EMERGENCY MEDICAL SERVICES FOR CHILDREN NEWSLETTER

news

VOLUME 14, NO.4, JULY/AUGUST 2001

HRSA Announces New Trauma/Emergency

Medical Services Program 

T

he 106th Congress appropriated $3 million to the Health Resources and Services Administration (HRSA) for fiscal

year (FY) 2001 to “improve the nation’s overall emergency medical system, including the

joint efforts between HRSA and the National

Highway Traffic Safety Administration

(NHTSA) to assess state systems and recommend improvements to the current system.”

HRSA’s Maternal and Child Health Bureau

(MCHB) and Office of Rural Health Policy

(ORHP) and NHTSA will co-administer this

effort. The goal is to promote a comprehensive system for the delivery of high-quality

trauma care services nationwide.

The principal activities to be conducted

during FY 2001 include:

1. Conduct a State-by-State Trauma Systems

Needs Survey;

2. Organize and staff a national stakeholders

group on trauma/EMS systems;

3. Focus on the special needs of rural communities by fostering relationships with

the State Offices of Rural Health and

Offices of EMS, as well as by conducting a

demonstration project on rural access to

automatic external defibrillators;

4. Conduct a national public awareness initiative; and

5. Facilitate the creation of or enhance an

existing comprehensive trauma/EMS data

system.

EMSC Welcomes New Federal Staffer

T

he Maternal and Child Health Bureau

recently hired Dan Kavanaugh, MSW,

LCSW-C, as a project officer for the

Emergency Medical Services for Children

(EMSC) Program. His primary responsibility

will be to work closely with EMSC Program

Director Cindy Doyle, RN, in providing the

highest level of customer service and technical assistance to EMSC grantees. His hiring is

a part of an overall effort to ensure that professionals in EMSC have the skills, knowledge, and resources necessary to provide

quality care to those experiencing a crisis.

According to Kavanaugh, his main challenge in taking this position is applying the

clinical knowledge that he’s gained over the

years to the larger

public health system. “Coming as I

did from the largest

biomedical

research facility in

the world, one has

to quickly learn

how to negotiate many complex systems and

how to help families negotiate these same

systems,” said Kavanaugh.

Kavanaugh began his health care career

in 1991 at the University of Maryland Medical

Systems providing clinical social work services to pediatric patients and their families.

The following year, he entered the U.S. Public

Continue on page 2

Continue on page 3

INSIDE THIS

ISSUE

Page 2

John Nance to Keynote

National Congress

Page 3

EMSC to Assist in 

2002 Winter Olympics

Page 5 

Hospitals Lacking Pediatric

Expertise

Page 6 

Delaware Develops New

Paramedic Programming

Page 6 

MCHB Awards New Grants

Page 13

TBI Center Provides Focal

Information

Page 15 

NHA Winners Announced

Dan Kavanaugh
EMSC Program Project Officer, MCHB

Cindy Doyle, RN, BSN, MA

Dan Kavanaugh, MSW, LCSW-C

Director, EMSC National Resource Center

Jane Ball, RN, DrPH

Communications Director

Millree Williams

Managing Editor

Suzanne Sellman, MA

Editor

Donna Frassetto

Contributing Writers

Leslie Green

Rhonda Willingham, MA

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 six times a year

by the EMSC National Resource Center,

111 Michigan Avenue, NW, Washington,

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

202/884-6845 (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. 

© 2001 EMSC Program. All rights reserved.

T

he third National Congress on

Childhood Emergencies, scheduled for April 15-17, 2002, in

Dallas, TX, will feature internationally

recognized air safety analyst and advocate John Nance as the keynote speaker for the Opening General Session.

Nance is best known to North American television audiences as the aviaABC News Consultant John Nance to Keynote 2002

National Congress

tion analyst for the ABC television

network and as the aviation editor for

Good Morning America. 

Nance will provide an exciting

presentation on the comparison

between improving airline safety and

patient safety. This presentation will

be an excellent way to launch the

conference theme Taking Action, Saving Lives. 

Before joining ABC, Nance had

delivered more than 3,000 newscasts

on radio and television, including

three years with ABC affiliate WFAA

in Dallas. He has also appeared on

MacNeil-Lehrer News Hour, CBS

Evening News, Nova, Oprah, Larry

King Live, and many other local and

national shows.

In addition to his broadcast

career, Nance is an author of 10 books

and two editorials for The Los Angeles

Times and USA Today. Six of his

books are bestsellers, including Final

Approach, Scorpion Strike, Phoenix

Rising, The Last Hostage, Pandora’s

2 EMSC News JULY/AUGUST 2001 

New Federal Staffer, from page 1

Clock, and

Medusa’s

Child. The latter two both

aired as major,

successful twopart miniseries on television. 

Nance is a decorated Air Force

pilot and a veteran of Vietnam and

Operation Desert Shield/Desert Storm.

He serves as a lieutenant colonel in

the Air Force Active Reserve, and

remains involved in flight safety education for the Air Force. Nance has

extensive flight experience, having

piloted many jet aircraft, including

Boeing 727s, 737s, 747s, and Air

Force C-141s. He has logged more

than 13,000 hours of flight time in his

commercial airline and Air Force

careers. 

Nance is one of several featured

speakers scheduled to present at the

2002 Congress. Information about

other speakers and conference programming will be featured in future

John Nance

Health Service as a commissioned

officer and subsequently worked at

the National Institutes of Health’s

(NIH) Clinical Center in Bethesda,

MD. During his tenure at NIH, his primary role was the provision of psychosocial services to patients and

their families participating in clinical

trials. In this position, Kavanaugh’s

emphasis included working with children diagnosed with rare genetic illnesses, most of whom had multiple,

complex needs and frequent interaction with various health care systems.

He helped to ensure that the health

care needs of these children were

being managed well in their local community.

Kavanaugh was instrumental in

developing the NIH Clinical Center’s

Department of Social Work Education

Forum, and received the NIH Clinical

Center Director’s Award for his work

as a member of the Head and Neck

Cancer Interdisciplinary Care Team.

In addition, he has spoken locally and

nationally on utilizing a strengthsbased assessment approach in the area

of psychosocial patient care.

Kavanaugh can be reached at

(301) 443-1321 or dkavanaugh@hrsa.gov.
EMSC to Assist Organizers of 2002 Winter Olympics

EMSC News JULY/AUGUST 2001 3

Recently, Utah’s Brian Garrett,

director of the EMS and Fire

Office for the 2002 Winter

Olympics, approached the Emergency

Medical Services for Children (EMSC)

Program to request assistance in

preparing the state’s prehospital

providers and volunteers to respond to

potential medical emergencies involving children during the Winter Games.

