EMERGENCY MEDICAL SERVICES FOR CHILDREN NEWSLETTER

news

VOLUME 12, NO.3, FALL 1999

Page 2

Eighteen New

Objectives Proposed

for EMSC Five-year

Plan

Page 3

EMSC Region

Meeting Calendar

Page 5

NRC Steps-Up

Research Activities

Old Ambulances

Save Lives

Page 8 

EMSC Activities Help

Childcare Providers

Page 11

Tennessee 

Participates in 

Family Reunion 8

Page 13 

Women’s Clubs 

Recognized for 

Support of EMSC

MCHB Increases EMSC

Targeted Issue Funding

Seven New Grants Awarded

in FY 2000

O

n October 1, 1999, seven new targeted

issue grants for emergency medical services for children (EMSC) officially will 

be up and running. This year, the Maternal and

Child Health Bureau (MCHB) received a record

of 26 applications in this category. Although

MCHB originally intended to fund only four

grants, sufficient funds were secured to support

seven, based on competitive review and scoring. 

The targeted issue grant category was

established to address special needs or concerns

of regional and national significance affecting

children throughout the EMSC continuum of

care. These grants typically yield new products,

Telehealth: Do the Benefits 

Outweigh the Costs?

INSIDE THIS

ISSUE

T

he topic of telehealth continues to interest

many members of the EMSC community.

However, there are still a number of unanswered questions concerning how it can

be utilized to improve children’s care throughout

the EMS continuum and whether its benefits outweigh the costs of the new technologies. In other

words, will certain telehealth systems reduce

assessment and treatment time, prevent unnecessary or inconvenient transport, and improve

access to health care in rural communities?

The EMSC National Resource Center (NRC)

is reviewing governmental reports and meeting

with key agency representatives to better understand the conceptual framework for and emerging

issues in telehealth. Much of the information collected emphasizes the importance of conducting

a needs assessment and establishing a coalition of

supporters prior to any technology investment. 

Reports also indicate that many early telehealth demonstration projects failed because they

were too expensive or difficult to use. Problems

often arose because existing practice patterns and

preferences were not analyzed before new systems were implemented. Issues such as how

physicians will be compensated for online consultations were unresolved. 

Other major challenges to broad-based

implementation of new telehealth systems

include: 

• the life expectancy and incompatibility 

of equipment;

• requirements for on-site technical 

expertise;

• concerns about patient confidentiality;

• legal issues related to multi-state 

licensure;

• risks of malpractice; and 

• the need for better reimbursement schemes. 

(See MCHB Increases Funding, page 9

Telehealth System Development

Debate continues to center on which

broadcast technologies offer the best service at

the lowest price. The most popular options are

single- or multiple-user T-1 lines, low-orbit

satellites, and microwaves. 

T-1 lines, which are telephone lines with 

a special connection that allows them to 

send and receive digital signals, offers a data

transfer rate of 1.54 million bits per second.

That is double the rate of a standard 28.8 kilobits per second modem. The T-1 line is also 

a dedicated connection, meaning that it is 

permanently connected to the Internet. In

addition to being very expensive, these types 

(See Telehealth, page 14)
2 EMSC News FALL ’99 

EMSC Program Director, MCHB

David Heppel, MD

Director, EMSC National Resource Center

Jane Ball, RN, DrPH

Managing Editor

Suzanne Sellman, MA

Associate Editor

Makita Weaver

Editor

Margo Gillman

Design 

Design Central, Inc.

EMSC News is a publication of the 

Emergency Medical Services for Children

(EMSC) Program, a federally funded initiative jointly administered by the Health

Resources and Services Administration’s

Maternal and Child Health Bureau

(MCHB) and the National Highway Traffic

Safety Administration. ISSN 1522-5275.

EMSC News is published four times a year

by the EMSC National Resource Center,

111 Michigan Avenue, NW, Washington,

DC 20010-2970; 202/884-4927 (phone);

301/650-8045 (fax); info@emscnrc.com 

(e-mail); www.ems-c.org (web). 

Subscriptions to EMSC News are free.

EMSC News welcomes articles on people,

programs, and procedures related to

emergency medical services for children.

All manuscripts, artwork, or photography

should be submitted to Suzanne Sellman

at the EMSC National Resource Center. 

© 1999 EMSC Program. All rights reserved.

news

Eighteen New Objectives Proposed for the EMSC Five-year Plan

I

n June, more than 25

experts met at the

Emergency Medical

Services for Children

(EMSC) National

Resource Center (NRC)

in Silver Spring, Maryland, to develop new

objectives and activities

that support the revision

of the EMSC Five-year

Plan. The document,

which provides guidance

for the EMSC Program,

prioritizes national activities, and promotes the

integration of EMSC into

the vision of the broader

EMS system, is being 

amended to address the unmet pediatric emergency care needs for the

years 2001-2005.

The group of leaders were divided

into six task forces addressing Human

Resources, System Finance, Legislation,

and Regulation; Communications and

Public Access; Professional Education

and Public Education; Medical Direction, Clinical Care, and Integration of

Health Services; Research, Evaluation,

and Information Systems; and Health

Promotion

and Prevention. Their

preliminary

work resulted in the

proposed

development of 

18 new

objectives

and the

revision 

of 31 

current objectives. Fifteen objectives were proposed for deletion

from the plan because they were

completed between 1995 and 1999.

“This is one of the only

plans I have come across that

does not simply get filed away,”

said David Heppel, MD, director

of the Maternal and Child Health

Bureau’s Division of Maternal,

Infant, Child, and Adolescent

Health. “You can be sure that

what is suggested and what is

finalized will influence the

daily activities of the NRC

staff, state grantees, and the

Partnership for Children

Consortium.”

In August, the EMSC National

Steering Committee reviewed the task

force recommendations. The task

forces are expected to reconvene in the

Fall for additional revision activities.

In March 2000, the draft plan 

will be posted to the EMSC web site 

at www.ems-c.org for a 60-day public

comment period and sent to approximately 200 individuals for consideration. The final version of the EMSC

Five-Year Plan, 2001-2005 will be

released at the Annual EMSC Grantee

Meeting in early 2001.

Professional Education and Public Education Task Force members’ Jane Ball, RN, DrPH; Deb

Henderson, RN, PhD; and George Foltin, MD, discuss the importance of expanding EMSC’s

role in monitoring and using new technologies for EMS education.

Jon Krohmer, MD, and Jim Flaherty, MD, review EMSC Five-year Plan objectives

related to medical direction, clinical care, and health service integration. In March 2000, 

a draft plan will be posted to the EMSC web site for a 60-day public comment period.
••• •••PUBLIC POLICY NETWORK••• •••

EMSC News FALL ’99 3

Public Policy and School Bus

Safety

In the recent report, Transportation Review: School Bus Safety, by

the National Conference of State Legislatures (NCSL), Transportation Policy

Associate Melissa Savage discusses

school bus safety and shares information about public policy strategies

under consideration at the state level.

