Healthy People 2010 - With Annotations

Clinical Preventive Care

1-14. Increase the number of States and the District of Columbia that have implemented guidelines for prehospital and hospital pediatric care.

1-14a. Increase the number of States and the District of Columbia that have implemented statewide pediatric protocols for online medical direction.

Target: All States and the District of Columbia.

Baseline: 18 States had implemented statewide pediatric protocols for online medical direction in 1997.

Target setting method: Total coverage.

Data source: Emergency Medical Services for Children Annual Grantees Survey, HRSA.

Emergency medical service systems try to bring essential prehospital medical treatment to patients as quickly as possible. Emergency care of children presents a particular challenge since prehospital providers often treat fewer children and have limited pediatric experience and assessment skills. It can be more difficult to assess the severity of illness or injury since characteristic changes in vital signs that signal deterioration in adults may not occur in children. Important anatomic, physiologic, and developmental differences exist between children and adults that affect their responses to medical care and their risk of injury and illness.(70) Most EMS systems operate independently of hospitals or other facilities and typically have few physicians to ensure appropriateness of care.

Experienced providers can offer medical direction in two ways, either online or offline. Online direction involves direct communication (for example, voice) between EMS medical directors (for example, at hospitals) and emergency medical technicians (EMTs) and paramedics to authorize and guide the care of patients at the scene and during transport. Offline medical direction includes the development of guidelines, protocols, procedures, and policies, as well as planning for, training in, and evaluation of their use.

1-14b. Increase the number of States and the District of Columbia that have adopted and disseminated pediatric guidelines that categorize acute care facilities with the equipment, drugs, trained personnel, and other resources necessary to provide varying levels of pediatric emergency and critical care.

Target: All States and the District of Columbia.

Baseline: 11 States had adopted and disseminated pediatric guidelines that categorize acute care facilities with the equipment, drugs, trained personnel, and other resources necessary to provide varying levels of pediatric emergency and critical care in 1997.

Target setting method: Total coverage.

Data source: Emergency Medical Services for Children Annual Grantees Survey, HRSA.

Emergency care for life-threatening pediatric illness and injury requires specialized resources, medical direction, equipment, drugs, trained personnel, and properly staffed and equipped hospitals.(70) Children, however, receive emergency care in a variety of settings --from rural community hospitals to large urban medical centers. Hospitals vary in terms of their readiness to treat children’s emergencies. If the hospitals are properly equipped and staffed, children frequently can receive the care that they need at local hospitals, but some children require the advanced care available only at regional specialty centers. Categorization is essentially an effort to identify the readiness and capability of a hospital and its staff to provide optimal emergency care.(71) Compliance can be voluntary or assigned by official agencies.

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Rev. 20-Aug-2001 at 07:24 hours.