DOCUMENT RESUME ED 399 024 PS 024 408 TITLE Emergency Medical Services for Children: Abstracts of Active Projects FY 1996. INSTITUTION National Center for Education in Maternal and Child Health, Arlington, VA. SPONS AGENCY Health Resources and Services Administration (DHHS/PHS), Washington, DC. Maternal and Child Health Bureau. ISBN-1-57285-032-9 REPORT NO PUB DATE 96 MCU-117007 CONTRACT 185p.; For the 1995 edition, see ED 381 285. NOTE AVAILABLE FROM National Maternal and Child Health Clearinghouse, 2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536 (single copy, free). PUB TYPE Reference Materials Directories/Catalogs (132) Reports Descriptive (141) EDRS PRICE MF01/PC08 Plus Postage. DESCRIPTORS Abstracts; *Child Health; Children; *Emergency Programs; *Medical Services; Pediatrics; Pilot Projects; Program Descriptions; Rehabilitation; Resource Centers IDENTIFIERS Child Safety; *Emergency Medical Services; National Highway Traffic Safety Administration; Office of Maternal and Child Health ABSTRACT This publication provides abstracts of 58 active and 42 completed projects designed to improve emergency medical services for children (EMSC). The projects were funded by the United States Department of Health and Human Services' Maternal and Child Health Bureau, in collaboration with the United States Department of Transportation's National Highway Traffic Safety Administration. Issues addressed by the projects include injury prevention, children's needs in disasters, poison control services, EMS access through out-of-hospital and pre-hospital services and emergency rooms, intensive care, rehabilitation, and reintegration into the community. Abstracts of projects are divided into six sections: (1) projects to support EMS improvements; (2) the EMSC resource network; (3) state system development grants; (4) targeted issue grants; (5) research grants; (6) continuing education grants; and (7) completed projects. Each abstract contains: (1) the name, grantee, director(s), contact information, project number, and project period; (2) the problem addressed; (3) goals and objectives; (4) methodology; in most (5) evaluation; and, in some cases, cases, (6) experience to date. (KDFB) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** EMERGENCY MEDICAL SERVICES FOR CHILDREN It/ U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) )(his document has been reproduced as received from the person or organization originating it. 0 Minor changes have been made to improve reproduction Quality. Points of view or opinions stated in this docu- ment do not necessarily represent official OERI position or policy. EMSC 1111 I 14 RS A 'I. 1.1. 0 0 ABSTRACTS OF ACTIVE PROJECTS FY 1996 EC C E E a VICES FO C N. SE E Abstracts of Active rojects FY 1996 Supported by Maternal and Child Health Bureau Health Resources and Services Administration Public Health Service U.S. Department of Health and Human Services Published by National Center for Education in Maternal and Child Health Arlington, Virginia Cite as National Center for Education in Maternal and Child Health.1996. Emergency Medical Services for Children: Abstracts of Active Projects FY 1996. Arlington, VA: National Center for Education in Maternal and Child Health. Emergency Medical Services for Children: Abstracts of Active Projects FY 1996 is not copyrighted. Readers are free to duplicate and use all or part of the information contained in this publication. In accordance with accepted publishing standards, the National Center for Education in Maternal and Child Health (NCEMCH) requests acknowledgment, in print, of any information reproduced in another publication. The mission of the National Center for Education in Maternal and Child Health (NCEMCH) is to promote and improve the health, education, and well-being of children and families by leading a national effort to collect, develop, and disseminate information and educational materials on maternal and child health; and by collaborating with public agencies, voluntary and professional organizations, research and training pro- grams, policy centers, and others to advance knowledge in programs, service delivery, and policy devel- opment. Established in 1982 at Georgetown University, NCEMCH is part of the Graduate Public Policy Program. NCEMCH is funded primarily by the U.S. Department of Health and Human Services through its Maternal and Child Health Bureau. Library of Congress Catalog Card Number 96-68729 ISBN 1-57285-032-9 Published by: National Center for Education in Maternal and Child Health 2000 15th Street North, Suite 701 Arlington, VA 22201-2617 (703) 524-7802 (703) 524-9335 fax Internet: [email protected] Single copies of this publication are available at no cost from: National Maternal and Child Health Clearinghouse 2070 Chain Bridge Road, Suite 450 Vienna, VA 22182-2536 (703) 821-8955 (703) 821-2098 fax This publication has been produced by the National Center for Education in Maternal and Child Health under its cooperative agreement (MCU-117007) with the Maternal and Child Health Bureau, Health Resources and Services Administration, Public Health Service, U.S. Department of Health and Human Services. 