Excerpts from the full article, which

can be found at the NCSL web site,

www.ncsl.org, are provided below.

Every week 23.5 million children

travel to and from school by bus. In

fact, more than 400,000 school buses

travel approximately 4.3 billion miles

each year. According to the National

Highway Traffic Safety Administration

(NHTSA), school bus transportation is

one of the safest forms of transportation — nearly 2,000 times safer than

traveling in the family car. 

On average, nine passengers under

the age of 19 and 23 school-age pedestrians are killed in school bus crashes

each year. Although each fatality is

tragic, this figure is small when compared to the 5,400 or more children

between the ages of 5 and 18 who died

in motor vehicle crashes during 1997. 

The current school bus safety

record indicates that the present occupant protection system is succeeding.

As a result, legislation requiring seat

belts on school buses often is difficult

PUBLIC POLICY NETWORK 

to pass. In addition, the installation of

school bus seat belts can be costly and

it can be difficult to ensure that each

child is wearing the lap belt correctly.

Until recently, New York and New

Jersey were the only states that had

enacted school bus seat belt laws. However, the New York law only requires

seat belts be installed on school buses,

not that they be worn. A 1997 survey

conducted by the New York Department of Education found that only 44

of the state’s 709 public school districts

require students to wear seat belts. 

In 1999, more than 30 states introduced legislation requiring the installation of seat belts on school buses. Florida was the only state that passed legislation. The new law requires the installation of seat belts on school buses purchased after December 31, 2000, which

passengers will be required to wear. 

Some state legislatures have

addressed other issues relating to

school bus safety. For example, in

North Carolina, designated bus monitors supervise children as they get on

and off the bus and while they ride,

allowing the bus driver to concentrate

on driving. Other states have installed

video cameras on school buses to monitor student behavior. In addition, some

states have developed safety-training

programs to teach students and their

parents how to avoid accidents while

getting on and off of the school bus.

Heartland EMSC Coordinating

Council (HECC)

Date: Tentatively scheduled for late

April or early May 2000

Location: To be determined

Participating states: Iowa, Kansas,

Minnesota, Nebraska, North Dakota,

South Dakota, and Wyoming

Contact: David Boer at 

boerd@siouxvalley.org 

New England EMSC Regional

Teleconference

Date: October 1, 1999

Location: individual state sites

Participating states: Connecticut,

Maine, Massachusetts, New Hampshire,

Rhode Island, and Vermont

Contact: Patrick Malone at

pmalone@zoo.uvm.edu 

Southeastern EMSC Regional

Meeting

Date: Spring 2000

Location: Charleston, South Carolina

Participating states: Alabama, Florida,

Georgia, Kentucky, Mississippi, North

Carolina, South Carolina, and Tennessee

Contact: Karen Frush at

frush002@mc.duke.edu 

Three region meetings were held in

September. Coverage for these meetings will be provided in the next issue

of EMSC News.

Intermountain Regional EMSC

Coordinating Council (IRECC)

Date: September 16-18, 1999

Location: Reno, Nevada

Participating states: Arizona, 

Colorado, Idaho, Montana, Nevada,

New Mexico, Utah, and Wyoming

Contact: Nels Sanddal at

nsanddal@citmt.org 

EMSC/Great Lakes Injury

Prevention Network (Region V)

Date: September 24- 25, 1999

Location: Oakbrook, Illinois

EMSC Region 

Meeting Calendar 

Participating states: Illinois, Indiana,

Iowa, Kentucky, Michigan, 

Missouri, Minnesota, Ohio, 

and Wisconsin 

Contact: Evelyn Lyons at

elyons@wpo.it.luc.edu 

Region IX Injury Prevention

Network 

Date: September 16-17, 1999

Location: Honolulu, Hawaii

Participants: Arizona, California,

Hawaii, Nevada, the Health Resources

and Services Administration, the

National Highway Traffic Safety

Administration, and the Federal 

Highway Traffic Safety Administration.

Contact: Aida Berkovitz at

aida.berkovitz@nhtsa.gov
4 EMSC News FALL ’99 

“The Epidemiology of Pediatric

Air Medical Transports in Utah,” a

study published in the July/September

1999 issue of Prehospital Emergency

Care, found that:

• children four years of age and

younger are more likely to be air-transported for illness-related conditions;

• children five years of age and

older are more likely to be air-transported for injury-related conditions;

• children with special health care

needs use a higher volume of air 

medical transport services than the

general pediatric population; and

• air medical transport is expensive,

and inappropriate air medical transports may occur.

The primary purpose of the 

study was to identify the patients who

utilize the air medical transport system,

describe the medical services provided

in the prehospital setting, and analyze

the charges for transport to and treatT he Emergency Medical Services

for Children (EMSC) National

Resource Center (NRC) has

agreed to serve as moderator for the

pediatric EMS section of the Mobile

Healthcare Forum (MHF), an online

‘hub’ for professionals, agencies, and

suppliers seeking EMS-related information and resources. In this capacity, NRC will provide content links and

annotations to various pediatric

resources, moderate the pediatric discussion group, and facilitate chat discussions with various EMS experts. 

“This arrangement is very 

beneficial to both parties,” said NRC’s

Librarian Linda Pierce, MLS. “We

have the pediatric knowledge,

resources, and contacts. In addition,

we have experience in conducting

online chats and moderating electronic discussions. In return, MHF will

enable EMSC to reach a broader audience. Our current listserv, which will

remain fully active, only reaches

EMSC grantees and federal officials.

Now all prehospital providers, as well

as other health care providers, have

access to online pediatric discussion

groups and chat rooms.”

To access the pediatric section,

visit www.mhf.net and click on “EMS

Compass.” In addition to pediatrics,

this section features resources for cardiology, critical care transport, dispatch/communications, education,

News from NEDARC

A

study initiated by the National

EMSC Data Analysis Resource

Center (NEDARC) found that

school-based EMS incidents more

often are attributable to injury, related

to a sports activity, and resulted in

transport to a medical facility. 

The study is highlighted in the

article, “Prehospital Emergency Care

for Children at School and Nonschool

Locations,” which was published in

the June 1999 issue of Pediatrics.

The study examined South Dakota’s

emergency medical services (EMS)

data involving children between the

ages of 5 to 18 years to determine the

differences between school-based and

nonschool-based EMS incidents. By

describing the characteristics of

school emergencies resulting in an

EMS dispatch, this population-based

study may help emergency medical

providers and school personnel prepare for school-based incidents.

NRC Moderates Mobile Healthcare Forum’s Pediatric Section 

medical direction, respiratory, and

general EMS.

MHF also offers numerous unique

electronic facilities for EMS professionals, including: a conference center

with moderated message boards and

chat rooms; a mall with more than 150

EMS-specific product and service

providers; a university with an index

of online courses from multiple education providers and EMS suppliers;

online polls, surveys and debates; a

library; two auditoriums for virtual

conferences; and much more. For

more information about EMSC’s

involvement with MHF, contact Pierce

at (301) 650-8015 or via e-mail at

lpierce@emscnrc.com.

ment at Primary Children’s Medical

Center, a pediatric tertiary care center

in Utah and a referral center in the

Intermountain region.