“We will have thousands of children at the various venues. Some of

them will be competitors and others

observers,” said Garrett. “Our medical

staff and the hundreds of volunteer

EMS personnel need to be adequately

prepared to treat ill or injured children

of all ages.”

Utah EMSC Project Coordinator

Breck Rushton and his co-workers

have been extremely aggressive in

educating the International Olympic

Committee, the U.S. Olympic Committee, and the Utah Olympic Committee about the special training needed to prepare health care providers for

pediatric medical emergencies. Utah’s

EMSC program has rallied the

resources of the EMSC National

Resource Center to help conquer this

endeavor. 

With the Center’s help, Rushton

and his staff carefully reviewed the

EMSC Product Catalog to determine

the best products to meet the specific

parameters of the task. Approximately

20 different products were selected on

topics ranging from assessment and

airway management to trauma and

disaster preparedness. Fifty copies of

each product were shipped to the Utah

Department of Health, the home to

both the Utah EMSC program and the

2002 Utah Olympic EMS and Fire

Office. 

Utah’s EMSC program will assist

in disseminating the products and

conducting training sessions throughout the state. “We are very excited to

receive the additional resources,” said

Rushton. “We have such a short time

frame to train these providers.” The

resources–-most of which are designed

as self-paced learning tools (i.e., CDROMs)—will enable Utah’s EMSC program to reach those who are unable to

attend the training sessions.

“Providers of all levels can use

many of these resources on their own

time as long as they have access to a

computer,” said Rushton.

New Trauma/Emergency Medical Services Program, from page 1

Trauma Systems Need Survey

Currently, work is underway to

develop a 15- to 20-question needs

survey tool for states to use to collect

baseline data on trauma system development. Emergency Medical Services

for Children (EMSC) grantees that are

interested in utilizing this survey and

realize the importance of integrating

trauma services into the delivery of

care nationwide are eligible to receive

$35,000 - $40,000. The funding is

designed to help EMSC grantees convene a meeting involving representatives from their state EMS agencies,

Office of Rural Health, and trauma

community for the purpose of collaborating on the implementation of the

assessment survey.

Information collected from the

survey will be used to help develop

federal funding strategies to assist

states in their efforts to enhance trauma care, to assure access to trauma

services in rural and geographicallyisolated areas, and to encourage system development and collaboration.

An official notice of funding is

expected to be available in late July or

early August. The grant guidance is

now available from MCHB’s web site at

www.mchb.hrsa.gov. To facilitate the

application award process, MCHB has

received permission to supplement

existing EMSC grants. It is anticipated

that the Notice of Grants Awards will

be available in late September 2001.

For questions regarding technical

and program issues, eligibility, or

assistance in preparing a request, contact MCHB’s Rick Smith, MS, at (301)

443-5372 or rsmith@hrsa.gov; ORHP’s

Jennifer Riggle, JD, at (301) 443-7530;

or NHTSA’s Jeff Michael, EdD, at (202)

366-4299 or jmichael@nhtsa.dot.gov.

For assistance with grant management

aspects of your application, requirements and budgets, contact Ms. Mickey Reynolds at (301) 443-0724 or

mreynolds@hrsa.gov.

Editors Note: Within MCHB, the

Injury/EMS Branch is responsible for

the following programs: Traumatic

Brain Injury, Injury/Violence Prevention, Poison Control Centers, Trauma

Care Systems, and EMSC. This article is featured in this edition of EMSC

News because of its timely nature

and the issues of mutual concern to

the EMSC program and our grantees.
T

he Emergency Medical Services

for Children (EMSC) Program’s

National Public Information and

Education (PIE) Campaign has taken

another step toward reaching its

national goal of educating the general

population—especially parents—about

the importance of being prepared for a

pediatric emergency. 

Last Fall, EMSC, in cooperation

with a range of government, national,

and professional organizations,

launched its three-year campaign with

the release of the Pediatric Emergency

Care Resource Kit for emergency

medical services (EMS) professionals.

The comprehensive kit was designed

to give professionals the tools they

need to provide state-of-the art pediatric emergency care. It was also

designed to help evaluate and bring

organizations, communities, and

states into compliance with accepted

standards for pediatric emergency

care. The kit, produced in CD-ROM

format, contains more than 2,000

pages of critical information on pediatric injury and illness prevention,

treatment, and rehabilitation. 

Following the kit’s successful

release, EMSC began to implement

phase two of the campaign: gauging

public awareness of and preparedness

for effectively handling pediatric

emergencies. This phase

National PIE Campaign Moving Forward 

would be more successful, print or

broadcast advertising? 

Although all messages seemed to

motivate interviewees to create a preparedness plan for emergencies related to their children, most participants

leaned toward those that use a positive approach and provide more specific references to the concept of “preparedness.” 

There were mixed feelings about

statements that hinged on guilt as a

motivating factor. Whereas some

admitted that guilt does provoke parents to act, many felt that a positive

message would do a better job. Focus

group results also indicated that many

people thought they were prepared for

an emergency but in reality were not.

Questions such as “Do you know your

child’s blood type?” and “Do you

know which hospital(s) in your community is most capable of treating

children?” served to open participants’ eyes to the components of a

detailed plan.

The EMSC Program is currently

reviewing the preliminary results of

the focus groups. The next step is to

turn this research into a range of communication strategies, tactics, and

tools that will be most effective in

educating a national audience about

this very critical issue.

Information on the next step in

this effort will be forthcoming. 

will focus on reaching out to parents,

caregivers, and children. It will

emphasize prevention methods and

preparation for pediatric emergencies,

such as identifying illness warning

signs, choosing the most appropriate

hospitals for pediatric emergencies,

and implementing guidelines for treating ill or injured children. 

To this end, a series of 12 onehour focus groups were conducted to

assess the levels of awareness and preparedness among parents regarding

pediatric emergencies. The focus

groups—eight in general markets and

four in Hispanic markets—were conducted in six U.S. cities: New York

City, NY; Chicago, IL; Jackson, MS;

Seattle, WA; Minneapolis, MN; and

Tampa, FL.