4 7ablis of ©Ogiltafflib Emergency Medical Services for Children: The Need and the Goal The EMSC Five-Year Plan vii Projects to Support EMS Improvements Joint Projects with the National Highway Traffic Safety Administration (NHTSA) 1 Contracts 11 The EMSC Resource Network 19 State System Development Grants 27 Planning Grants 31 Implementation Grants 39 System Enhancement Grants 69 Targeted Issue Grants 105 Research Grants 141 Continuing Education Grants 153 Completed Projects 159 Appendix 183 5 Em agency SeTVICSE, gar ChEidiren The Need and the Goal Most people do not realize that advanced, highly organized emergency medical services (EMS) systems are relatively new. We take for granted a network of life- saving resources and technology that entered its early stages of development barely 30 years ago. Even fewer people realize that these EMS systems initially made no allowance for children's unique medical needsa critical omission that hurt the quality of pediatric emergency care. Upgrading the existing EMS system to provide for children is a complex and continuing challenge. This is true because: Children suffer from a different spectrum of diseases and injuries than adults. Children have unique physiological responses to illness and injury, and so their treatment demands specific training, equipment, and approaches that aren't always available in a system designed for adults. Children's intense emotional responses during emergencies combined with the inability of many young children to describe their symp- toms requires caregivers to develop special skills to communicate effectively and to help minimize distress. Statistically, fewer emergencies involve children than adults, making it more dif- ficult to maintain treatment skills. Prevention and rehabilitation are essential for ensuring a complete system for o children. 6 The need to integrate pediatric emergency care into EMS was first indicated by research in the late 1970s that showed that children had higher mortality and mor- bidity rates than adults. However, when children had access to a higher level of care, their mortality and morbidity decreased. The ongoing need for and impor- tance of special attention to children was summarized in the 1993 Institute of Medicine report Emergency Medical Services for Children. The Emergency Medical Services for Children (EMSC) program is designed to address the entire continuum of pediatric emergency services, from injury preven- tion and EMS access through prehospital and emergency department care, intensive care, rehabilitation, and reintegration into the community, while ensuring that the ongoing involvement of the child's primary care provider at each step. Dedicated efforts by EMSC States over the last decade have led to significant improvements in children's emergency care. More ambulances and emergency departments have pediatric equipment on hand. Many new protocols ensure that children are sent to the medical facilities best able to help them. Extensive training programs in pediatric care have promoted confidence and competence among emergency medical technicians, paramedics, and emergency room nurses and physicians. And more people are working to prevent needless childhood injury. Most important of all, more children's lives are being saved. However, much remains to be accomplished. This publication describes projects that are currently supported through the EMSC program and briefly notes those projects that have been completed. It docu- ments the scope of efforts to improve pediatric emergency care around the Nation. The projects described here are funded by the U.S. Department of Health and Human Services, U.S. Public Health Service, Health Resources and Services Administration, Maternal and Child Health Bureau, in collaboration with the U.S. Department of Transportation, National Highway Traffic Safety Administration. 