# Presentation: 939040

## COMMITTEE AND SECTION ON PEDIATRIC EMERGENCY MEDICINE

- AMERICAN ACADEMY OF PEDIATRICS

- EMSC Grantee Meeting
- April 2005

**Notes:**
Greetings from the AAP !

## OBJECTIVES

- Introduction to the AAP Committee on Pediatric Emergency Medicine or COPEM
- Introduction to the AAP Section on Emergency Medicine
- Update you on programs, products, work of the American Academy of Pediatrics in EMSC

## WHAT IS THE COPEM?

- 10 member committee appointed by the AAP Board of Directors
- Serves in a primary advisory role for the Board
- Development and review of AAP policies and guidelines
- Interface with other organizations
- Members of the COPEM
- Geographic representation
- Expertise
- Special skills
- Liaisons

**Notes:**
Members are selected from a group on nominees based on a number of factors that include geographic representation from each of the AAP regions, expertise in areas like pre-hospital care, office emergencies, school emergencies and special skills such as writing skills.  

Nominees are reviewed and members are chosen by the AAP Board.

Typical term for a member is 3-two year terms.

## AAP COPEM MEMBERS 2004/05

- Steve Krug [Chair] - Illinois
- Margaret Dolan - Virginia
- Kathy Shaw – Pennsylvania
- Joan Shook – Texas
- Tom Bojko – New Jersey

- Karen Frush – North Carolina
- Paul Sirbaugh - Texas
- Robert Sapien – New Mexico
- Loren Yamamoto – Hawaii
- Pat O’Malley - Massachusetts

**Notes:**
Committee members for 2004/05

Newest additions are Loren Yamamoto from Hawaii and Pat O’Malley from Massachusetts.

We are encouraging Loren to host a COPEM meeting at his home!!!

## COPEM: Organizational Liaisons

- ACEP – Sharon Mace, Ohio
- NAEMSP – Kathleen Brown, Washington, DC
- ACS – David Tuggle, Oklahoma
- MCHB – representative
- EMSC NRC – Jane Ball
- AAFP – New ! (TBD)
- AAP Staff – Sue Tellez

**Notes:**
The committee has a number of formal liaisons with other organizations.

The amazing Sue Tellez makes all of this work!!!

Recognizing the role that family physicians play in pediatric primary care, and as physicians staffing so many emergency departments, the AAP has reached out to the AAFP, and we hope that we will have a liaison attending the upcoming COPEM meeting later this week.

## WORK OF THE COPEM

- Spectrum of EMSC
- Systems of care
- AAP policy and guidelines
- Educational programs & resources
- Liaisons and collaboration with other organizations and initiatives
-  EMSC regional meetings
-  NAEMSP, ACEP, ACS, AHA, others
- Political action

**Notes:**
The spectrum of emergency services includes: acute care, prevention and rehabilitation.

We work nationally but also want to be connected with efforts at the grass roots level.  This is why we are sending representatives to all the regional meetings.  We also try to link with AAP state chapter COPEM’s.

Systems of care can includes prehospital, community, disaster response, EIF

Educational brochures include: What to do in an emergency

As you might expect, the committee has also played a leadership role in the AAP’s advocacy efforts on behalf of EMSC and on other key issues such as trauma, disaster preparedness and EMS.

## WHAT IS THE SECTION ON EMERGENCY MEDICINE?

- Membership – 1200 members
- Education
- Subcommittees
- Prehospital Care
- Collaborative Research
- Fellowship Directors
- PEM in Non-Children’s Hospitals
- Administrative
- Future Leaders in PEM – NEW !!
- Communication
- Awards

**Notes:**
The Section has steadily grown, now with over 1200 members, representing the third largest specialty section in the AAP.

One of the primary roles of the section is the development of educational programs, directed towards the members of the section (there is a two-day section educational program annually at the NCE) and presentations and workshops for the over 60,000 members of the AAP (e.g. directed towards general pediatricians and other specialists).

The Section has sponsored educational programs for PEM fellow trainees (annual Fellow’s Course), an intensive PEM CME course (PREPEM), and a PEM Leadership forum.

The section members are also involved in a variety of committee, including......

An important recent addition to the Section is the ‘Future Leaders’ committee – this is targeted to engage the interests and needs of the many young PEM specialists who have recently entered the field.