The general market participants

included a mix of ethnicities reflective

of the general population, and the Hispanic market included a mix of countries of origin. Each group had

approximately six to eight participants of both sexes and varying ages

and income levels, with at least a high

school degree or general equivalency

degree (GED), one child under age 16

at home, as well as a set of other key

demographic parameters. 

The participants tested a range of

messages and concepts to

determine which would resonate. Would messages

laced with guilt be more

effective than ones with a

positive spin? Would participants be most responsive to messages related

to parenting skills?

Should the messages be

quick, concise, and

proactive? Would radio

or television be more

or less effective in certain communities? Which

4 EMSC News JULY/AUGUST 2001
cut here

Printed with permission from Steve Berry.

Astudy published in the June

2001 issue of Pediatric Emergency Care found that the

majority of hospitals that usually

admit pediatric patients do not have

separate pediatric facilities. According

to Jean Athey, PhD, lead author of

“Ability of Hospitals to Care for Pediatric Emergency Patients,” nearly 10%

of hospitals without pediatric intensive care facilities admit critically

injured children to their own facilities.

Likewise, 7% of hospitals routinely

admit pediatric patients known to

require intensive care to their adult

intensive care units rather than transferring these patients to a facility with

pediatric intensive care services.

The Emergency Medical Services

for Children Program funded the

study—using the Consumer Product

Safety Commission’s National Electronic Injury Surveillance System

(commonly referred to as NEISS)—to

help evaluate hospital preparedness

on a national basis.

Other findings include:

• Less than half (47%) of hospitals

without pediatric intensive care

units have written transfer agreements with facilities containing

pediatric intensive care units.

• Approximately 76% of U.S. hospitals

care for pediatric emergencies in

the adult/pediatric combined emergency department (ED), 18% in the

adult ED, and 7% in a separate pediatric ED.

• Only 23% of U.S. hospitals reported

that they had a pediatric emergency

physician in-house or on call 24

hours a day. However, pediatricians

were available in 64% of EDs.

• Equipment for infants and children

was more likely to be missing than

adult-sized equipment; for example,

43% of hospitals indicated that they

did not have cervical collars for

infants, whereas only 5% did not

have adult-sized cervical collars.

Study Finds Children Admitted to Hospitals

Lacking Pediatric Expertise The editors of EMSC News want to

make sure you don’t miss a single

issue. If you have recently moved or

the contact person for your organization has changed, please let us

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EMSC National Resource Center,

111 Michigan Avenue, NW, 

Washington, DC 20010.

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EMSC News JULY/AUGUST 2001 5
actual histories and physical assessments, and honing their communication skills with a variety of age

groups,” said Delaware EMSC Project

Coordinator Marie Renzi, RN. “With

the high volume of children in the

pediatric office, prehospital providers

can be assured they will have direct

contact with at least four or five 

children during this time period.” 

The program, which will begin on

a voluntary basis, will help paramedics

meet their required biannual 72-hour

continuing education requirement.

Parents who agree to participate in the

program will be required to sign a consent form. Paramedics will not be

allowed to perform any invasive procedures in the physician’s office.

For more information about PCAP,

contact Renzi at (302) 739-6637 or

mrenzi@state.de.us.

Delaware Develops Innovative Program to Enhance Paramedics’ Pediatric Skills

MCHB to Award Pediatric Patient Safety Grants

L

ast year, Delaware paramedics

responded to approximately

30,000 advanced life support

calls. Of those, only 3,000 were pediatric related. According to State Paramedic Administrator Steven Blessing,

prehospital providers throughout the

state, especially those serving rural

areas, do not see enough children to

feel comfortable in treating them. “It

may be months between pediatric

contacts,” said Blessing.

To improve comfort levels in

assessing ill and injured children,

Delaware paramedics will be breaking

ground in a new clinical setting. Starting this September, paramedics will

rotate through local pediatrician

offices to get “hands-on” pediatric

experiences for recertification. This

innovative initiative, known as the

Pediatric Clinical Assessment with

Pediatricians (PCAP) program, guarantees that prehospital providers will

have direct clinical contact with chilI

n May, the Health Resources and

Services Administration’s (HRSA)

Maternal and Child Health Bureau

(MCHB) announced it would be

awarding two Enhancing Pediatric

Patient Safety (EPPS) demonstration

grants to support the assessment

and/or implementation of an existing

strategy or tool with the potential to

improve patient safety in pediatric

emergency care delivery in multiple

prehospital and hospital emergency

department settings. A total of

$500,000 has been set aside to fund

the two projects for up to a three-year

project period.

dren. Historically, emergency departments (EDs) served as the pediatric

training ground for paramedics. In

Delaware, however, pediatric interactions during clinical time in the ED

are a hit-or-miss prospect. 

To ensure success of the program,

Delaware’s Division of Public Health is

working in collaboration with the

Alfred I. duPont Hospital for Children.

The hospital has a network of 10 pediatric primary care practices in medically underserved areas throughout

the state. Delaware’s Emergency Medical Services for Children (EMSC) program is working with these practices

to implement its Office Preparedness

program, a performance improvement

project that includes mock codes,

policies for standardizing emergency

equipment and medications, and

model emergency care protocols. 

“The plan is for the paramedics

to spend four hours with a pediatrician or nurse practitioner, completing

6 EMSC News JULY/AUGUST 2001

The issue of patient safety has

generated much concern since the

publication of the Institute of Medicine’s (IOM) report To Err Is Human

in November 1999, and subsequent

articles in medical journals and the

mass news media. The IOM report

highlighted one critical aspect of

health care quality—the ability of the

system to render care to the patient

without causing injury in the process.

The report synthesized the available

evidence on patient safety and noted

that medical errors are a leading

cause of death and injury. 

Currently, there are few well-tested strategies for improving patient

safety for children receiving emergency care. One tool MCHB is interested in testing is the pediatric colorcoded system, which allows access to

accurate precalculated medication

doses and equipment sizes and emergency treatments for critically ill and

injured children. 

More information about the EPPS

grants, which will be awarded on September 26, will be featured in a future

issue of EMSC News. 
••• •••PUBLIC POLICY NETWORK••• •••

Congress Approves Fiscal Year

2002 Budget Outline

The Senate and the House of Representatives have approved a budget

resolution containing nearly $2 trillion

in federal spending for fiscal year 2002

(FY02), which begins on October 1,

2001. The broad budget plan calls for

a 4% increase in spending for FY02

and permits $1.35 trillion in tax cuts

over the next 11 years. The budget

outline adopted by both chambers

closely resembles what President

George W. Bush proposed in his budget on April 9, 2001.

