EMERGENCY MEDICAL SERVICES FOR CHILDREN NEWSLETTER

news

VOLUME 13, NO.1, MAY/JUNE 2000

Page 2

EMSC National

Heroes Honored

Page 4

Attendees Re-energize

at EMSC Grantee

Meeting

New Chief of Injury 

and EMS Branch

Named

Page 5

OMH Releases

Cultural Compentency

Standards

Page 9

EMSC Succeeds

with Healthy 

People 2010

Page 15

Family Urged to

Keep Roads Safe

This Summer 

It’s Official ... National Congress on Childhood

Emergencies Achieves A Resounding Success

INSIDE THIS

ISSUE

On March 27, approximately 900 health

care professionals (including physicians

and surgeons, nurses, emergency medical

technicians and paramedics, school and mental

health professionals, EMS planners, and health

care administrators), policymakers, and consumers from throughout the nation convened at

the Omni Inner Harbor Hotel in Baltimore, MD,

for the 2000 National Congress on Childhood

Emergencies. 

According to Jane Ball, DrPH, RN, director of

the EMSC National Resource Center, the conference achieved a 40% increase in attendance from

the previous Congress held in 1998. “We are

excited to announce that we surpassed everyone’s

expectations for both attendance and content,”

Dr. Ball said. 

The three-day conference included a Pediatric Education for Prehospital Professionals

(PEPP) Pre-conference Course; two general sessions; a school safety seminar; four plenary sessions; the National Heroes Award Luncheon;

guided tours of The Johns Hopkins Children’s

Center, University of Maryland Hospital for Children, R. Adams Cowley Shock Trauma Center,

and the Maryland Institute for EMS Systems; 70

concurrent sessions; and two news conferences.

PEPP Preconference

Sixty Congress pre-registrants participated in

the roll-out of the American Academy of Pediatrics’ (AAP) PEPP Train-the-Trainer Course on

March 25 and 26. The course featured eight lectures on the topics of child development, respiratory emergencies, child maltreatment, children

with special health care needs, medical emergencies, trauma, cardiovascular emergencies, and

emergency delivery and newborn stabilization

with skills stations, mock scenarios, and a written test. For information about future PEPP

course dates and locations, please contact AAP

at (800) 433-9016, Ext. 7083.

(continued on page 6)

Attendees participate in one of the PEPP Train-the-Trainer 

course skills stations.

(continued on page 11)

EMSC Releases Managed Care

White Papers Series

F

our Emergency Medical Services for Children (EMSC) Managed Care White Papers

recently were published in the Annals of

Emergency Medicine and released at a special

reception during the National Congress on

Childhood Emergencies. 

The documents included: “Emergency

Medical Services for Children in Managed Care

White Paper Series,” “Twenty-four-Hour Access

to Emergency Care for Children in Managed

Care,” and “Quality and Accountability: Children’s Emergency Services in a Managed Care

Environment,” which were published in the

December 1999 issue of Annuals of Emergency

Medicine; and “Injury Prevention and Emergency
EMSC Program Director, MCHB

David Heppel, MD

Director, EMSC National Resource Center

Jane Ball, RN, DrPH

Managing Editor

Suzanne Sellman, MA

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. 

© 2000 EMSC Program. All rights reserved.

news

More than 1,000 EMSC

grantees, family members,

and special guests attended a

March 28 luncheon at the Omni Inner

Harbor Hotel in Baltimore, MD, to

honor this year’s National Heroes

Award recipients. 

“The individuals, state teams, and

organizations who are being recognized

reflect the best of the best,” said Rick

Smith, the event’s master of ceremonies and chief of the Injury and

Emergency Medical Services Branch of

the Health Resources and Services

Administrations’ Maternal and Child

Health Bureau. “These individuals have

committed their time and talents to

transforming the way emergency medical care is provided to children

throughout the U.S. 

