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NRC’s ToolBox is a collection of information and resources on
a specific topic currently of interest to the EMSC community.
If you would like a copy of a journal article(s) featured in the Toolbox, please contact the EMSC National Resource Center (NRC) resource specialist.
The resource specialist can assist you in locating the full text article. However, due to copyright issues, the NRC may not be able to provide an entire copy of an article featured in the Toolbox. Select portions or summaries may be available on a case-by-base basis.
This section features the latest information about the EMSC Federal Program and its state grantees and national partners. Information about independently funded products, meetings, and activities is also included.
Early EMS systems were designed to provide rapid intervention for sudden cardiac
arrest in adults and rapid transport for motor vehicle crash victims. The was limited
recognition that children required specialized care. Pediatricians and pediatric
surgeons, identifying poor outcomes among children receiving emergency medical care,
became advocates on behalf of their patients. They sought to obtain for children
the same positive results that EMS had achieved for adults.
In the late 1970s, Calvin Sia, M.D., president of the Hawaii Medical Association,
urged members of the American Academy of Pediatrics to develop multifaceted EMS
programs that would decrease illness and death in children. Dr. Sia worked with
US Senator Daniel Inouye (D-HI) and his staff assistant, Patrick DeLeon, Ph.D.,
to generate legislation for an initiative on pediatric emergency medical services
for children.
In 1984, Senators Orrin Hatch (R-UT) and Lowell Weicker (R-CT) joined Senator Inouye
in sponsoring the first EMSC legislation. C. Everett Koop, M.D., then Surgeon General
of the United States, strongly supported this measure, as did the American Academy
of Pediatrics.
The Emergency Medical Services for Children (EMSC) program was established with
the passage of the legislation in 1984. Two years later, Alabama, California, New
York, and Oregon became the first recipients of Federal grant money specifically
earmarked to improve pediatric emergency medical services.
Since then, grants have helped all 50 States, plus the District of Columbia, the
Commonwealth of the Northern Mariana Islands, American Samoa, US Virgin Islands,
Guam, and Puerto Rico.
In 1990, HRSA-MCHB funded the Institute of Medicine (IOM) to conduct a study of
pediatric emergency medical services. The IOM study report, which was released in
July 1993, details the nature, extent, and outcomes of pediatric illness and trauma
emergencies; describes the current state of pediatric emergency care; identifies
the data and standards needed for surveillance and evaluation of EMSC services;
and provides policy recommendations to promote the development of better systems
of care.
The vision for EMSC is a system that works perfectly for all children, everywhere,
but is needed less frequently as both illness and injury prevention reduce the number
of life-threatening emergencies.
Federal Authorizing Statute (codified as amended at 42 U.S.C. § 300w-9)
Institute of Medicine (IOM) Report: Future of Emergency Care: Emergency Care for Children – Growing Pains from 2006 (not a U.S. Government Web site)
Institute of Medicine (IOM) Report:
Emergency Medical Services for Children from 1993 (not a U.S. Government Web site)
EMSC Strategic Plan for FY 2008-FY 2010: Recommendations of the Partnership for Children Stakeholders Group
Since its establishment in 1984, the EMSC program has improved the availability
of child-appropriate equipment in ambulances and emergency departments. Through
grants to States and territories, it has supported hundreds of programs to prevent
injuries, and has provided thousands of hours of training to EMTs, paramedics and
other emergency medical care providers.
EMSC Program support has led to legislation mandating EMSC programs in several states,
and to educational materials covering every aspect of pediatric emergency care.
Most important, EMSC efforts are saving kids' lives.
Although EMSC has made great progress over the years, much remains to be done to
ensure children receive optimal medical care.
Taking Action – Saving Lives: Emergency
Medical Services for Children
IOM 10-Year Retrospective Report
EMSC grants fund States and U.S. Territories to improve existing emergency medical services (EMS) systems and to develop and evaluate improved procedures and protocols for treating children. The EMSC program is the only federal program that focuses specifically on improving the quality of children’s emergency care. All States, U.S. Territories, and the District of Columbia have received federal funding. Currently, only State governments and accredited schools of medicine are eligible to receive EMSC grants.
- Targeted Issue grants are intended to address specific needs or concerns that transcend state boundaries. Typically the projects result in a new product or resource or the demonstration of the effectiveness of a model system component or service of value to the nation. Funding for Targeted Issue grants are up to $200,000 per year. Project periods are for three years.
- Network Development Demonstration Project Cooperative Agreement demonstrates the value of an infrastructure or network designed to be the platform from which to conduct investigations on the efficacy of treatments, transport, and care responses including those preceding the arrival of children to hospital emergency departments. Creation of this infrastructure will help overcome present difficulties in assessing efficacy and quality of care and ensuring accountability in State EMSC programs that derive from the relatively small incidence rates of pediatric emergency events and the lack of a current mechanism to pool sites and treatment experiences. Once established, the infrastructure can also be utilized as a means to conduct observational and randomized studies on a variety of issues related to EMSC, including processes involved in transferring research results to treatment settings. Projects were approved for a 3-year period, with average yearly awards of $700,000 in total costs.
- Central Data Management Coordinating Center provides Pediatric Emergency Care Applied Research Network (PECARN) Regional NODES with data services including collection, management, guidelines for analysis and a central repository for PECARN generated data. Approximately $615,000 per fiscal year is available to support one CDMCC Cooperative Agreement.
- State Partnership grants solidify the integration of a pediatric focus within the state EMS system, the only eligible applicant is the State EMS agency, unless the State specifically requests and designates another State entity. States receive as much as $115,000 per year, for as many as three years.
The Partnership (PFC) Stakeholder Group was formed in 2003. The group is a collaborative of diverse organizations and EMSC Program grantees convened to improve the emergency medical care of children through the exchange of knowledge, development of partnerships, and provision of input and counsel to the EMSC Program. The PFC Stakeholder Group is composed of representatives from three U.S. Government agencies (the National Highway Traffic Safety Administration’s Office of Emergency Medical Services, the Indian Health Service, and the Agency for Healthcare Research and Quality), six EMSC grantees, and the following 22 national organizations:
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