The budget resolution, H.Con.Res.

83, does not require the President’s

signature and, therefore, lacks the

force of law. Essentially, it is a nonbinding planning tool that sets boundaries for tax and appropriations legislation this year. Congress may ignore

its budget blueprint, however, and

exceed limits on spending and taxes.

PUBLIC POLICY NETWORK

Sustaining Access to Vital

Emergency Medical Services Act

of 2001 

On March 21, 2001, Senator Kent

Conrad (D-ND) introduced the Sustaining Access to Vital Emergency

Medical Services Act of 2001. The bill

(S.587) seeks to uphold access to vital

emergency medical services in rural

areas. Additionally, S.587 would award

grants that would improve EMS training and equipment assistance in rural

areas and require the prudent layperson standard for emergency ambulance services under Medicare and

Medicaid. 

The bill, which has six co-sponsors, was referred to the Committee

on Finance where it awaits further

action. 

If you have questions about these

or other legislative matters, contact 

a member of the EMSC National

Resource Center’s public policy staff

at (202) 884-4927. 

I

t began as an idea. It’s become a

movement. On October 2, 2001,

the world celebrates International

Walk to School Day. It’s a chance to

teach kids and their parents to think

of walking as both a form of exercise

and a safe means of transportation.

The Evolution

In 1997, the Partnership for a

Walkable America sponsored the first

National Walk Our Children to School

Day in Chicago, IL. Back then, it was

simply a day to bring community 

leaders and children together to make

a community more walkable. Last

year, 2 million children, parents,

teachers, and community leaders in

cities and towns around the world had

celebrated the first International Walk

to School Day. 

The Issue

The reasons for walking have

grown just as quickly as the event

itself. Thanks to lifestyles that favor

convenience over activity, children

have become increasingly sedentary.

This holds particularly true in the U.S.

where one child in four is obese. Exercise habits formed in childhood are

likely to carry over into adulthood, so

children should begin forming healthy

habits now.

Children are also some of the

most vulnerable users of our streets.

For example, in the U.S. children less

than 15 years of age represent only

15% of the population but make up

30% of pedestrian injuries. Instilling

good safety skills, such as looking both

ways before crossing the street, obeying street signs, and walking on sidewalks, teaches children not only to

become better pedestrians, but also to

become pedestrian-considerate

motorists when the time comes. 

Getting Started

If you are interested in sponsoring a Walk to School Day event in

your community, begin planning now.

First, choose your school(s) and get

your event partners lined up. Recruit

the participation of key community

leaders, sports figures, or other

spokespersons. Second, register your

event on the Walk to School web site

(www.walktoschool.org) to obtain regular e-mail updates. While at the site,

take the time to download the free

resources available to help make your

event a success. Last, and most important, spread the word. Let everyone in

your community know about the

event and the importance 

of their participation.

Whether your concern is healthier habits, safer and improved streets

and sidewalks, or cleaner air, Walk to

School Day events are aimed at bringing forth permanent change to

encourage a more walkable America—

one community at a time. For more

information, contact Laurie Flaherty

at the National Highway Traffic Safety

Administration’s Office of Communications and Outreach at (202) 366-

2705 or lflaherty@nhtsa.dot.gov.

Plan to Celebrate 

International Walk 

to School Day

EMSC News JULY/AUGUST 2001 7
8 EMSC News JULY/AUGUST 2001

developed. I had experienced a previous miscarriage, and was petrified at

the thought of losing another baby.

The doctors advised me against

pain medication so that the baby

would have a fighting chance. I was,

however, given an injection of

Betamethasone, a steroid medication

to promote the development of her

lungs. Moments later, I pushed and

could hear the faint cries of my little

angel. There was sigh of relief as my

husband and I looked at each other

and then at our daughter, whom we

named Alesha Imani. The relief

quickly turned to panic as a herd of

nurses and doctors rushed into the

delivery room. The doctors shouted

out instructions, codes, numbers, and

medical terms as they quickly administered oxygen to my helpless baby

and whisked her away to the Neonatal

Intensive Care Unit (NICU).

Later that day, our doctor

explained that Alesha was doing well

for an infant her size, which, at the

time was only 1 pound 7 ounces. She

was every bit of a miracle. The staff

made sure that my husband and I

understood that Alesha would have to

stay on oxygen in the hospital for a

least another three months. Her conT

en percent of all pregnancies

result in premature birth. Unfortunately, four out of five women

arrive at the hospital too late for treatment. The risk of death for infants at

the gestational age of 23-24 weeks is

50%. And, for those who survive, there

is still a chance that the infant will

have a significant disability or handicap, including brain abnormalities,

chronic respiratory problems, or

blindness.

In 1998, with the help of Prince

George’s Hospital Center in Cheverly,

MD, I overcame the odds when I gave

birth 24 weeks into my pregnancy. I

often wonder what the outcome would

have been if the hospital staff had not

been trained in advanced life support

for infants. It was a great comfort to

know that when our baby’s birth suddenly became an emergency, highquality care was available.

As I recall, the last minutes were

like a freight train of pain ripping

through my body as I lay in the hospital delivery room. The neonatologists

on duty had just finished preparing

me for the outcome of my baby’s premature delivery. They said that my

baby had only a 50/50 chance of survival because her lungs were not fully

dition was stable, but could change

from better to worse at any time, and

it did.

During the ensuing, exhaustive

weeks, my family and I would make

daily trips to the hospital — sometimes twice each day. Faith, the support of family and friends, and the

expertise of the hospital personal got

me through those rough times, even

when our daughter experienced a collapsed lung.

The staff was very accommodating, supportive, and empathetic to our

situation. They always gave us the

hard facts in a caring and supportive

way— even an occasional hug.

With the exception of a few minor

scars from lifesaving medical procedures, our daughter finally came home

weighing a hefty four pounds. I carefully dressed her in a pink-flowered

dress that her grandmother handmade. My husband and I thanked the

NICU staff and bundled up our little

angel to take home.

Today, Alesha’s development is

where it should be, both physically

and mentally. We have the professionalism and caring at Prince George

Hospital Center to thank for that! 

—Leslie Green, communication’s

assistant, EMSC National Resource

Center 

Pediatric Expertise Helps Alesha Beat the Odds

F

ernando Daniels, MD, medical chief of

EMS for DC Fire addresses staff, parents, and emergency personal during

an event celebrating the first National EMSC

Day held at Children’s National Medical

Center in Washington, DC.

