A joint statement recently published by the American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), the Emergency Nurses Association (ENA) and the American College of Surgeons (ACS) highlights the steps all emergency departments (ED) should take to be more prepared to care for pediatric patients.
| MORE: New ED readiness guidelines aim to cut pediatric deaths by 76%
The document includes a list of standards EDs are encouraged to meet related to:
- Administration and coordination
- Competencies for caregivers
- Quality improvement
- Policies, procedures and protocols
- Patient and medication safety
- Disaster response
- Equipment, supplies and medications
Why is this needed?
You have heard it before; kids aren’t just little adults. The assessments and care we provide to them aren’t the same as those for adults and our systems of care and preparedness for their emergencies shouldn’t be the same either.
High quality, reliable management of pediatric patients requires intentional effort, and the document published by these expert organizations provides a template for all levels of emergency departments to begin that work.
In larger population centers, there are dedicated children’s hospitals or large healthcare facilities with specialized pediatric emergency departments. These are great for the areas and kids they serve, but 80% of pediatric emergency visits occur at general EDs.
“ Only 51% of children in the U.S. live within an hour of a pediatric trauma center. ”
All emergency departments must be prepared to provide quality care to pediatric patients and the EMS for Children (EMSC) National Pediatric Readiness Project (NPRP) aims to make that achievable.
A 2021 NPRP assessment found that the median score for U.S. EDs’ pediatric readiness was 69.5 points out of 100. Evidence suggests that higher levels of pediatric readiness (>87 points) are associated with improved outcomes. A 76% lower mortality in ill children and 60% lower mortality for injured children could translate to 2,143 lives saved in the United States each year.
A press release from the ACS highlights that these preparedness efforts are not expensive. Improved readiness could cost between $4 to $48 per pediatric patient, depending on the patient volume a particular facility sees.
Why is ED pediatric readiness important to EMS?
Many of our EMS patient care protocols direct us to transport our patients to the closest, most-appropriate hospital. Being aware of hospitals in your region that have participated in and scored well on the assessment may help you make better transport destination decisions. Hospitals may even choose to widely promote their high scores as part of public relations campaigns.
Additionally, EMS has an opportunity to partner with their local emergency departments to help them increase their pediatric readiness. The EDs should also be reaching out to the EMS agencies that transport kids to their facilities to include them in some of the readiness checklist items. Several of the recommendations require involvement of outside partners, including quality improvement, patient safety, death review and disaster planning.
EMS for Children has a similar program for EMS agencies called the Prehospital Pediatric Readiness Project (PPRP), which has many of the same checklist items. EMS agencies that participate in readiness planning for their emergency department will be able to check many of those same items off in their PPRP checklist.
What resources are available to emergency departments?
The EMSC Program has numerous resources available to help EDs continue the journey to improve pediatric care.
Beginning March 3, 2026, a national assessment will launch to gauge the current status of ED pediatric readiness. All emergency departments in the U.S. will be asked to complete the assessment, which will allow them to:
- Highlight their improvements since the 2021 assessment
- Benchmark against the updated national standards
- Identify gaps and opportunities for improvement in their programs
- Contribute to research and policy efforts related to pediatric emergency care
In addition to the checklist of standards, the EMSC also offers a Toolkit that EDs can download to give them resources, sample documents, educational materials and references related to the standards. The Toolkit is currently being updated for the 2026 assessment, but some of the resources are already posted.
What can EMS do?
EMS and EDs are in this together. EMS leaders should reach out to their local EDs to encourage them to participate in the assessment and to download the Toolkit. EMS and EDs can work together on many of the standards to improve care in both the prehospital and hospital settings.
In a couple of years, the EMSC will launch a reassessment of EMS pediatric readiness. Check out the resources available from EMSC and begin work in your services now to improve.
Stay safe out there.
