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AAP News Vol. 18 No. 4
April 2001, p. 174
Emergency care guidelines ensure best care for childrenLori O’KeefeCorrespondent A two-year collaboration between the Academy and the American College of Emergency Physicians (ACEP) has resulted in pediatric care guidelines for use by U.S. hospital emergency departments.
The statement, titled Care of Children in the Emergency Department: Guidelines for Preparedness (
Pediatrics. 2001;107: 794-798 It includes: • guidelines for administration and coordination of the emergency department for the care of children, including the qualifications and responsibilities of physician and nursing coordinators; • guidelines for physicians and other practitioners staffing the emergency department; • quality improvement guidelines for the emergency department; • guidelines for policies, procedures and protocols for the emergency department; • guidelines for support services for the emergency department, including a transport plan; and • guidelines for equipment, supplies and medications for children in the emergency department. "Pediatricians are responsible for children’s care in smaller community hospitals, so it’s important for them to read the guidelines and set standards," Dr. Wiebe said. "They need to make sure they’re referring children to hospitals that can handle pediatric emergencies with the necessary resources." The U.S. Consumer Product Safety Commission surveyed a sample of 101 hospitals with emergency departments and extrapolated the results to represent the more than 5,300 U.S. hospitals with emergency departments. The survey results indicate that less than 10% of hospitals have pediatric emergency departments or intensive care services, yet 76% admit children to their facilities. In addition, 25% of hospitals without trauma services admit critically injured children to their hospitals (Athey J, et al. Pediatr Emerg Care. 2001; in press). "We want hospitals to have all of the necessary skills and resources to stabilize critically ill or injured children. When hospitals don’t have the resources to give children the best possible chance, then they need to have a plan for triaging and transferring patients to a more definitive facility," Dr. Wiebe added.
In 1995, the Academy issued the Policy Statement Guidelines for Pediatric Emergency Care Facilities (
Pediatrics. 1995;96:526-537 "We felt that categorization tends to leave people out. Developing guidelines that can be universally met and achieved at a reasonable cost improve the chances that equipment and staff will be available everywhere," Dr. Gausche-Hill said. "Parents assume the emergency department is prepared to care for children, and indeed most are, but we need to ensure all emergency departments have the ability to care for children that are brought in because of location." Dr. Gausche-Hill said ACEP hopes emergency department or hospital administrators will implement the guidelines once the new statement is published. ACEP plans to send copies of the guidelines to every hospital emergency department director, followed later by a survey to determine whether recommendations were implemented and any barriers encountered during the process. "By institutionalizing these guidelines, we will be able to keep them updated with the latest technology, drugs, protocols and advancements. Without a method to make updates, information can get stale fast," Dr. Wiebe said.
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