Roving Reporter
••••••••• ••••••••• •••••••••EMSC SYSTEMS SCOOP ••••••••• ••••••••• •••••••••

F

rom the initial grant that established the Emergency Medical

Services for Children (EMSC)

Program to the present, one of the

most difficult challenges facing all

pediatric emergency care advocates is

visioning for the future. Like the

proverbial “snowball,” we must continue to work diligently to be sure the

snowball neither comes to rest at the

bottom of the hill nor breaks up into

smaller, less effective pieces. With the

help of many talented individuals from

throughout the nation the process continues at an impressive tempo. 

Some of the highlights nationally

include:

The Emergency Information

Form (EIF). 

Jointly developed by the American

Academy of Pediatrics (AAP) and the

American College of Emergency Physicians (ACEP), the EIF is designed to

furnish health care providers with

needed medical information about a

child who has a special health care

need. Although the form has been

available for several years, the overall

implementation of the form has been

less than either group anticipated. In

an effort to increase its utilization

nationally, the EMSC Program sponsored a meeting of vested organizations. From all accounts, the meeting

brought forth significant discussion

and produced a number potential recommendations. These recommendations will assist AAP, ACEP, and EMSC

in their objectives regarding how to

best serve medically fragile children. 

The EMSC Research Network. 

The EMSC Research Network is a

$1.8 million initiative designed to create regional “hubs” or “nodes” that

will work collaboratively to gather evidence-based pediatric research information from around the nation.

Although many details continue to be

defined, a formal announcement

about the initiative is expected shortly. 

Clinical Practices in Emergency

Departments (EDs).

In June, experts in pediatric

emergency care came together to

begin the process of determining how

to continue to improve the clinical

practices in EDs caring for children.

Using the foundational work from

AAP’s Children in the Emergency

Department: Guidelines for Preparedness, efforts will be directed at moving pediatric and adolescent clinical

practice guidelines in the ED to the

next level. This effort will evolve into

another funded initiative slated for

release in early 2002. 

National EMS Database

Feasibility Study.

This new initiative is designed to

assist with the collection and utilization of emergency medical services

(EMS) data on a national scale. Currently, no such collaboration nor

repository exists by which prehospital

and ED information can be analyzed.

The National EMSC Data Analysis

Resource Center is working closely

with the federal EMSC Program and

the EMSC National Resource Center

to develop this initiative and bring it

to fruition. 

EMSC SYSTEMS SCOOP

EMSC News JULY/AUGUST 2001 9

Trauma/EMS Program. 

The Maternal and Child Health

Bureau’s Injury and EMS Branch is

working with the Office of Rural

Health Policy and the National Highway Traffic Safety Administration to

develop a new Trauma/EMS Program. 

The principle activities to be conducted by the new program include:

• A State-by-state Trauma Systems

Needs Survey;

• Organizing and staffing a national

stakeholders group on trauma/EMS

systems;

• Focus on the special needs of rural

communities by fostering relationships with the State Offices of Rural

Health and Offices of EMS as well as

by conducting a demonstration project on rural access to automatic

external defibrillators;

• Conducting a national public awareness initiative; and

• Facilitating the creation of or

enhancing an existing comprehensive trauma/EMS data system.

For more information about these

initiatives, read the corresponding

article on page 1 or contact Rick

Smith, MS, acting program director for

EMS/Trauma, at (301) 443-5372 or

rsmith@hrsa.gov.
Z

K

Florida

Florida Emergency Medical Services

for Children (EMSC) program. On

March 21, 2001, in commemoration of

Florida’s Emergency Medicine Day,

EMSC project staff exhibited at the

state capitol. On April 30 and May 1,

staff members provided 

implementation training to six county

Risk Watch

Springtime is a busy time for the

coalitions. Risk Watch

Risk Watch

is a

M

school-based injury prevention curriculum created by the National Fire

Protection Association. 

To help celebrate May 23,

2001, as the first National

EMSC Day, a copy of the

recently released Pediatric

Emergency Care Resource Kit

and the Broselow Pediatric

Emergency Tape were sent

along with a quiz to each Florida prehospital service. 

For more information

about these activities, contact

Melissa Bassett at Melissa_Bassett@doh.state.fl.us.

S

tate of the States

•

Gr

a

ntee Up ad oC et nr er

•

S

tate of the States

•

Gr

a

ntee Up ad oC et nr er

•

Hawaii

Hawaii reports that its paramedics

and emergency medical technicians

(EMTs) commemorated EMS Week and

EMS for Keiki (Children) Day in the

true spirit of aloha. It began with the

mayor’s recognition of outstanding personnel and included a bicycle helmet

giveaway event, a Keiki identification

booth, informational displays, ambulance demonstrations, medical screenings, and a hands-on emergency vehicle exhibition. 

Entertainment included Hawaii’s

unique cardiopulmonary resuscitation

hula and performances by talented

emergency medical service (EMS)

musicians. 

For more information, contact

Lois Sugai at lasugai@mail.health.

state.hi.us.

Mississippi

The Mississippi EMSC program is

currently in its third year of implementation. Since funding became

available, EMSC project staff have

trained more than 800 health professionals using the Training in Pediatric

Education for Prehospital Professionals (PEPP) course and approximately

1,500 health professionals using the

Basic Trauma Life Support course.

Both courses have been offered at no

cost to participants. 

On the injury prevention front,

Mississippi is collaborating with the

state’s Department of Education and

Trauma Care System in an effort to

increase awareness of the Risk Watch

curriculum and its availability to

schools. More than 20 schools are now

using Risk Watch at no cost. In addition, EMSC staff are collaborating with

the Mississippi Poison Control Facility

to collect pediatric-specific poison

data that will be used to develop targeted poison prevention messages and

activities.

For more information about these

activities, contact Keith Parker at

kparker@msdh.state.ms.us.

10 EMSC News JULY/AUGUST 2001

On March 21, 2001, in commemoration of Florida’s

Emergency Medicine Day, EMSC state project staff

exhibited at the state capitol.
k

h

Statistic of Importance . . . . . . . . . . . . . . .

ter for Pediatric Emergency Medicine’s

(CPEM) National Child Protection Education Project will hold a meeting in

Washington, DC, to bring together the

EMSC and child protection communities. Based on data analyzed from

CPEM’s national survey of EMTs and

New York

On October 10-11, 2001, the Cen- q

paramedics, participants will create an

educational blueprint to train prehospital providers in the recognition,

treatment, and reporting of child abuse

and neglect. 