7 vi EMERGENCY MEDICAL SERVICES FOR CHILDREN ABSTRACTS OF ACTIVE PROJECTS FY 1996 'he ERNS© Flive-Yearn Plan In 1995, the Maternal and Child Health Bureau (MCHB) and the National Highway Traffic Safety Administration (NHTSA) published a 5-year plan for EMSC. The plan's objectives are based on recommendations laid out by the Institute of Medicine (IOM) in the 1993 report Emergency Medical Services for Children. Staff from MCHB and NHTSA joined with a panel of expert advisors to convert the TOM recommendations into action steps. The resultant draft plan was sent to individuals, groups, and organizations around the country for review and discussion. The draft was revised and the comments incorporated into the plan. The plan's objectives are to: A. Include pediatric issues in all aspects of emer- gency medical services development. B. Develop broad-based support for improving emergency medical services. C. Improve and expand emergency pediatric training programs for health professionals. D. Ensure that prehospital and interhospital pedi- atric transport meets children's needs. E. Improve hospital classification and regional system development. F Ensure access to emergency medical dispatch ser- vices for all children and their families. G. Ensure universal access to the emergency care system for all children and their families. H. Expand the availability of injury prevention, first aid, and CPR programs. Include pediatric protocols in medical direction for all EMS agencies. I. Integrate pediatric components into the development of all trauma systems. J. K. Ensure a coordinated approach to EMSC. L. Institutionalize EMSC within the State EMS system. M. Improve data collection systems, data analysis methodology, and research to describe and evaluate emergency medical care for children. P[roikacts t© Support EMS !wow Joint Projects with the National Highway Traffic Safety Administration (NHTSA) The Maternal and Child Health Bureau and the National Highway Traffic Safety Administration work cooperatively to enhance the Nation's EMS system. Clearly, children's emergency medical services can only be as good as the overall emergency medical services system. MCHB and NHTSA continued their collabo- ration with the Federal Emergency Management Agency (FEMA) to support the Make the Right Call Campaign, initiated a new activity with FEMA on disaster preparedness, and co-funded six projects: Emergency Medical Technician-Intermediate and Emergency Medical Technician-Paramedic: National Standard Curricula and Associated Refresher Courses Revisions . .DTNH22-95-C-05108 . Workshop on Children's Emergencies OWF 53293 in Disasters Development and Implementation of National Consensus on Emergency Medical Services Communications: Problems and Remedies DTNH22-94-G-05222 Model Quality Improvement Program for Emergency DTNH22-75-C-05107 Medical Services Systems Emergency Medical Services Agenda for the Future DTNH22-95-G05188 First Responder Training Program Revision DTNH22-94-R-05123 Role of Out-of-Hospital Emergency Medical Services in Primary Injury Prevention 95H03381A0000000 Emergency Medical Services Instructor Training Program: National Standard Curriculum DTNH22-94-C-05008 9 Emevgency Medricall Techrdicrian-OnterrnlecHate and Errtrilevgency Medlica[l Techn[lcb'an-Pavamedlic: NathIna[l Standavd Cafirridcada and Assodated Rekeshert Cowses Reviisliourts Project Director Grantee Walt Stoy, Ph.D. Center for Emergency Medicine 230 McKee Place, Suite 500 DTNH22-95-C-05108 Project Number Pittsburgh, PA 15213 (412) 578-3200 (412) 578-3241 fax Methodology Problem The curriculums will be developed through for- The Emergency Medical Technician-Basic (EMT- B) curriculum has recently been revised, and the mation of several teams: An administrative team, an radically different in both expert writing panel, a national review team, and a new .curriculum is peer review team. Designees from all national instructional design and medical content. To ensure groups with an interest in EMS will be involved in linkage and bridging among all curriculums, the the curriculum development by participating in the Emergency Medical Technician-Intermediate (EMI- peer review team. The EMT-P standard curriculum T) and Emergency Medical Technician-Paramedic will be revised first, and the EMT-I will be extracted (EMT-P) curriculums must also be revised. from it. Goals and Objectives This project will revise the EMTI and EMT-P standard curriculums and associated refresher courses. These curriculums will also include the new pediatric components that have been inte- grated into EMT training over the last few years. 10 3 ABSTRACTS OF ACTIVE PROJECTS FY 1996 EMERGENCY MEDICAL SERVICES FOR CHILDREN