Presentations

NEDARC staff recently presented

at the California EMSC Conference in

Oakland and the EMSC/Great Lakes

Injury Prevention Network (Region V

Meeting) in Oakbrook, Illinois. If you

need assistance with your EMSC project or would like a NEDARC representative to present at your meeting,

please call (801) 581-6410. For more

information about NEDARC or either

of the studies, visit www.nedarc.med.

utah.edu.

NEDARC
EMSC News FALL ’99 5

T he Emergency Medical Services

for Children (EMSC) National

Resource Center (NRC) would

like to welcome Isabelle Melese-d’Hospital, PhD, who joined its team in May

as the full-time research specialist.

Melese-d’Hospital previously worked

as a social science researcher in the

area of adolescent sexual and reproductive health attitudes and behaviors

at the University of California, San

Francisco. Her background is in

health promotion, early pregnancy,

and sexually transmitted infection

prevention education. 

In her new role, Melese-d’Hospital

provides technical assistance to EMSC

grantees and federal representatives.

She also works on several national

Paramedics for Children (PFC),

an all-volunteer organization

dedicated to bringing aid to 

children of third-world countries, is

scouring the United States for surplus

ambulances, emergency medical

equipment, and volunteers to help

expand emergency medical services

for children in Honduras.

“Emergency medical services of

any type are non-existent for many of

the poor people in the outlying areas

of Honduras. It’s the children and the

elderly who seem to suffer the most,”

said Rodger Harrison, director of PFC.

“Because we are small, we can mobilize fast and react to any emergency.

We take great pride in knowing that

all the money and supplies we receive

are delivered by us directly to 

the people of Honduras.”

EMSC-funded research projects. Two

of her current projects are described

below.

National Registry of EMTs Survey

In this survey, currently registered emergency medical technicians

at the basic, intermediate, and paramedic levels from all 50 states, Puerto

Rico, and the U.S. Coast Guard, were

asked to assess their training and

knowledge of pediatric emergency

care, identify shortfalls in pediatric

continuing education, rate their level

of comfort in responding to critical

pediatric emergency calls, and identify

barriers to obtaining pediatric continuing education.

The data, which is currently

being analyzed, will be disseminated

NRC Steps-up Research Activities: Hires New Specialist

Harrison

got the idea of

sending ambulances to Honduras after

experiencing

first-hand the

devastating

effect that Hurricane Mitch had on the

country in 1998. Mitch killed approximately 10,000 people and caused 

millions of dollars in property damage. 

“If these units had been in place

during the hurricane, we could have

saved a lot of people,” Harrison said.

In addition to establishing allvolunteer EMS services, PFC coordinates relief flights of food and medicine to third-world countries such as

Colombia and Jamaica. 

to state EMS directors to illustrate

how their states fare in relation to the

national average. 

Interagency Committee for

EMSC Research

In September 1999, this committee of federal agency representatives

met at NRC in Silver Spring, Maryland,

to review and comment on a draft

EMSC Joint Program Announcement, 

a federal initiative to promote EMSC

research and research funding. The

final announcement is expected to

facilitate researchers’ attempts to

obtain feedback on and funding for

EMSC-related research projects.

For more information, call (704)

525-1121 or visit the PFC web site at

www.paramedicsforchildren.com.

Spanish-speaking individuals with

medical backgrounds are desperately

needed for the missions. 

In August 1999, the first ambulance donated to PFC

arrived in Honduras by boat. It will be reconditioned

and used in Copan Ruinas, where PFC is establishing

the country’s first all-volunteer ambulance service.

Old Ambulances Save Lives, Bring Hope

to Hondurans
Emergency Care Committee of the

Ohio chapter of the American Academy of Pediatrics. 

The cost of printing the booklet

will depend on the type of paper and

binding used, and the number of booklets ordered. To keep costs to a minimum, the EMSC National Resource

Center (NRC) suggests the use of nonglossy paper, 80 to 120-pound cover

stock, and 60-pound text stock. Fold

and paste binding — where color tape

is placed along the spine of the booklet

— is less expensive than spiral binding.

Individuals with access to a color

printer, should consider printing one

copy from the web site and having it

duplicated at a local copy center.

For assistance in downloading this

document, please contact NRC at (202)

884-4927. Emergency Guidelines for

Schools is one of more than 25 products that are available as downloadable

documents from the EMSC web site.

6 EMSC News FALL ’99 

Responding to a request from its

membership, the American

Academy of Pediatrics (AAP) in

1981 established the Section on Emergency Medicine (SEM) to provide a

forum for the discussion of problems

relating to the treatment and care of

pediatric cases in the emergency

department. Since that time the section’s membership has grown to 806

members and 10 affiliates. “Membership continues to grow at a rapid

rate,” said SEM Liaison Susan Tellez.

“In the past three years, membership

has increased by 27%.”

The section’s overall mission is to

improve the care of acutely ill infants,

children, and adolescents by stimulating research in, and the teaching of,

emergency care for children and disseminating knowledge of pediatric

emergency care through Academy

channels to the medical profession 

at large.

The section’s current activities

include: 

• educational programming at AAP’s

Annual Meetings and Spring Sessions;

• PREP-EM (Pediatrics Review and

Education Program in Emergency

Medicine), a four-to five-day continuing

medical education course that reviews

the salient issues of the clinical practice of pediatric emergency medicine;

• the Ken Graff Young Investigator

Award, which provides up to $10,000

for a research project that addresses

issues pertinent to the acutely ill or

injure child; and

• special leadership retreats conducted in collaboration with the

American College of Emergency

Physicians.

AAP’s Section on Emergency Medicine Grows by 27%

In addition, the committee publishes a biannual newsletter, Emergency Section News, and hosts its own

section of the AAP web site, located at

www.aap.org/sections/pem.

Membership in the section is open

to all fellows of the Academy with an

interest in pediatric emergency medicine. An applicant must meet certain

criteria in order to join. The annual

dues are $35.

For more information or to join

the section, contact AAP’s Division of

Sections via e-mail at sections@aap.org

or visit www.aap.org/sections.

Emergency Guidelines for

Schools 

Now Available for

Local Reproduction

T he Emergency Guidelines for

Schools, an emergency care

resource for school staff without

full-time medical or nursing support,

can be downloaded from the EMSC

web site at www.ems-c.org as an IBMcompatible, PageMaker 6.5 file. Once

transferred to a disk or CD-ROM, the

guidelines may be duplicated at any

local print shop. 

The guidelines contain colorcoded first-aid flowcharts, an explanation of more than 37 of the most common pediatric illnesses and injuries, a

list of recommended first-aid equipment and supplies, and advice for caring for students with special health

care needs. This popular booklet was

produced in 1998 by the Ohio Department of Public Safety’s Emergency

Medical Services for Children (EMSC)

program in cooperation with the

27%
Pediatric Dispatch Cards. Based

on available evidence, the panel does

not believe that a specific pediatric

dispatch card set is necessary or

appropriate. The current card sets,

which cover 32 common medical complaints, are adequately meeting pediatric needs. Developing an additional

set of cards without specific evidence

of need might complicate the protocols

Emergency Medical 

Dispatch for Children

Today, nearly 90% of the nation is

covered by an organized emergency

medical dispatch (EMD) system.

