A newly released national statement is raising the bar for how emergency departments prepare to care for children — a shift experts say could prevent thousands of pediatric deaths each year.
The joint statement, “Pediatric Readiness in the Emergency Department,” updates earlier recommendations issued in 2009 and 2018 and outlines the essential staffing, equipment, training and systems EDs need to effectively care for pediatric patients. The guidance was developed by professional organizations representing emergency physicians, nurses, pediatricians and trauma surgeons.
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According to the National Pediatric Readiness Project (NPRP), widespread adoption of the updated recommendations could save more than 2,100 children’s lives annually.
Why pediatric readiness matters for EMS and EDs
More than 80% of children who present to emergency departments are treated at general community hospitals rather than dedicated children’s hospitals, according to NPRP leaders. That reality places added importance on ensuring every ED — regardless of size or pediatric volume — is prepared to manage critically ill and injured children.
Research cited in the statement shows that children treated in the top quartile of pediatric-ready EDs are up to 76% less likely to die than those treated in the lowest-performing departments. Notably, the cost to reach higher readiness levels is relatively modest, estimated at $4 to $48 per pediatric patient, depending on volume.
The updated guidance emphasizes that pediatric readiness is achievable even for departments facing workforce shortages, limited resources or low pediatric call volumes, including rural and critical access hospitals, NPRP states.
The recommendations also guide the National Pediatric Readiness Project, which is supported through the federal Emergency Medical Services for Children program that works with emergency departments nationwide on pediatric readiness.
What’s new in the updated pediatric readiness recommendations
Many core elements of pediatric readiness remain unchanged, including the recommendation that EDs designate both a physician and nurse pediatric emergency care coordinator (PECC) to oversee readiness efforts.
The updated statement builds on those foundations with expanded guidance in several key areas:
- Standardized pediatric care: Greater emphasis on pediatric-specific clinical practice guidelines and decision-support tools to reduce variability in care
- Quality measurement: A new set of pediatric-specific quality measures, including condition-focused metrics
- Case review: A stronger call for multidisciplinary review of pediatric deaths and adverse events
- Mental health: Expanded focus on pediatric mental health care, including universal suicide screening for adolescents
- Medication safety: Reinforcement of weight-based resuscitation systems, immediately available pediatric resuscitation carts and tools that reduce manual medication calculations
- Disaster preparedness: Broader expectations for incorporating pediatric considerations into emergency and disaster planning
The statement also includes a Pediatric Readiness Checklist and is accompanied by a technical report detailing the evidence behind each recommendation.
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2026 national assessment set to begin
The updated guidelines will serve as the framework for the upcoming 2026 National Pediatric Readiness Project Assessment, which is scheduled to open March 3.
Participating emergency departments will be evaluated using a 100-point readiness scale and receive a gap analysis highlighting areas for improvement. NPRP leaders say the assessment offers EDs a practical roadmap for strengthening pediatric care capabilities.
Emergency departments can begin preparing now using NPRP resources, including readiness toolkits and checklists. A free informational webinar is scheduled for Feb. 12.