## SECTION EXECUTIVE COMMITTEEELECTED BY SECTION MEMBERS

- Joan Shook [Chair] – Texas
- Milt Tenenbein – Winnipeg, CA
- Jim Chamberlain –Washington, DC
- Mark Joffe – Pennsylvania
- Charles Macias – Texas
- Marc Gorelic - Wisconsin

- Nate Kuppermann – California
- Steve Selbst – Delaware
- Martha Wright - Ohio
- Dan Isaacman – Pennsylvania
- Liaisons
- Committee Chairs
- Sue Tellez – AAP Staff

**Notes:**
The Section Executive committee is elected by the members of the section.......

Milt is the chair-elect.

## PEDIATRIC EDUCATION FOR PREHOSPITAL PROFESSIONALS

- EMS-C National Heroes Award
- Developmental approach
- Case-based, videos, hands on
- _[www.PEPPSite.com](http://www.peppsite.com/)_

**Notes:**
AAP Outreach Educational programs include PEPP, PALS, APLS and PREP-EM.
This slide contains information on the PEPP Course.
More information is available at the PEPP website.

## ADVANCED PEDIATRIC LIFE SUPPORT COURSE

- Collaborative effort between ACEP & AAP
- Revision – 4th Ed.
-  New slide set
-  New manual
- Broader in depth and breadth than PALS
- Offers flexibility in course design

**Notes:**
This is information about the APLS Course. The course can be offered in a 2-day format or in smaller clocks of time over several weeks or months  such as in a residency training or hospital in-service

There are several skill tracks including: emergency medicine office emergencies and trauma

It can be customized with lectures on environmental emergencies, submersion injuries, toxicology and neonatal emergencies.

There is more information on the ACEP website and the AAP website  

## PREP-EM

- Intensive PEM review course
- PEM sub-board candidates
- Emergency physicians
- Pediatricians
- Family physicians
- Expert national faculty
- Offered every other year
-  Summer 2006

**Notes:**
PREP-EM is another education program sponsored by the Section.   This 5 day intensive review course occurs semi-annually.  The course has been designed to serve not only as an excellent tool used by PEM sub-board candidates to prepare for their exam, but as an excellent review program for pediatricians, emergency physicians and family physicians.

This course attracts a prominent group of national expert faculty in the field of PEM

## THE COPEM MANUAL

- Reference manual
- For all levels of emergency care
- Individual
- Office
- Hospital
- Community

**Notes:**
Comprehensive contains copies of the EIF, First Aid Chart, State Emergency Management Directors, history of the Federal EMS-C program, Legal aspects of EMS-C, description of Life Support Programs , examples of mock codes and much more

## FAMILY READINESS KIT

- Disaster planning kit for parents
- Developed by talking to families
- Over 20 different fact sheets & topics
- Available online at:
-  aap.org/family/frk/frkit.htm

## EDUCATIONAL RESOURCES

- First Aid CPR Chart
- What to do in an emergency brochure
- First Aid and Choking Brochure

## AAP WEBSITE ON TERRORISM

- All the information in one place
- Links to other sites
- Responding to Children’s Emotional Needs During Times of Crisis
- Brochure – The Youngest  Victims
- Smallpox FAQ’s
- Statement on Radiation Disasters and Children – June 2003

- www.aap.org/terrorism

**Notes:**
Another excellent AAP resource is the terrorism website......

## AAP POLICY AND COMMITTEE OPINION CITATIONS

- Death of a Child in the Emergency Department (5/05)
- Role of Pediatricians in Advocating for Life Support Courses for Parents and the Public (12/04)
- Relief of Pain and Anxiety in Emergency Medical Systems for Children (11/04)
- Overcrowding Crisis In Our Nation’s Emergency Departments: Is Our Safety Net Unraveling? (9/04)
- Consent for Emergency Medical Services for Children and Adolescents (3/02)
- Care of Children in the Emergency Department: Guidelines for Preparedness (94/01)
- Emergency Preparedness for Children With Special Health Care Needs (10/99)

**Notes:**
On this slide is a list of some fairly important policy statements and/or technical reports authored by the COPEM.

Dates in parenthesis represent the date of publication.

The Death of a Child policy will also appear in Annals of Emergency Medicine as it represents the collaboration of both AAP and ACEP.

All of these are available at the AAP website.

## AAP POLICY AND COMMITTEE OPINION – New & Revised [In Progress] 

- Ventricular Fibrillation and AED Usage in Children (New !)
- Pediatrician’s Liability During Disasters (12/02)
- Pediatric Care Recommendations for Freestanding Urgent Care Facilities (5/99)
- Access to Emergency Medical Care (10/92)
- Pediatrician’s Role in Disaster Preparedness (1/97)
- Role of the Pediatrician in Rural EMSC (5/98)

- Available at:  http://www.aap.org

**Notes:**
The following AAP policy statements and technical reports on this slide are all in the process of being updated by the COPEM

A new policy statement and technical report is under development regarding VF and AED use.