Dispatch often is the first link in

the chain of emergency response.

As a result, the strength of the

nation’s EMS system depends on

rapid access to a skilled emergency medical dispatcher. This is

especially true in emergencies

involving children.

In June 1998, a group of

experts met in Washington, DC,

to discuss EMD for children.

Jointly sponsored 

by the Health Resources and Services Administration’s Emergency Medical Services for Children (EMSC) Program, the

National Highway Traffic Safety

Administration, and the 

Georgia Department of Human

Resources’ Office of Emergency

Medical Services, the gathering

aimed to address the following:

Capability of Current EMD 

System.The group believes that

the EMD system generally is

meeting the needs of children. 

It contends that an ongoing commitment to continuous quality

improvement, research, and

training is needed to maintain 

adequate coverage for children and 

the community.

••••••••••••••

EMSC News FALL ’99 7

•••••••••• •••••••••• ••••••••••EMSC SYSTEMS SCOOP •••••••••• •••••••••• ••••••••••EMSC SYSTEMS SCOOP

unnecessarily, resulting in a net negative effect on system performance.

Improving the Nation’s EMD 

System. Two additional concerns

with the EMD system relate to the

consistency of local adherence to

established protocols and the utilization of a continuous quality

improvement program. The group

recognized that national standards, such as the ASTM Standard

for EMD Management, have been

developed to identify the essential

elements of an effective EMD system. The experts stress that the

overall quality of the national

EMD system depends on the manner and degree to which voluntary

standards are implemented

throughout the nation. In addition, a continuous quality

improvement system must be in

place to actively monitor and

assess a statistically significant

percentage of EMD calls.

Barriers to Further 

Development. The group contends that one of the most serious

barriers to progress in EMD is a

widespread assumption that strict

adherence to standards is unnecessary. System administrators and

the communities they serve may

believe that a partial adoption of the

EMD standard is adequate. Members

maintain that this false confidence may

prevent many system administrators

from allocating sufficient attention and

resources to EMD.

Survey on Pediatric

Emergency Medical Dispatch

• Agencies in 17 of 25 states (68%)

“Strongly Agreed” or “Agreed”

that their communications officers were comfortable in dealing

with adults calling for medical

help concerning child patients.

• Four agencies “Strongly Agreed”

and 10 “Agreed” that their 

communications officers were

comfortable in dealing with 

children calling for medical help

concerning adult patients.

• Agencies in 10 states “Strongly

Agreed” or “Agreed” that their

communications officers would

feel comfortable in dealing with

children calling for medical help

concerning child patients.

Source: National Communication Center

Survey, 1997. Twenty-five of the 50 states

completed the survey instrument.
8 EMSC News FALL ’99 

EMSC Activities Help Childcare Providers

T he Emergency Medical Services

for Children (EMSC) National

Resource Center (NRC) and 

several EMSC grantees are working to

improve the health and safety of children in childcare programs through

collaborations with state and national

childcare organizations. EMSC’s aim is

to ensure that childcare settings are

safe, healthy environments and that

caregivers are prepared to handle

pediatric emergencies. 

NRC Activities: The recently 

re-designed EMSC web site contains 

a special section on childcare issues

with links to childcare products,

national programs, and resources,

including state-by-state childcare 

profiles. This section can be searched

by key words. Topics include playground

safety, first aid and CPR, licensing 

regulations, and training curricula,

among others. 

The new NRC fact sheet on childcare for providers and other members

of the EMSC community, can be

downloaded from the EMSC web site

at www.ems-c.org. 

New EMSC Grantee Products:

The Ohio and Oklahoma EMSC programs have developed curricula for

childcare providers that are available

on CD-ROM. To order these materials,

contact the EMSC Clearinghouse at

(703) 902-1203. Information about 

the CD-ROMs also can be downloaded

from the EMSC web site. 

First Aid for Day Care Personnel:

Developed by the Ohio EMSC program,

this curriculum contains a trainer

manual with sections focusing on

injury prevention, emergency preparedness, bleeding and shock, children with special health care needs,

first aid, and much more. The curriculum is accompanied by PowerPoint

visual aids and participant handouts.

To order the curriculum, contact the

EMSC Clearinghouse.

Emergency First Care and

Injury Prevention: A Training Curriculum for the Childcare Provider

(2nd edition): Developed by the

Oklahoma EMSC program, this

revised curriculum contains modules

on injury prevention, childcare

provider well-being, emergency action

principles, airway and breathing emergencies, bleeding, shock, soft tissue

injuries, and much more. This product is also available through the EMSC

Clearinghouse.

The National Training Institute

for Childcare Health Consultants:

This MCHB-funded, train-the-trainer

program is geared for health consultant trainers for state-level childcare

health consultation programs. It is

taught in two three-day training sessions

at the University of North Carolina at

Chapel Hill with a three-month athome study section. For more information, please contact Sandra Cianciolo, RN, MPH at (919) 966-6288 or via

e-mail at sandra_cianciolo @unc.edu.

EMSC Seeks Members for

Family Advocacy Network

T he Emergency Medical Services

for Children (EMSC) National

Resource Center (NRC) is looking for family and consumer representatives to participate in the National

EMSC Family Advocacy Network

(FAN). Parents serving on EMSC advisory committees and task forces, parents of children who have received

emergency care or who have special

health care needs, and state consumer

advocates, including those affiliated

with the state chapter of Parent

Teacher Association and Family Voices

are encouraged to participate. 

Individuals who are interested in

or know of a parent or other consumer

representative who is willing to assist

with state EMSC programs are encouraged to contact Shulamit Lewin via 

e-mail at slewin@emscnrc.com.

FAN members will receive quarterly mailings of EMSC-related materials on

important family and consumer issues.

NRC will also provide members with

information to assist families in advocating for the improvement of pediatric

health care and in supporting EMSC

programs throughout the nation.

Printed with permission from Steve Berry.
WHAT HAT’SS NEW? An EMSC Product Update An EMSC Product Update An EMSC Product Update ••• •••

EMSC News FALL ’99 9 EMSC PRODUCT UPDATE

Course on Pediatric 

Emergencies (COPE)

By the West Virginia EMSC 

Project (1998)

This pediatric emergency training

manual is intended to prepare emergency medical technicians (EMTs) for

the changing needs of children in the

new millennium. It presents a multifaceted program that addresses all of

the elements necessary for raising

healthy children with special attention

focused on pediatric assessment and

intervention. The 330-page manual

costs $21. Ask for product #795.