In other news, the Paramedic

TRIPP (Teaching Resource for Instructors in Prehospital Pediatrics) will be

available this Fall. For further information, go to www.cpem.org. 

Ohio 

Ohio reports that it has conducted

two PEPP courses and several PEPP

instructor courses. The new instructors are charged with institutionalizing

PEPP within their hospitals and providing regularly scheduled courses. 

Ohio also reports that the revised

Emergency Guidelines for Schools is

now available through its web site.

Through its EMSC partnership grant

Ohio is providing 18 EMS agencies

with funds to implement communitybased injury prevention projects. In

addition, project staff have recently

completed regional injury prevention

trainings for EMS providers in five

locations throughout Ohio. 

For more information on these

projects, go to www.state.oh.us/odps/

division/ems/ems_local/emsc/EMSForChildren.htm or contact Christy

Beeghly at cbeeghly@dps.state.oh.us. 

EMSC News JULY/AUGUST 2001 11

y South Dakota

On April 19, 2001, the Heartland

EMS for Children Coalition (HECC)

held its Annual Meeting in Bismarck,

ND. The meeting was hosted by the

North Dakota EMSC and held in conjunction with the North Dakota EMT

Conference. 

Highlights of the meeting included

state project reports from Nebraska,

North Dakota, South Dakota, Minnesota, Iowa, and Kansas; program updates

from the Maternal and Child Health

Bureau and the EMSC National

Resource Center; and informational

presentations on collaborating with

school nurses and family advocates.

For more information about this

meeting or HECC, contact Dave Boer

at (605) 333-6652 or boerd@siouxvalley.org.

Wisconsin

The Wisconsin EMSC program

collaborated with the state’s Bureau of

EMS and Injury Prevention and

Bureau of Transportation Safety on a

statewide children’s drawing contest

to commemorate EMSC Day 2001. 

EMS services, fire services, law

enforcement agencies, nurses, physicians, parents, grandparents, and anyone involved in the care of children

were encouraged to work with their

local schools and child care centers 

to have children of various ages draw

pictures related to emergency care,

injury prevention, and transportation

safety. 

The drawings will be used to

develop products to decorate the walls

and tables at the Second Annual Wisconsin Childhood Emergencies Conference to be held at the Kalahari

Resort and Conference Center from

October 14 -15, 2001. 

For more information about this

activity, contact Mary Jean Erschen at

(608) 266-7457 or erschmi@dhfs.

state.wi.us.

Estimated number of nonfatal injuries treated in hospital emergency

departments, by age, U.S., 2000

Age Group (years) Nonfatal Injuries (Percent 

of total population)

0–4 2,587,021 (8.4%)

5–9 2,411,708 (7.8%)

10–14 2,696,014 (8.8%)

15–19 3,327,434 (10.8%)

20–24 3,071,245 (10.0%)

STATISTIC OF IMPORTANCE
consent requires conditions that are

free of coercion and undue influence.

Potential participants also must not

feel like their treatment will be compromised if they do not participate.

For example, if a physician asks a

patient if they would like to participate in a research they are doing and

the patient declines, they should not

feel as if their right to good and 

competent care is compromised in

any way.

One particular concern about

obtaining written informed consent in

EMS is the nature of emergency situations that are not conducive to paperwork. The Code of Federal Regulations, CFR 21 Part 50, section 50.24,

specifies the requirements for exception from informed consent for emergency research. The Federal Drug

Administration recently released a

draft document providing guidance

for implementing the rules. In those

circumstances in which waiver of the

written consent requirement is not

appropriate, other strategies for

streamlining the consent process

might be possible. The consent form

does not necessarily need to be a

multi-page document. 

Some researchers have had success

with a two-step process involving a

structured verbal consent in the field

followed by formal written consent

once the patient arrives at the emergency department. 

It is important to note that some

patients, such as those in coma, in

extremis, and in the pediatric age

group, will never be able to give

informed consent. Further, those

patients who may be able to give

informed consent may still be unduly

influenced by the emergent nature of

their condition. Researchers must

work with their Institutional Review

Boards and within the federal regulators

to develop consent mechanisms that

account for these issues and protect

these patients while not unfairly

excluding them from the research

process and the potential benefits 

of those efforts.

Many areas of prehospital care in

need of research involve patients who

are competent and not in extremis.

Obtaining consent from such patients

should be comparable to obtaining

consent from patients in any other

clinical setting. One difference is that

the process of obtaining consent from

an EMS patient may take place in a

public environment and therefore

those enrolling the patient in research

must protect confidential patient

information. EMS training programs

need to better educate their students

about the importance of patient ? confidentiality.

? ? ?

?

•••••••••••• •••••••••••• ••••••••••••QUESTION UESTION UESTION CORNER••••••••••••• ••••••••••••• ••••••••••••• QUESTION CORNERQ: I’m starting a new research

project and would like information about general principles

guiding the informed consent

process. Can you help?

A:According to staff from theEmergency Medical Services for

Children (EMSC) Program, informed

consent is more than just signing a

form. It is a process of information

sharing, comprehension, and an individual’s voluntary agreement to participate in a study. Research participants must be given sufficient information to make an informed choice. 

“The manner and context in

which the information is conveyed is

as important as the information

itself,”said Isabele Melese d’Hospital,

PhD, research specialist for the EMSC

Netional Resource Center. It is necessary to adapt the presentation of the

information to the participant’s 

capabilities, and the investigator is

responsible for ascertaining if the

participant has comprehended the

information.

An agreement to participate in a

research study is only valid if it is

voluntary. The element of informed

12 EMSC News JULY/AUGUST 2001
Atraumatic brain injury (TBI)

occurs every 21 seconds. Even

more surprising is the fact that

brain injuries are more likely to occur

than a heart attack or cancer and are

the number one cause of death and

disability among children and young

adults. In fact, experts are now saying

that everyone probably knows someone with at least a mild traumatic

brain injury.

Recently, writers for EMSC News

had the opportunity to sit down with

specialists from the TBI Technical

Assistance Center (TAC) to discuss

the causes, consequences, and 

misconceptions of traumatic brain

injuries.

What is a TBI and how does it

differ from a brain attack?

A traumatically induced brain

injury occurs when the head hits

something, something hits the head,

or something penetrates the brain. 

