emergency Medical Services for Children (EMSC) Project supports efforts to improve the safety of children being transported in ambulances. Through an EMSC grant, the Division of Pediatric Emergency Medicine at Johns Hopkins Children's Center is working to fill critical knowledge gaps and to develop standards for pediatric EMS transport safety. In the meantime, here are some guidelines that may help you make sure that your ambulance is a safe place for children.
Guidelines for Hospital Emergency Departments
In May 2000, the EMSC Pediatric Resource Group completed guidelines for hospitals that provide care to children in their emergency departments. These guidelines include staff education and training; equipment; policies and competencies; and quality improvement. They are designed to enable every acute care hospital to stabilize and appropriately triage a sick or injured child. The Pediatric Resource Group was composed of emergency department physicians, nurses, and paramedics from pediatric tertiary care centers and community hospitals.
Emergency Readiness Guidelines
Children cannot fend for themselves in an emergency. They are not able to exercise judgment as to when an emergency has occurred, and they must rely on the adults who are responsible for them wherever they may be. They might be in school or child care; they might be playing sports or on an excursion; they might be at home, with relatives, at their pediatrician's office. As one of its primary objectives, Emergency Medical Services for Children (EMSC) has developed guidelines on emergency readiness for primary care physician offices, schools, and families.
Office Readiness for Primary Care Physicians
Emergencies can happen in any physician's practice where children are seen. Although they do not happen frequently, pediatricians and family practice physicians, as well as their staff, need to be prepared to handle them when they do occur. EMSC has produced a manual for primary care providers, Office Preparedness for Pediatric Emergencies, which includes a self-assessment tool, a list of emergency care equipment, and a number of protocols for the most common office emergencies. For a copy of this document, contact the EMSC Project Director at (617) 624-5088.
School Emergency Readiness
EMSC facilitated the development of guidelines to assist schools in preparing for emergencies. Entitled Developing An Emergency Response Plan For Your School, these guidelines were developed by a statewide group of school nurses and paramedics. They include suggestions for developing an emergency response team in the school, suggestions for equipment and supplies to stock, and guidelines for training staff and students in bystander response. For more information, contact the EMSC Project Director at (617) 624-5088.
Emergency Readiness for Parents
Parents and other family members are often the first adults who must deal with a child's emergency, particularly in the case of illness. Thinking about possible emergencies ahead of time and planning what to do in advance is the best guarantee of getting a child the most appropriate care if an emergency does occur. With this in mind, the EMSC Project has adapted guidelines from the Federal Emergency Management Agency (FEMA), , to assist parents in recognizing and responding to a child's emergency.
This information is provided by the Injury Prevention and Control Program within the Department of Public Health.