Pediatric Emergency Care: A Decade of Advancements
Emergency care for children in the United States is the best in the world.
No one is more qualified to care for children in a medical emergency than emergency physicians. They receive comprehensive training in treating childhood emergencies and have more training in pediatric emergencies than other physicians, including pediatricians.
Many emergency physicians devote their careers to pediatric research, training and development of clinical standards. Others educate the public about injury prevention and the warning signs of medical emergencies.
After emergency medicine was officially recognized as a specialty in 1979, the American College of Emergency Physicians (ACEP) was one of the first organizations to develop pediatric guidelines for emergency departments and ambulances. ACEP has partnered with the American Academy of Pediatrics (AAP), the American College of Surgeons, the Emergency Nurses Association and federal agencies (such as Emergency Medical Services for Children) to improve pediatric emergency care in the United States and around the world.
Emergency physicians are trained for pediatric emergencies as part of their medical residency training.
They also continue to develop new treatment techniques and advocate for the widespread availability of specialized pediatric equipment in all emergency departments. ACEP has advanced pediatric emergency care in numerous areas, including trauma, pain management, drug dosing, poison control, procedural sedation, mental health, disaster preparedness and pre¬hospital (or EMS) care. ACEP is a leading publisher of pediatric emergency medicine textbooks and the main sponsor of The Advanced Pediatric Scientific Assembly, the most prestigious gathering of pediatric emergency care providers in the world.
Emergency physicians have led the way to continuously improve the medical care children receive in emergency departments. Today, children are less likely to be admitted to the hospital, in part because of advances in ultrasound imaging. Emergency physicians can now safely send home most babies with fever who are more than one month old, provided they meet certain criteria.
Children with broken bones who once might have required deep sedation and surgical intervention now can be mildly sedated, treated painlessly and released much more quickly than before. Safe reductions in imaging and alternatives to intravenous lines are other ways that emergency care for children has improved in recent years.
|1980s||An emergency physician invents a color¬coded system that bases medication dosages on the child’s weight. The BroselowTM Pediatric Emergency Tape helps prevent medical errors and has been an industry standard in pediatric emergency care.|
|1992||ACEP establishes clinical standards on “The Use of Pediatric Sedation and Analgesia,” an award¬winning paper that emphasizes the importance of managing pain and fear in children who are emergency patients.
ACEP establishes the “Evaluation and Treatment of Minors: Reference on Consent” policy. It addresses the role of adult consent when minors receive medical treatment. ACEP actively educates the public about the need for parents to provide a consent¬to¬treat form to caregivers such as babysitters, relatives, teachers and school nurses.
|1993||ACEP sets standards for emergency care of children in the nation’s emergency departments through its report “Preparedness of the Emergency Department for the Care of Children.” Aspects of this report are later incorporated into a joint
policy statement with AAP in 2001.
|1998||ACEP and AAP publish the “Emergency Information Form for Children with Special Health Care Needs.”
ACEP adopts a clinical policy for “Procedural Sedation and Analgesia in the Emergency Department.” The management of pain in children has been a significant advancement in their care.
|2000||ACEP and the American College of Surgeons establish a joint policy on “Equipment for Ambulances” that details the supplies and equipment needed to care for patients of all ages.
ACEP establishes a policy on the “Immunization of Pediatric Patients,” which advocates for using emergency departments to immunize children.
|2002||AACEP and AAP jointly publish a policy on the “Death of a Child in the Emergency Department,” establishing principles for handling one of the most emotional and tragic times – the loss of a child.
|2006||ACEP and AAP publish the joint policy statement “Pediatric Mental Health Emergencies in the Emergency Medical Services System.”
|2008||ACEP publishes “Clinical Policy: Critical Issues in the Sedation of Pediatric Patients in the Emergency Department.” This policy was developed by a multidisciplinary panel, including the Emergency Medical Services for Children Program.
ACEP publishes “The Guidelines for Preparedness for Emergency Care for Children,” which was developed in collaboration with AAP, the Emergency Nurses Association and Emergency Medical Services for Children, a program run by the United States Department of Health & Human Services. The guidelines are a compilation of best practices, first response and triage guidelines and benchmarking data for improving emergency department wait times and flow for children.
|2010||ACEP and AAP jointly publish policy statements on emergency preparedness for children with special health care needs. ACEP makes available for free the Emergency Information Form for children with special health care needs.
|2011||ACEP begins work on the National Pediatric Readiness Project alongside partners Emergency Medical Services for Children, AAP and the Emergency Nurses Association.
|2012||Emergency physicians invent a web and iPhone application to provide a real-time, bedside medication dosing safety system to help prevent medication errors.
|2015||Results of National Pediatric Readiness Project are published and now show that more than 90% of emergency departments have all the necessary equipment to effectively treat children.|