TRIPP: Teaching Resource for

Instructors in Prehospital

Pediatrics (Print version)

By the Center of Pediatric Emergency

Medicine (CPEM) (1998)

This 807-page resource is an

“encyclopedia of prehospital pediatric

knowledge.” It contains a multitude of

didactic and clinical information —

from educational methodologies and

teaching skills to issues concerning

children with special health care

needs and injury prevention. TRIPP

provides EMS instructors instant

access to fundamental pediatric information. The printed version costs $25.

Ask for product #798. A CD-ROM version of the guide can be downloaded

from the CPEM web site at

www.cpem.org. 

EMSC: Making It A Matter 

of Public Policy

By the EMSC National Resource 

Center (1999)

As of 1999, 18 states have passed

legislation mandating EMSC-related

measures or programs. Other states

are in the process of developing such

efforts. This two-color, two-page fact

sheet briefly describes each state’s

EMSC laws and when they were enacted. The first 100 copies are provided

free of charge. Each additional set of

100 costs $5. Ask for product #800.

NAEMSP Model Pediatric

Protocols

By the National Association of EMS

Physicians (1999)

This publication documents

developing field treatment protocols

for children. It presents selected protocols from a comprehensive review of

more than 250 representative protocols that were collected from a national sample. The selected protocols represent optimal treatment practices

that comply with accepted national

standards, such as those found in the

EMT-Basic and EMT-Paramedic

National Standard Curricula. The first

copy of the guide is available free of

charge. Each additional copy costs

$3.50. Ask for product #819.

To obtain hard copies of any of

these resources, contact the EMSC

Clearinghouse at (703) 902-1203 or

access the EMSC web site at

www.ems-c.org.

data and research findings, clinical

practice guidelines, and model systems.

EMSC wishes to congratulate 

all of the grant recipients, listed 

below by title, organization, and 

project director.

Analysis of the Impact of 

Economic Status and Health 

Insurance Status Upon Delivery of

EMSC, University of Utah, Anthony

Suruda, MD, MPH.

EMSC Child Care Risk Reduction

Initiative, Pennsylvania Department

of Health, Margaret Trimble.

Implementation and Evaluation

of a Support Group Network for the

Families of Severely Injured Children

Using Interactive Video at Regional

Sites in a Rural State, University of

Kentucky, Susan Pollack, MD.

Injury Prevention Resources for

Medical Care Providers, Loyola 

University of Chicago and Critical 

Illness and Trauma Foundation,

Thomas Esposito, MD, MPH.

Mental Health Services for Youth

Who Present to Emergency Departments for Self-destructive and 

Interpersonal Assault Injuries,

George Washington University, 

Tina Cheng, MD, MPH.

Outcome Assessment in 

Children Requiring Interfacility

Transport, University of Pittsburgh,

Richard Orr, MD.

School Health Emergency 

Assessment Program, Northwestern

University Medical School, Vidya

Chande, MD.

MCHB Increases Funding ••• •••

(from page 1) . . . . . . . . . . . . . . . 
h

j

pating in the first simultaneous, multi-site

cardiopulmonary

resuscitation

(CPR) training in

the United

States. Approximately 2,253

Florida residents received

the training and

a copy of the

EMSC-funded

handbook, How to

Handle and Prevent

Childhood 

Emergencies. For more

information, contact Janet

Tiberian via e-mail 

at jtiberian@nbhd.org.

New York

The Center for Pediatric Emergency Medicine (CPEM) is collecting

positive news stories, such as those

featuring doctors, nurses, and paramedics going beyond the call of duty

to save a child’s live, to inspire and

educate people about EMSC. The 

stories will be featured in “Making a

Difference,” an ongoing column

appearing in each issue of CPEM Bear

Facts. Please e-mail your article to

Marsha Treiber at mt31@is6.nyu.edu.

To view the latest issue of CPEM Bear

Facts, visit www.cpem.org.

North Carolina 

In September, North Carolina’s

EMSC hosted the American Association of Pediatrics’ field test of the new

Pediatric Education for Prehospital

Professionals (PEPP) course. North

Carolina will implement the new 

version in 2000. 

North Carolina is also conducting

a randomized, controlled study of

emergency preparedness in 50 

emergency departments throughout

10 EMSC News FALL ’99 

v

the state. An office preparedness 

manual will be available in the Spring

of 2000. For more information, 

contact Sue Hohenhaus via e-mail at

sue.hohenhaus@ncmail.net.

North Dakota

Between 1987 and 1996, North

Dakota had the second highest suicide

rate for adolescents between the ages

of 10 and 14, and the sixth highest

suicide rate for adolescents between

the ages of 15 and 19 in the United

States. As a result, the state’s EMSC

project is focusing its activities on

adolescent suicide prevention. An

Adolescent Suicide Prevention Task

Force has been established to write a

statewide prevention plan, which is

scheduled for completion this Fall. 

North Dakota also has trained

more than 900 emergency medical

technicians, using its Pediatric 

Prehospital Care Course; assisted with

the production of training videotapes

on child abuse and shaken baby 

syndrome; developed and distributed

basic and advance life saving equipment lists; and started analyzing state

ambulance-run report data and the

emergency department survey results.

For more information, contact Shelly

Arnold at (701) 328-2388 or (701)

328-1026 or via e-mail at

sarnold@state.nd.us.

Virginia

In September, Virginia’s EMSC

program worked in collaboration with

the Maryland EMSC program and the

Massachusetts EMSC continuing education program to conduct a pediatric

disaster life support (PDLS) train-thetrainer course in Leesburg, VA. The

course uses interactive lectures and

hands-on skills training to provide

information about triage, diagnosis,

treatment, equipment needs, communication with and transport of pediatric

State of the States •

Gr

antee Up ad oC et

nr er

•

State of the States •

Gr

a

ntee Up ad oC et

nr er

•

C

K

Alaska

Alaska’s Emergency Medical Services for Children (EMSC) program has

begun the preceptorship program for

pre-hospital emergency medical care

responders. During the 20- to 24-hour

course, pediatricians and pediatric

nurses provide hands-on pediatric

assessment training in a hospital pediatric unit. Fifteen EMS providers will

be selected from around the state to

participate in the course free of charge.

Three Anchorage hospitals have volunteered to participate as host sites.

At the state’s Annual EMS Symposium this November, several presentations will include discussion of pediatric care and EMSC. For more information, please contact Doreen Risley

at (907) 465-8633 or via e-mail at

drisley@health.state.ak.us. Additional

information can be found at

www.hss.state.ak.us/dph/ems/

ems_home.htm. 

Florida 

As part of its EMS Week activities,

Florida’s EMSC program helped make

history on May 22, 1999, by partici-
w

EMSC News FALL ’99 11

disaster patients, and the special 

psychosocial needs of pediatric

patients and their families and caregivers during mass casualties and 

critical incidents. 

The course was offered to EMS

personnel in Virginia, Maryland, and

Washington, DC, who were willing to

become PDLS trainers. For more

information, contact Melinda Duncan

at (703) 425-0080 or via e-mail at

melinda@vaems.org.