The COPEM is involved in 2 projects involving the use of AED’s in children.  One is a policy statement regarding the use of AED’s in children the second is a collaborative effort with the AHA called The Medical Emergency Response Plan for Schools:  Preparation for Initial Response to Life-Threatening Medical Emergencies.  This statement sets forth a public health initiative for AED’s in schools.  I t contains information for legislators, school personnel and community leaders.

Dates in parenthesis are the original date of publication.

All  policy statements are available at the AAP website.

## AAP POLICY AND COMMITTEE OPINION – On the Horizon

- Preparation for Office Emergencies
- Patient Safety in Emergency Medical Services for Children
- Mental Health Emergencies
- Pediatric Disaster and Bioterrorism Preparedness
- Access to Care

**Notes:**
There are several issues that COPEM is presently working on.

COPEM will produce a policy statement addressing the important issue of office-based preparedness for emergencies.

Another important endeavor that COPEM has taken on is the issue of pediatric patient safety in the broad realm of EMSC.  This will likely result in several products, and may be an area of collaboration between the AAP, ACEP and others.

Mental health emergencies is a collaborative monograph being written with the ACEP COPEM as a resource document.  The AAP recently convened a task force to examine this growing problem.  We expect the COPEM to play a role in the work of the task force.

Likewise, the AAP formed a task force several years ago to address the growing concern regarding pediatric disaster and bioterrorism preparedness.  Much more remains to be done. 

## CARE OF CHILDREN IN THE ED   GUIDELINES 

- Published jointly by AAP and ACEP
*Pediatrics 2001;107:777-781.*
- Defines guidelines for hospital ED’s in areas of care for children
- Administration and coordination
- Staffing
- QI and support
- Policies and procedures
- Equipment and supplies

**Notes:**
COPEM has a number of special projects under way.  One is the implementation kit for the Care of Children in the ED Guidelines.

The goal of the guidelines is to define standards of emergency care for children
Reference is Pediatrics 2001;107:777-781.

## CARE OF CHILDREN IN THE ED GUIDELINES

- Implementation kit
- Model policies
- Clinical practice guidelines
- Transfer guidelines
- Medication calculator
- Relevant policies
- Reference articles

**Notes:**
The implementation kit will contain many resources for ED’s

## CARE OF CHILDREN IN THE ED  GUIDELINES

- Goal is implementation in ED’s nationwide
- A research study is being designed to evaluate the process and effect of implementation
- Collaborative effort with ACEP and the EMSC program
- Project is presently in progress

**Notes:**
MGH is the PI

## AAP POLITICAL ADVOCACY

- Medicaid
- Immunizations
- Access to care
- Tort reform
- Trauma systems
- EMS
- EMSC !!

**Notes:**
The AAP is hard at work in an advocacy role on behalf of pediatric healthcare issues such as Medicaid, immunizations and access to care. and as well, on issues relevant to EMSC.

The AAP is helped to lead a coalition of professional organizations advocating for effective legislative re-authorization and funding for trauma systems

Likewise for EMS

Finally, the AAP is taken an important leadership role advocating for appropriate levels of funding and the continued presence or re-authorization of the EMSC program, which has helped lead the way towards substantial improvements in the delivery of emergency care to our nation’s children.   

?? Refer the audience to the editorial which was published in Pediatrics, Academic Emergency Medicine, Pediatric Emergency Care, and Clinical Pediatric Emergency Medicine ?????  See next slide

## EMSC COMMENTARY 

- Krug S, Kuppermann N: Twenty Years of
- Emergency Medical Services for Children:
- A Cause for Celebration and a Call for Action.

- April 2005

**Notes:**
Refer the audience to the commentary written by S Krug and N Kuppermann which will be simultaneously published in the April 2005 issues of Pediatrics, Academic Emergency Medicine, Pediatric Emergency Care, and Clinical Pediatric Emergency Medicine.

## WHAT CAN COPEM DO FOR YOU?

- Direct link to the 60,000 members of the AAP
- Development of new educational resources and initiatives
- Let us know what you think or what you need!
- Legislative issues
- AAP Washington office
- AAP State government affairs committee

**Notes:**
We work with the AAP Washington office on legislative initiatives and model legislation regarding emergency medical services for children