The 2000 National Heroes Award

recipients include:

EMS Provider of the Year —

Frank Marcucio, III, EMT-P

Frank Marcucio

is a paramedic

and certified

EMS instructor

for the state of

Connecticut. He

also serves as

the chief of Seymour’s EMS system and the director and chief executive officer of the Seymour Ambulances Association (SAA). In 1998,

under Marcucio’s leadership, the association received a three-year grant to

establish the EMS Safe Communities

Program. Within one year, the program

received national recognition as a

“Model Safe Community Program.” To

date, approximately 4,000 individuals

have participated in more than 20 SAA

Safe Community projects. Marcucio

also founded the Valley-Amity Safe

Kids Coalition and is a member of the

State of Connecticut’s EMSC Prevention Subcommittee and the Connecticut Safe Kids Coalition Steering 

Committee. 

EMSC Project Coordinator of

Distinction Award — Rhonda

Phillippi, RN

In 1988, Rhonda

Phillippi helped

make legislative

history when Tennessee became the

first state to enact

a law ensuring

appropriate pediatric educational

and equipment requirements for all

emergency departments. Phillippi also

has initiated and sustained relationships with more than 30 pediatricrelated organizations, including the

state’s Parent Teacher Association, Safe

EMSC National Heroes Honored at National Congress Kids Coalition, and Department of

Transportation. 

In addition to working with local

high schools to promote car seat and

seat belt use and the prevention of

teenage drinking and driving, Phillippi

directs a considerable amount of time

into assisting families with special needs

children and serving on numerous

EMSC tasks forces. 

EMSC Project Coordinator of

Distinction Award — Dave Boer,

EMT-P, MBA

One of Dave Boer’s

most noted contributions to the

EMSC program is

his dedication to

building meaningful and lasting relationships with the

Aberdeen Area

Native American Tribal Organizations.

These relationships have enabled the

South Dakota EMSC project to help an

often overlooked and underserved segment of the population. Through Boer’s

vision and hard work, the South Dakota

EMSC project recently provided the

organizations with pediatric emergency

training and enhanced advocacy of

injury prevention programs. 

Boer also partnered with the local

Red Cross and the Department of Social

Services to provide injury prevention

and bystander first-aid training to childcare providers throughout the state. In

addition, he played an instrumental role

in acquiring the continuing education

grants that sponsor the Annual Heartland Regional EMSC meetings. 

EMSC State Achievement

Award — The State of Alaska

The state of Alaska received its initial

EMSC funding 10 years ago. Since that

time, the state has conducted several

pediatric surveys; developed more than

20 injury prevention projects; organized

numerous two- and three-day instructor

2 EMSC News MAY/JUNE 2000 
courses for prehospital providers,

school nurses, and

hospital personnel;

and assembled an

EMSC task force to

provide ongoing

guidance and

direction for the Alaska Council of

EMS. In addition, project staff have

purchased and distributed pediatric

equipment and training products to

volunteer EMS first responder and

ambulance services, and produced several original publications, including the

Alaska Medevac Manual; the Family

Resource Guide; and ASK, a survey

tool to assess whether an adolescent’s

illness or injury was unintentional or

self-inflicted. 

Under its third grant, the state codeveloped a widely respected “gatekeeper” suicide prevention program to

reduce the incidence of suicide among

Alaskan, Native American, and Hawaiian youth. The state achievement

award honors Mark Johnson, Doreen

Risley, Matt Anderson, Pat Carr, David

Thompsen, Alice Rarig, Martha Moore,

Larry Bussone, and Lance Brown. 

EMSC Parent Volunteer of 

the Year —

Tina Standing Soldier

Tina Standing Soldier is a relentless

crusader whose

principal concern

is to raise awareness and improve

services for children living in and

around the Pine Ridge Indian Reservation in South Dakota. As a parent of a

disabled child, Soldier knows all too

well what it is like to live with cultural

and disability barriers. She directs her

hard work, compassion, and vision

toward assisting the families of children with disabilities so they don’t

have to suffer the same heartaches she

has endured. 