Washington

The Washington EMSC project’s

statewide survey of hospital pediatric

capabilities and its survey of CPR

training for public high school 

students are well underway. Project

staff are also busy completing a 

needs assessment resource guide,

which will be used to identify and 

prioritize gaps in pediatric emergent

care and prevention services. For

more information, contact Sheri 

Reder via e-mail at sreder@chmc.org.

T ennessee’s Emergency Medical

Services for Children (EMSC)

project presented information to

a national audience on EMSC’s state

and national efforts to reduce child

and youth death and disability during

Family Reunion 8: Family and Community, on June 21-22, 1999, at 

Vanderbilt University in Nashville,

Tennessee. Moderated by Vice President Al Gore and his wife Tipper, 

Family Reunion is an annual conference that strives to strengthen family

life in America.

At the request of the White

House, Tennessee’s EMSC Statewide

Project Coordinator Rhonda Phillippi,

RN, facilitated a roundtable discussion

on “Efficient Links Between People

and Neighborhoods: Transportation,

Communication and Access to Technology.” The need for accessible

nationwide emergency numbers, carefully coordinated transport services,

and programs that build relationships

among community members to help

address the unmet needs of children

in emergency situations were discussed.

“The roundtable was an excellent

opportunity to share information about

EMSC initiatives and to network with

other professionals and community

Tennessee’s EMSC Project Participates in Family Reunion 8

members who are

concerned with the

well-being of our

nation’s children,”

Phillippi said. 

The Tennessee

EMSC project was

spotlighted as an

example of how

families and 

communities can

influence public

policy. “Thanks to

EMSC’s initiatives

to bring community

members into public

policy, Tennessee now has one of 

the broadest legislative packages

regarding pediatric equipment and

provider education requirements,”

Phillippi said.

The Tennessee EMSC program

became involved with Family Reunion

through a partnership with Boost 4

Kids, a federal initiative championed

by the Vice President’s National

Partnership for Reinventing Government, which recognizes state and

local leaders who improve the lives

of children. 

For more information about

Tennessee’s EMSC project, contact

Phillippi via e-mail at Rhonda.Phillippi

@mcmail.vanderbilt.edu. To find out

more about Family Reunion and Boost

4 Kids, visit www.familyreunion.org.

Second Biannual

National Congress 

on Childhood Emergencies

March 27-29, 2000

(Annual EMSC Grantees Meeting: 

March 26-27)

Omni Inner Harbor Hotel

Baltimore, MD

For information, 

please call (202) 884-4927

Above: Tennessee EMSC Project 

Coordinator Rhonda Phillippi meets with

Vice President Al Gore. Above Left: 

Pictured from left to right are U.S. S

ecretary of Transportation Rodney Slater,

JD; Phillipi; and National Highway Traffic

Safety Administration Administrator Rick

Martinez, MD.
12 EMSC News FALL ’99 

••••••••••• •••••••••••YOUR QUESTION UESTION COUNTS!••••••••••• •••••••••••YOUR QUESTION COUNTS!

?

?

? •••••••••••YOUR QUESTION COUNTS!•••••••••••

Q: Why did the EMSC Grant

Submission Deadlines Change?

A:In previous years, the deadlinefor submitting EMSC and other

Maternal and Child Health Bureau

(MCHB) program grant applications

was designated for the early Spring.

Usually within two months after the

deadline, grant review panels met,

reviewed applications, and forwarded

their decisions to MCHB’s Grants Management Branch. During the summer,

Grants Management Branch worked

diligently to ensure that the grants

were awarded by September 30, the

end of the fiscal year. 

Last year, MCHB’s Grants Management Branch was directed to balance

its workload. As a result, many MCHB

programs, including EMSC, changed

their Fiscal 2000 application deadline

to November 1. In addition, the anticipated date of grant awards and project

start-up will change to March 1.

Future deadlines for grant applications

may vary by a week or two, but they

will always occur in the Fall. 

To comply with the new grant

deadline, nearly all state system grants

must submit a competitive proposal

for future funding during the Fall 1999

cycle. Implementation Grants in the

first or second year of funding and

Partnership and Targeted Issues

Grants in the first year of funding

were the only grants excluded from

competition for funds in Fiscal 2000. 

Q: What Is the EMSC Grant Review

Process for New Applications?

A:The grant review process usuallyconsists of five-steps:

Step One: Staff from the EMSC Program and MCHB Grants Management

check to ensure that each application

is complete and includes all of the

required information.

Step Two: Peer reviewers are recruited. Three panels of eight to ten peer

reviewers usually are needed for the

EMSC grant review process. Each

panel includes at least one EMSC

grantee, emergency physician, pediatrician, EMS state director, MCH

state director, nurse, and prehospital provider. 

Step Three: Completed applications

are separated into groups of 15 or 

20 and forwarded to a peer review

panel. A comprehensive review of

each proposal is performed by two 

to three peer reviewers. Each

reviewer prepares a written

evaluation based on the criteria

provided in the grant application

guidance. 

Step Four: The full panel reviews 

the peer reviewer evaluations and

discusses each proposal’s strengths

and weaknesses. Once completed,

the panel votes to approve or disapprove the proposal. If a specific

weakness is identified in a proposal,

the panel can make an approval

conditional upon meeting a specific

requirement. The applicant must

fulfill the condition before funding 

is awarded. The panel also may offer

recommendations to the applicant 

of an approved grant to help

improve the project, but they are

not mandatory.

Step Five: Approved proposals are

rated by each peer reviewer on a

scale of one to five, with one indicating the highest priority or greatest

importance. An average score is calculated, which becomes the ranking

score for funding. MCHB funds the

top-ranked proposals until the available funding is exhausted. 

EMSC policy prohibits a reviewer

from participating in the review of

any grant proposal of which he or

she has a conflict of interest

Roving Reporter

Arthur Cooper, MD, from the Center of Pediatric Emergency

Medicine, and Andrew Stern, a paramedic with the New York

State Department of Health, demonstrate the proper use of

bag valve masks on infants during a regional Teaching

Resource for Instructors in Prehospital Pediatrics (TRIPP)

train-the-trainer session at St. Luke’s EMS Training Center 

in Utica, New York.
Statistic of the Quarter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STATISTIC

EMSC News FALL ’99 13

O

n June 19, 1999, the Emergency

Medical Services for Children

(EMSC) Program presented three

national club and four state awards to

Junior members of the General Federation of Women’s Clubs (GFWC) for their

efforts to improve injury prevention and

medical care for the nation’s children.

The awards program, which began

last year, recognizes clubs that are

active in childhood injury prevention

projects as well as the provision of pediatric equipment and training for their

local EMS squads and hospitals.

“This collaboration shows that

members of voluntary communitybased organizations can be excellent

partners in the fight to keep our

nation’s kids safe,” said Ken Williams,

national field director of the EMSC

National Resource Center. “We owe a

lot of credit to Gail LeShane, chairman

of the GFWC Juniors’ Special Project,

and Maxine Scarbro, GFWC’s international president, who helped make this

partnership a reality.” Scarbro said that

“the work performed by Juniors’ clubs

in support of children’s health and safety is a real source of pride to GFWC.”