A brain attack is the preferred term

for a stroke. Although there is no 

cure for TBI, there is treatment 

and rehabilitation. 

A brain injury is not contagious,

although victims are often ostracized.

Brain injury is the only disability that

can mimic or replicate any other disability. Because computed axial

tomography (CAT) scans do not

always reveal a brain injury, patients

are often misdiagnosed and given the

wrong treatment or none at all. 

What are the leading causes of

TBI?

Currently, the number one cause

of TBI is motor vehicle crashes,

although in some countries violence is

becoming the leading cause. Other

causes may include shaken baby syndrome, a gunshot, wounds, falls, sport

activities, and surgical episodes. The

results can be devastating. 

What happens to a person who

experiences a TBI?

A person may experience changes

in behavior, emotions, communication, memory, mobility, energy, decision-making abilities, eating and sleeping patterns, performance of tasks, or

relationships. TBIs have also resulted

in death.

The TBI TAC is making great

strides in raising awareness of TBI.

This past Spring, the Center launched

the TBI web site, which features

resources, grantee information, and

search functions.

In addition, new

fact sheets and a

leadership guide

are being created

for local and

national distribution. TAC is also

working collaboratively with the

Brain Injury Association of America

(BIAA) to identify other ways to

increase awareness and build strong

partnerships with other related

organizations.

For more information about TBI,

contact a TAC specialist at (202) 884-

6802 or visit www.tbitac.com.

TBI Center Provides Focal Information

3rd National 

Congress on 

Childhood 

Emergencies

April 15-17, 2002

Dallas, TX

Taking Action, Saving Lives

*Currently accepting program 

proposals and research abstracts

at www.ems-c.org.

TAC Specialists Donna

Davidson and Sandra

Knutson present information about TBI at a

recent training program.

EMSC News JULY/AUGUST 2001 13
••••••••• ••••••••• •••••••••LATEST LIBRARY ADDITIONS DDITIONS DDITIONS••••••••• ••••••••• •••••••••

of Care.” Clinical Padiatrics. 40,

No. 2 (2001): 93-98.

• Junkins, Edward Jr.; Knight, Stacey;

Olson, Lenora; Lightfoot, Amy;

Keller, Patricia; and Corneli,

Howard. “Analysis of School

Injuries Resulting in Emergency

Department or Hospital Admission.” Academic Emergency Medicine. 8, No. 4 (2001): 343-48.

• Melnyk, Bernadette; Moldenhauer,

Zendi; Veenema, Tener; Gullo,

Sharon; McMurtrie, Madelyn;

O’Leary, Elaine; Small, Leigh; and

Tuttle, Jane. “The KySS (Keep Your

Children/Yourself Safe and Secure)

Campaign: A National Effort to

Reduce Psychosocial Morbidities in

Children and Adolescents.” Journal

of Pediatric Health Care. 15, No. 2

(2001): 31A-4A.

• Niermeyer, Susan; Van Reempts,

Patrick; Kattwinkel, John; Wiswell,

Thomas; Burchfield, David;

Saugstad, Ola; Milner, Anthony;

Knaebel, Stefanie; Perlman, Jeffrey;

Azzopardi, Dennis; Gunn, Alistair;

Boyle, Robert; Toce, Suzanne; and

Solimano, Alfonso. “Resuscitation

of Newborns.” Annals of Emergency

Medicine. 37, No. 4 (2001): s110-

125.

• Quan, Linda; Bennett, Elizabeth;

Cummings, Peter; Henderson,

Peter; and Del Beccaro, Mark. “Do

Parents Value Drowning Prevention

Information at Discharge from the

Emergency Department?” Annals

of Emergency Medicine. 37, No. 4

(2001): 382-85.

• Rivara, Frederick; Thompson,

Diane; and Thompson, Robert.

“Bicycle Helmets: It’s Time to Use

Them: The Evidence That They

Reduce Head Injuries Is Too Strong

LATEST LIBRARY ADDITIONS

to Ignore.” BMJ. 321, No. 7268

(2000): 1035-36.

• Smith, Elizabeth; Singh, Tasmeen;

and Adirim, Terry. “A Prehospital

Notification System Makes a Difference for Special Needs Children.”

JEMS. 26, No. 5 (2001): 48-55.

• Sobo, Elisa; Andriese, Steve;

Stroup, Craig; Morgan, Dana; and

Kurtin, Paul. “Developing Indicators for Emergency Medical Services (EMS) System Evaluation and

Quality Improvement: A Statewide

Demonstration and Planning Project.” Journal on Quality Improvement. 27, No. 3 (2001): 138-54.

• Stein, Ruth; Johnson Silver, Ellen;

and Bauman, Laurie. “Shortening

the Questionnaire for Identifying

Children with Chronic Conditions:

What Is the Consequence?” Pediatrics. 107, No. 4 (2001): e1-5.

• Woodward, George and Fleegler,

Eric. “Should Parents Accompany

Pediatric Interfacility Ground

Ambulance Transports? Results of

a National Survey of Pediatric

Transport Team Managers.” Pediatric Emergency Care. 17, No. 1

(2001): 22-27.

• Zideman, David; Zaritsky, Arno;

Carlo, Waldemar; Osmond, Martin;

Gausche-Hill, Marianne; Hazinski,

Mary; Rasmussen, Gail; and Nadkarni, Vinay. “Airways in Pediatric

and Newborn Resuscitation.”

Annals of Emergency Medicine.

37, No. 4 (2001): s126-36.

If any interesting publication or

product (written or produced within

the last 18 months) has crossed your

desk that you would like to share,

please contact the EMSC National

Resource Center Medical Librarian,

Kathryn Willis, at (202) 884-6835 or

kwillis@emscnrc.com. 

14 EMSC News JULY/AUGUST 2001

• American Academy of Pediatrics;

Committee on Pediatric Emergency

Medicine; American College of

Emergency Physicians; and Pediatric Committee. “Care of Children

in the Emergency Department:

Guidelines for Preparedness.”

American Academy of Pediatrics.

107, No. 4 (2001): 777-81.

• American College of Emergency

Physicians. “The Role of Emergency Physicians in Emergency

Medical Services for Children.”

Annals of Emergency Medicine. 37,

No. 4 (2001): 428.

• Babl, Franz; Vinci, Robert; Bauchner, Howard; and Mottley, Lawrence. “Pediatric Pre-Hospital

Advanced Life Support Care in an

Urban Setting.” Pediatric Emergency Care. 17, No. 1 (2001): 5-9.

