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Prehospital Emergency Care Volume 26, 2022 - Issue 4
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Focus on Pediatrics

Ready for Children Part II: Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting

Hilary A. HewesReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.Correspondence[email protected]
, MD,
Andrea L. GenovesiReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.
, MA,
Rachel CoddenReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.
, MPH,
Michael ElyReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.
, MHRM,
Lorah LudwigReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.
, MA,
Charles G. MaciasReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.
, MD, MPH,
Patricia SchmuhlReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.
, BA &
Lenora M. OlsonReceived April 28, 2021 from Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, School of Medicine, Salt Lake City, UT (HAH); Department of Pediatrics, University of Utah, Data Coordinating Center, Salt Lake City, UT (HAH, ALG, RC, ME, PS, LMO); Department of Health and Human Services, Emergency Medical Services for Children Program, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD (LL); Department of Pediatrics, University Hospitals Rainbow Babies and Children’s/Case Western Reserve University, Cleveland, OH (CGM). Revised received June 5, 2021; accepted for publication June 8, 2021.
, PhD show all
Pages 503-510 | Received 28 Apr 2021, Accepted 08 Jun 2021, Published online: 12 Jul 2021
 
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Abstract

Objectives: Treating pediatric patients often invokes discomfort and anxiety among emergency medical service (EMS) personnel. As part of the process to improve pediatric care in the prehospital system, the Health Resources and Services Administration (HRSA) Emergency Services for Children (EMSC) Program implemented two prehospital performance measures -access to a designated pediatric care coordinator (PECC) and skill evaluation using pediatric equipment-along with a multi-year plan to aid states in achieving the measures. Baseline data from a survey conducted in 2017 showed that less than 25% of EMS agencies had access to PECC and 47% performed skills evaluation using pediatric equipment at least twice a year. To evaluate change over time, the survey was again conducted in 2020, and agencies that participated in both years are compared. Methods: A web-based survey was sent to EMS agency administrators in 58 states and territories from January to March 2020. Descriptive statistics, odds ratios, and 95% confidence intervals were conducted. Results: The response rate was 56%. A total of 5,221 agencies participated in both survey periods representing over 250,000 providers. The percentage of agencies reporting the presence of a PECC increased from 24% to 34% (p= <0.001). However, some agencies reported that they no longer had a PECC, while others reported having a PECC for the first time. Fifty percent (50%) of agencies conduct pediatric psychomotor skills evaluation at least twice/year, a 2% increase over time (p = 0.041); however, a third (34%) evaluate skills using pediatric equipment less than once a year. The presence of a PECC continues to be the variable associated with the highest odds (AOR 2.15, 95% CI 1.91–2.43) of conducting at least semiannual skills evaluation.

Conclusions: There is an increase in the presence of pediatric care coordination and the frequency of pediatric psychomotor skills evaluation among national EMS agencies over time. Continued efforts to increase and sustain PECC presence should be an ongoing focus to improve pediatric readiness in the prehospital system.

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