The three national award winners are:

Best Injury Prevention Project

The GFWC Junior Women’s Club of

West Deptford, New Jersey 

The West Deptford, New Jersey

club runs an annual “safety town”

event that addresses bicycle helmet

usage, car safety seats, and first-aid 

for children. They also donate funds

for local EMS providers to purchase

equipment.

Best EMS Equipment and

Training Project 

The GFWC Junior Women’s Club of

Cumberland, Maryland 

The Cumberland, Maryland club

raised $999 to purchase pediatric

equipment for their local ambulance

squad and hosted a “play festival” that

featured injury prevention information

and a State Farm 9-1-1 simulator. 

Best Hospital Equipment and

Training Project

The GFWC Junior Women’s Club of

Warwick, Rhode Island 

The Warwick, Rhode Island club

hosted and staffed a special banquet

that raised $175,000 for Hasbro Children’s Hospital. This club also received

an EMSC state award.

The state award winners are:

The Juniors of New Jersey

Approximately 345 Juniors donated more than 694 hours to car child

safety seat training.

The Juniors of Ohio 

Members distributed emergency

care guidelines to area schools and to

domestic violence and homeless shelters.

The Juniors of Tennessee

Members worked with a regional

medical center to equip and decorate 

a pediatric room in the emergency

department. They also shared information about EMSC with a local television

station and donated a variety of stuffed

toys, coloring books, and other “comfort” items to a local hospital.

The EMSC Program wishes to 

congratulate and thank all of the

award recipients.

Women’s Clubs Recognized for Support of EMSC

The average annual

incidence and mortality

of children and 

adolescents under 

the age of 17 involved

in traffic accidents in

Northern Manhattan

during preintervention

(1983-1988) and

intervention (1989-

1995) periods. 

Numbers shown are

incidents per 100,000

children.

<5 Years <5 Years 5-16 Years 5-16 Years

1983-1988 1989-1995 1983-1988 1989-1995

Pedestrian

Incidence 40.5 29.1 127.2 76.5

Mortality .6 1.3 3.4 1.7

Bicycle

Incidence 3.9 3.0 37.4 19.8

Mortality 0 0 0 0

Motor Vehicle Occupant

Incidence 5.6 11.7 25.5 19.3

Mortality 0 .9 .3 .6

Other and unspecified traffic

Incidence 1.7 3.5 2.1 8.1

Mortality 0 0 0 .4

All Traffic Injuries

Incidence 51.5 47.3 192.2 123.7

Mortality .6 2.2 3.4 2.8

Source: Barlow, B; Durkin, MS; Laraque, D; 

and Lubman, I. “Epidemiology and Prevention of

Traffic Injuries to Urban Children and Adolescents.”

Pediatrics 103:6 (June 6, 1999).
14 EMSC News FALL ’99 

Telehealth (from page 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

of lines generally are only used by

companies conducting business that is

built around the Internet or needing

to transfer massive amounts of data. 

A low-earth-orbit (LEO) satellite

system is comprised of a fleet of specialized wireless receiver/transmitters

that are placed in orbit around the

earth at a constant altitude of a few

hundred miles. The entire system

operates like a cellular telephone network except these wireless

receiver/transmitters move in space

rather than on the earth. A welldesigned LEO system can wirelessly

access the Internet from any point on

the planet using an antenna that is no

more sophisticated than old-fashioned

television “rabbit ears.”

Microwaves transmit and receive

information-bearing signals without

wires in a specific radio frequency

range. This technology is widely available, however, it has one major disadvantage. Signals are unable to penetrate dead zones, such as behind tall

buildings and in rural or remote areas. 

Emerging Telehealth

Technologies

Many federally funded projects

are demonstrating the value of “store

and forward” technologies, where digital images and video clips of patients

are e-mailed to a specialist for consultation. This practice is becoming

increasingly common in radiology,

dermatology, and ophthalmology. 

Another opportunity may exist

with the evolution of the hand-held or

“palm pilot” computer, which combines the portability of the traditional

day planner with the connectivity of a

desktop computer. Once the handheld computer is fully integrated with

cellular technologies it may provide a

portable, inexpensive way for prehospital providers to exchange information from the field. 

State Telehealth Activities

Several states have tested telehealth delivery systems to cut costs.

Alaska, North Dakota, and South

Dakota are establishing links between

rural health clinics and urban specialists utilizing one or more of the previously mentioned technologies. Georgia

and North Carolina are testing largescale hospital and university-based

systems, while Texas is utilizing telehealth for prison health care delivery.

Duke University in Durham,

North Carolina, is currently working

to integrate color-coding concepts and

tools into a palm pilot system with

3Com Corporation, a technology firm

that helps individuals and organizations worldwide to communicate

through voice, video, and data.

Trippler Army Medical Center in

Honolulu, Hawaii, is using its web site

to facilitate communications between

physicians and nurses practicing in

the Pacific Islands and specialists in

Hawaii. Any provider with access to

the web can link to the Center’s online

patient record database. The database

can include doctor’s notes, X-rays,

magnetic resonance imaging, digital

images of a patient, and much more.

In San Antonio, Texas a private

corporation is teaming up with a local

ambulance service to research, develop, and potentially implement a system

that provides high quality, bi-directional

video and audio linkages between the

prehospital care provider and the

receiving emergency department. This

technology allows the emergency room

physician to see the patient and, with

the help of the paramedic, assess and

treat the patient despite the fact that

they may be miles apart. At an estimated cost of $100,000 per ambulance,

this type of technology is still in the

futuristic category. 

It is too early to know when and

how the “magic telehealth bullet” will

be found. There are numerous issues

that can only be resolved through legislation and additional demonstration

and evaluation. In the meantime, NRC

will continue to track and report on

emerging telehealth trends. Specifically,

NRC will continue its work with the

Maternal and Child Health Bureau’s

Office for the Advancement of Telehealth and the Association of Telehealth Services Providers to stay

abreast of telehealth advances and

progress and to encourage continued

federal attention to and investment in

EMSC-related activities. NRC will also

continue to update the telehealth section of its web site and monitor the

major innovations in low orbit, cellular, and palm pilot technologies. Workshops on telehealth and telemedicine

will be featured at the Annual EMSC

Grantees Meeting and the National

Congress on Childhood Emergencies. 

Telemedicine vs. Telehealth 

“Telemedicine” is the provision

of clinical care and consultation

(including teleradiology, teledermatology, telerehab, etc.). “Telehealth” is

the broader concept incorporating

educational and conferencing opportunities for health care providers and

the general public. 

Telehealth uses communication

technologies to overcome barriers to

quality health care, such as distance

and time. At its most basic level, telehealth includes the use of telephones

and faxes for consultation and medical

control. Web sites, 1-800 hotlines, and

public television programs addressing

specific health concerns are all examples of a broader concept of telehealth.
EMSC News FALL ’99 15

••• ••• LATEST LIBRARY ADDITIONS DDITIONS DDITIONS••• •••LATEST LIBRARY ADDITIONS

• Neely, Keith and Norton,

Robert. “Survey of Health Maintenance Organization Instructions to

Members Concerning Emergency

Department and 911 Use.” Annals of

Emergency Medicine, 31(1), 19-24.