Hospital Medical

Center of Akron,

OH. Her paper,

“Artificial Neural

Network Predicts

CT Abnormalities

In Pediatric Head

Injury,” was chosen to receive this award by a panel of

well-respected researchers who blindly

critiqued and scored all of the research

abstracts that were submitted to the

National Congress. Dr. Sinha also was

chosen to present a second platform

session at this year’s Congress, on

“Focussed Teaching Needed to Optimize Educational Objectives of Pediatric ED Rotation.” 

Innovation in EMSC Product

Development Award — Emergency Guidelines for Schools

The Emergency Guidelines for Schools

is an outstanding emergency care

resource for schools without full-time

medical or nursing support staff. Produced by the Ohio Department of Public Safety’s EMSC program, in cooperation with the Emergency Care Committee of the Ohio Chapter of the American Academy of Pediatrics, this 50-

page booklet contains color-coded firstaid flow charts, descriptions of more

than 37 of the most common pediatric

illnesses and injuries, a list of recommended first-aid equipment and supplies, and advice for treating students

with special health care needs. 

According to the EMSC Clearinghouse, which tracks all EMSC product

requests, the guide has been the most

sought-after product this year. 

In the past few years alone Soldier

has devoted countless hours of her time

and expertise to a variety of special

causes and events. She also is the parent

representative for the South Dakota

EMSC program. In 1995, she won the

Bush Foundation’s “We Think You’re

Wonderful” award. 

EMSC Community Partnership

of Excellence Award — Chicago

Fire Department Engine

Company 16 and Ambulance 35

The firehouse of this engine and ambulance crew is located within Chicago’s

largest and poorest public housing complex. The surrounding neighborhood, in

which children account for nearly twothirds of the population, is exceedingly

dangerous. Several years ago, the crew

opened its firehouse doors to local children venturing in for chats, minor medical assistance, or advice. Since that

time, the station has mentored the

neighborhood children with several

model community services, such as the

Perfect Attendance/ Good Grades

Bicycle Reward program, the Kids to

Read program, a clothing donation program, and an after-school tutoring and

hygiene program. 

The firefighters and paramedics

coordinate all of these activities during

their spare time. Their selfless efforts

have been featured in TIME Magazine

and the Chicago Tribune and on the

Oprah Winfrey Show.

Excellence in EMSC Research

Award — Madhumita Sinha, MD

Dr. Madhumita Sinha is a former resident of Saint Luke’s Roosevelt Hospital

in New York and fellow of Children’s (continued on page 15)

EMSC News MAY/JUNE 2000 3
On Sunday, March 27, more

than 250 Emergency Medical

Services for Children (EMSC)

grantees, EMS directors, and parent

representatives attended the 2000

Annual EMSC Grantee Meeting at the

Omni Inner Harbor Hotel in Baltimore, MD. The rigorous one-day meeting was held prior to the National

Congress on Childhood Emergencies,

which provided additional opportunities to collaborate, network, and share

insights and experiences with

more than 900 EMSC advocates. 

Maria Baldi and Cindy

Doyle, RN, BSN, MA, co-project

directors of the federal EMSC

program, opened the meeting

with a brief introduction to the

organizational structure of the

Maternal and Child Health

Bureau (MCHB) and its new

Injury and EMS Branch, which was

extremely well-received.

Baldi reviewed the new EMSC

grant cycle, which was implemented

last year and remains in effect indefinitely. Under the new cycle, the EMSC

grant applications will be due on

November 1, reviewed in December or

January, and awarded by March l. Similarly, the noncompeting continuation

grant applications will be due in

December with funding awarded the following March. Doyle concluded the presentation with an overview of current

Branch activities and initiatives. 

Following the federal presentations, Jane Ball, DrPH, RN, director of

the EMSC National Resource Center,

and Michael Dean, MD, principle

investigator of the National EMS Data

Analysis Resource Center, discussed

the various types of resources and

assistance that are available through

their individual centers. 