• Bernardo, Lisa Marie; Gardner,

Mary Jane; and Seibel, Karin. “Playground Injuries in Children: A

Review and Pennsylvania Trauma

Center Experience.” Journal of the

Society of Pediatric Nurses. 6, No.

1 (2001): 11-20.

• Cvijanovich, Natalie; Cook,

Lawrence; Mann, Clay; and Dean,

Michael. “A Population-Based Study

of Crashes Involving 16- and 17-

Year-Old Drivers: The Potential

Benefit of Graduated Driver Licensing Restrictions.” Pediatrics. 107,

No. 4 (2001): 632-37.

• Dayie, Amofah; Aronson, S.;

Jansen-McWilliams, L.; and Kelleher, K. “Use of a Statewide System

to Improve Health and Safety in

Child Care Facilities.” Ambulatory

Pediatrics. 1, No. 2 (2001): 73-78.

• Farmer, Janet and Muhlenbruck,

Laura. “Telehealth for Children

with Special Health Care Needs:

Promoting Comprehensive Systems
Satcher Unveils Suicide Prevention Initiative

S

urgeon General David Satcher

recently unveiled a “National

Strategy on Suicide Prevention”

that is aimed at reducing both the

number of suicides and the stigma of

mental illness.

Speaking at the University of

Pittsburgh’s graduation, Satcher said

that mental illnesses, including

depression, cause 80% to 90% of the

30,000 suicides that occur each year

in the U.S., adding that “social stigma”

contributes to suicide by “keeping

people from seeking treatment.”

Satcher added that the new initiative, “18 months in the making” would

have a threefold focus: an attempt to

make Americans more aware of the

magnitude and nature of the problem

of suicide, improve ways to diagnose

and treat mental illness to prevent suicides, and increase the amount of

research on suicide. “If we are able to

recognize and diagnose depression

early, we should be able to prevent

many of the suicides that are taking

place today,” Satcher said. (Barnes,

Pittsburgh Post-Gazette, 4/30).

EMSC News JULY/AUGUST 2001 15

Congratulations to Our

EMSC Heroes Award 

Recipients

On June 4, 2001, at a special

luncheon held during the

Annual EMSC Grantee Meeting, the following individuals, organizations, and products were recognized with a National EMSC Heroes

Award. Additional information about

each recipient will be featured in 

the September/October issue of

EMSC News.

EMSC Project Coordinator of

Distinction Award

Katrina Altenhofen (Iowa)

Claudia Hines (Minnesota)

EMSC State Achievement Award

State of Maryland

Outstanding EMS Provider 

of the Year

Keith Harris, EMT-P 

(North Carolina)

EMSC Parent Volunteer 

of the Year

E. Murney Rinholm (North Carolina)

EMSC Community Partnership

of Excellence Award

Indiana District Kiwanis, Kids for

Riley (Indiana)

Innovation in EMSC Product

Development

Pediatric Emergencies for 

Prehospital Providers (American

Academy of Pediatrics)

One common barrier to establishing an effective data collection system is getting key personnel to buy into the importance of

data collection. Some don’t want to

budget the time or the money for data

collection; others don’t understand the

value of acquiring data. To establish a

successful emergency medical services

(EMS) data system, it is important for

providers, agencies, and administrators

to understand the many benefits of

data collection.

Why Collect Data?

• It is the only reliable way to evaluate

the responsiveness and effectiveness

of EMS.

• It identifies service areas that need

improvement or further evaluation.

• It allows for dissemination of accurate public information.

• It encourages the development of

meaningful education and prevention programs.

• It promotes decision-making and

resource allocation based on solid

evidence rather than on isolated

occurrences, assumption, emotion,

and politics.

• So you can know what you don’t

know!

Data can be used to:

• Improve quality of emergency care

and procedures; 

• Stimulate new organizational ideas;

• Draw public and media attention to

a community issue;

• Influence legislative policies and 

regulations;

• Provide justification for an existing

program or illustrate a need for a

new program;

• Help obtain grant funding; 

• Promote initial and continuing education and research efforts;

• Allocate state or agency resources

effectively; and

• Help those in the EMS community

see the value of their work.

Data professionals at the National

EMSC Data Analysis Resource Center

(NEDARC) are available to help you

improve your data collection systems

and the quality of your Emergency

Medical Services for Children programs. If you have questions, contact

Michael Ely at (801) 585-9761;

Michael.ely@hsc.utah.edu or visit

NEDARC’s new web site at

www.nedarc.org.

News from NEDARC
EMSC News JULY/AUGUST 2001

EMSC National Resource Center

Children’s National Medical Center

111 Michigan Avenue, N.W.

Washington, DC 20010

2001

••••••••• IMPORTANT DATES TO REMEMBER ••••••••• ••••••••• IMPORTANT DATES TO REMEMBER ••••••••• ••••••••• IMPORTANT DATES TO REMEMBER •••••••••

n

PRSRT STD

Postage and

Fees

Paid HRSA

Permit No. G-286

16

July

National March of Dimes 

Mothers March 

Summer Campaign 

Contact: Lisa DíAgostino Leahy at

(914) 997-4451 

July 18-20

National Association of 

Hispanic Nurses 

Annual Meeting 

San Antonio, TX 

Contact: Cary Jo Lederman at 

(410) 749-3200 

July 22

National Parent’s Day 

Parents’ Day Council 

Contact: Gary Jarmin at 

(703) 548-4904

July 22-27

World Federation of Mental Health 

World Assembly 

Vancouver, CAN 

Contact: (604) 681-5226 

July 27

Burn Children Recovery Foundation 

Summer Ice Event Gala 

Indianapolis, IN 

Contact: Shawn Tabor at 

(317) 803-2876

August 3-5

American Medical Women’s 

Association 

International Conference 

Cleveland, OH 

Contact: Julie Dogil at 

(703) 838-0500 

August 8-12

National Black Nurses Association 

Annual Conference 

Los Angeles, CA 

Contact: Millicent Gorham at 

(301) 589-3200 

August 15-18

IRECC Conference

(Intermountain Regional EMS for

Children Coordinating

Council, Inc.)

Big Sky, MT

Contact: (406) 994-6683

August 24-28

American Psychological Association 

San Francisco, CA 

Contact: Jodi Ashcraft at 

(202) 336-5565

September

Baby Safety Month

Contact: Juvenile Products 

Manufactorers at 

(856) 231-8500