• Rivara, Frederick. (1999).

“Pediatric Injury Control in 1999:

Where Do We Go From Here?” Pediatrics, 103(4), 883-88.

• Sacchetti, Alfred; Brennan,

John; and Kelly-Goodstein, Nancy.

(1999). “Pre-Hospital Destinations for

Critically Ill Children.” Academic

Emergency Medicine, 6(5), 503-4.

• Tang, Nelson; Li, Guohua; DiScala, Carla; Meisel, Zachary; Levick,

Nadine; and Kelen, Gabor. (1999).

“Cardiopulmonary Resuscitation in

Pediatric Trauma Patients: Survival

and Functional Outcome.” Academic

Emergency Medicine, 6(5), 430.

• Wolfram, R; Timmel, Daniel;

Doyle, Cindy; Ackerman, Alice; and

Lebet, Ruth. (1998). “Incorporation of

a ‘Coping with the Death of a Child’

Module into the Pediatric Advanced

Life Support (PALS) Curriculum.”

Academic Emergency Medicine, 5(3),

242-46.

If an interesting publication or

product (written or produced within

the last 18 months) has crossed your

desk, please contact the EMSC

National Resource Center Librarian

Linda Pierce at (301) 650-8015 or via

e-mail at lpierce@emscnrc.com.

Notices or copies of journal articles,

books, videos, and reports on EMSCrelated topics should be mailed to:

EMSC National Resource Center,

Linda Pierce, 111 Michigan Avenue,

NW, Washington, DC 20010-2970.

Notable EMSC-Related Articles:

• Alessandrini, Evaline; Lavelle,

Jane; Grenfall, Stephanie; and Shaw,

Kathy. (1999). “Return Visits Within

48 Hours to A Pediatric Emergency

Department (PED).” Academic Emergency Medicine, 6(5), 464.

• Andazola, John and Sapien,

Robert. “The Choking Child: What

Happens Before the Ambulance

Arrives?” Prehospital Emergency

Care, 3(1), 7-10.

• Atkins, Dianne; Hartley, Lori;

and York, Douglas. (1998). “Accurate

Recognition and Effective Treatment

of Ventricular Fibrillation by Automated External Defibrillators in Adolescents.” Pediatrics, 101(3), 393-97.

• Baker, Chris; Kadish, Howard;

and Schunk, Jeff. (1999). “Evaluation

of Pediatric Cervical Spine Injuries.”

American Journal of Emergency Medicine,17(3), 230-234.

• Durkin, Maureen; Laraque,

Danielle; Lubman, Ilona; and Barlow,

Barbara. (1999). “Epidemiology and

Prevention of Traffic Injuries to Urban

Children and Adolescents.” Pediatrics,

103(6), 1273-74.

• Hostetler, Mark and Davis,

Colleen. (1999). “Research Training in

Pediatric Emergency Medicine Fellowships: A National Survey.” Academic

Emergency Medicine, 6(5), 411.

• Knight, Stacey; Vernon, Donald;

Fines, Robert; and Dean, J. (1999).

“Prehospital Emergency Care for Children at School and Nonschool Locations.” Pediatrics, 103(6),1276-77.

• Mulligan-Smith, Deborah;

Puranik, Subhash; and Coffman, Sherrilyn. (1998). “Parental Perception of

Injury Prevention Practices in a Multicultural Metropolitan Area.” Pediatric

Emergency Care, 14(1), 10-14.

EMSC Addresses the Injury

Prevention Needs of Children

with Special Health Concerns

According to data from the

National Pediatric Trauma 

Registry:

• Children with pre-existing chronic

illness like asthma, diabetes, and

seizure disorders are at the same risk

of injury as children without chronic

illness;

• Children with pre-existing physical limitations appear to have some

special issues related to injury; and 

• Children with pre-existing cognitive, social, and emotional limitations

had a significantly higher rate of injury

than their peers without limitations. 

Although this data is not population-based, when coupled with information from teachers and injury prevention specialists, it indicates that

children and adolescents with special

health care needs are at a greater risk

of injury. 

Despite the increased risk, parents

of special needs children rarely receive

general injury prevention information.

Prevention messages are written primarily for parents of healthy children. 

To address this lack of information, the Emergency Medical Services

for Children (EMSC) Program organized the Injury Prevention for Children with Special Health Care Needs

Work Group. 

To date, the group has produced

two fact sheets, Injury Prevention

Information For Children With Special

Health Care Needs and Children With

Special Health Care Needs: Information

For The Injury Prevention Community.

To obtain copies of the fact sheets or to

share additional information, contact

Ms. Wayne Neal at (301) 650-8281 or

via e-mail at wneal@emscnrc.com.
n

1999-2000

BULK RATE

Postage and

Fees

Paid HRSA

Permit No. G-286

EMSC National Resource Center

Children’s National Medical Center

111 Michigan Avenue, N.W.

Washington, DC 20010

October 

Child Health Month

Contact: American Academy 

of Pediatrics at

(847) 228-5005

October 9-11

American Academy of Pediatrics 

Annual Meeting

Washington, DC

Contact: Marisa Goldberg

(847) 981-4321

October 11-14

American College of Emergency 

Physicians Scientific Assembly

Las Vegas, NV

Contact: Dana Bellantone at 

(972) 550-0911, Ext 3273

October 13

Emergency Nurses Day

Contact: Emergency Nurses Association

at (800) 243-8362

October 15-17

Region II EMS Annual Conference

Las Cruces, NM

Contact: (505) 528-5059

October 28-30

American School Health 

Association Conference

Kansas City, MO

Contact: Robert Synovitz at 

(504) 429-8787

November 7-11

American Public Health Association

Annual Meeting

Chicago, IL

Contact: Lynn Schoen at 

(202) 777-2742

November 21-27

National Family Caregivers Week

Contact: Angela McArdell or 

Suzanne Mintz at

(800) 896-3650

December 2-4

1st Annual Federal Interagency 

Conference on Traumatic Brain Injury

Bethesda, MD 

Contact: Cynthia Harrison at 

(313) 745-1188

January 6-8

National Association of EMS 

Physicians Annual Meeting

Dana Point, CA

Contact: (800) 228-3677

January 17-20

American College of Emergency

Physicians Winter Symposium

Kauai, HI

Contact: (800) 798-1822

March 12-14

Lifesavers 18 National Conference 

on Highway Safety Priorities

Atlanta, GA

Contact: Mary Magnini at 

mmagnini@bellatlantic.net

March 26

EMSC Annual Grantee Meeting

Baltimore, MD

Contact: EMSC National Resource

Center at (202) 884-4927

March 27-29

2000 National Congress on 

Childhood Emergencies

Baltimore,MD

Contact: EMSC National Resource

Center at (202) 884-4927

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