Following the opening session,

attendees had the opportunity to participate in one

of four intensive two and a

half-hour seminars that

addressed the

topics of leadership development, maximizing EMS assessments, effective research design, and

building collaborative relationships

with parent representatives. During the

afternoon seminar series, participants

learned strategies for establishing successful partnerships, interesting

fundraising activities, data collection,

and working with the media. 

The event also featured the

Annual Grantee Meeting Reception,

held at the Baltimore National Aquarium. The evening started with a special update on the EMSC White

Papers Series (see corresponding article, front page) and a state basket

give-away. Following the presentations, attendees were able to explore a

living rain forest, come face to fin

with sharks, and enjoy the brilliant

colors of a coral reef while touring the

nation’s finest water exhibit. 

The EMSC Program would like to

thank the Robert Wood Johnson

Foundation for sponsoring this

unique, fun-filled reception. 

Attendees Reflect, Refocus, and Re-energize at

2000 EMSC Grantee Meeting 

Rick Smith Named Chief of

Injury and EMS Branch

During the 2000 Annual EMSC

Grantee Meeting’s Opening

General Session, Richard Smith

III, MS, was introduced as the new

chief of the Injury and Emergency Medical Services Branch

of the Maternal and

Child Health Bureau

(MCHB). Prior to

joining MCHB, Smith

served as acting

deputy director of

the Indian Health

Service’s (IHS) Office of Public Health.

In this capacity, he managed three divisions with more than 80 staff and

numerous branches concerned with

public health programs. 

Smith has an extensive knowledge

of injury and emergency medical services. He has served on numerous

national task forces and committees,

including the American Academy of

Pediatrics’ Committee on Injury Prevention and Poisoning; the Center for

Disease Control and Prevention’s Injury

Prevention and Control Advisory Committee; the National Safe Kids Campaign’s Technical Advisory Group; and

several National Highway Traffic Safety

Administration (NHTSA) committees. 

As the new branch chief Smith will

be responsible for providing leadership

and direction to the health professionals represented in the branch’s trauma,

traumatic brain injury, emergency

medical services for children, poison

control, and injury prevention programs. Additionally, he will collaborate

with the Department of Health and

Human Services, central and regional

MCHB offices, consumer groups, professional organizations, and state and

local agencies to exchange information,

resolve issues, and develop polices and

standards that will improve the content

and quality of services. 

EMSC grantees network and share

insights and experiences during the 

Annual Grantee Meeting Opening Session.

Rick Smith

To everyone’s delight, the 2000 Annual Grantee Meet- ing Reception was held at the Baltimore National

Aquarium, the home of more than 10,000 creatures in

naturalistic habitats.

4 EMSC News MAY/JUNE 2000
I

n January, the Health Resources

and Services Administration’s

Office of Minority Health (OMH)

released for public comment its

National Standards for Culturally and

Linguistically Appropriate Services

(CLAS) in Health. The 14 standards,

which are designed to ensure equal

access to quality health care by

diverse populations, are based on an

analytical review of key laws, regulations, contracts, and standards that

are currently used by federal and state

agencies and other national 

organizations. 

“Although the 120-day public

comment period ended on April 30,

2000, the draft standards continue to

draw a great deal of attention because

many feel that they will be adopted by

accreditation organizations, regulatory

agencies, and third-party payors,” said

Jean Moody-Williams, RN, MPP, of the

Emergency Medical Services for Children

(EMSC) National Resource Center.

To help solicit feedback, OMH

hosted three regional meetings across

the country. More than 100 individuals participated in a March 10 meeting

in Baltimore, MD, where comments

ranged from: “These standards are

long overdue” to “It will cost too much

to implement these standards.” Some

participants noted that the cost of not

implementing the standards would be

considerably greater due to the “disparities is health care that will continue

without them.” 

OMH Releases National Cultural Competency Standards

25 Organizations Launch Nationwide Effort to Teach Emergency Lifesaving Skills to Children in the School Setting

At the National Congress on Childhood Emergencies, the Emergency Medical Services for Children (EMSC) Program announced the

establishment of a nationwide program to encourage schools to incorporate basic emergency lifesaving skills

training into their current health education curricula.

Developed by more than 25 national organizations and medical institutions, the Basic Emergency Lifesaving

Skills (BELS): A Framework for Teaching Emergency Lifesaving Skills to

Children and Adolescents takes the

EMSC Program one step closer to its

long-term goal of increasing the number

of school districts requiring first-aid and

CPR proficiency as a condition for high

school graduation.

Every year, more than 31 million

individuals between the ages of one and

17 years visit the emergency department due to an illness or injury. Many of

the incidents occur in the home while a

parent is away at work, in a school

where a nurse is not available, or on the

playground when an adult is not present. Other children or adolescents

often become involved in these incidents when walking to or from school,

playing in the schoolyard, or while

babysitting, and may be the first person

available to render assistance prior to

the arrival of emergency medical services (EMS) personnel. 

According to EMSC officials, the

introduction, acquisition, and reinforcement of basic emergency lifesaving

skills — such as CPR and first-aid 

during Kindergarten through grade 12

— instills in students a sense of social

responsibility and allows them to gain

confidence in responding to sudden

and often frightening events. It also

teaches them to recognize the need for

emergency assistance and how to obtain

it. The primary advantages of schoolbased teaching are that its content

would be compulsory for a wide audience, including minority populations,

and that standardized training would be

provided consistently over time in a

developmentally appropriate manner.

Teachers also would be assured that the

previous content was taught, enabling

students to enhance their skills from

year to year. 

The BELS Framework is available

through the EMSC National Clearinghouse. To obtain a hard copy, call the

Clearinghouse at (703) 902-1203 or

send an e-mail to emsc@circsol.com and

ask for product #848. The Framework

is also available as a free downloadable

.pdf document from the EMSC web site

at www.ems-c.org. Once at the site,

click on “Products and Resources” then

“downloadable files.”

Some participants urged OMH 

to consider encouraging adoption of 

the standards for clinical trials and 

professional education and training. 

Others requested that there be no

unfunded mandates resulting from 

the standards. 

The draft standards can be downloaded from the OMH web site at

www.omhrc.gov/clas. In June 2000,

OMH will post the public comments

on its web site. The final CLAS standards will be published in a future

issue of the Federal Register as recommended national standards for

adoption or adaptation by stakeholder

organizations and agencies. 

For more information about the

CLAS standards, contact MoodyWilliams at (301) 650-8063 or via 

e-mail at jmwilliams@emscnrc.com.

EMSC News MAY/JUNE 2000 5
National Congress on Childhood Emergencies (from page 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

General Sessions

Speaking before a packed session,

James Espinosa, MD, a leading emergency physician specializing in quality

improvement, opened the Congress

with videoclips from some of America’s

most popular movies, illustrating how

the practice of patient- and familyfocused medical care has changed over

the last century. Following the presentation, John Sacra, MD, medical director for the Oklahoma EMS Authority,

provided a riveting account of how

many Oklahoma City Bombing victims

benefited from a well-designed, quality-driven medical response system in

a time of crisis. Both speakers energized and inspired the attendees to

make a positive difference in the

world of emergency medical care.

On March 29, the attendees

received a special presentation by

Hunter “Patch” Adams, MD, founder

of the Gesundheit Institute and subject of the hit Hollywood film Patch

Adams, which focused on “healing

should be a loving human interchange,

not a business transaction.” After

receiving a standing ovation for a performance that left the audience laughing and cheering, Dr. Adams visited

with attendees for more than two

hours, signing books and posing for

pictures.

School Safety Seminar and

Plenary Sessions

One of the biggest attendee attractions was an intensive three-hour

school safety seminar on March 27,

which featured acclaimed author Victor LaCerva, MD, the Honorable Judge

Michael Martone, and other leading

violence prevention advocates. Attendees crowded into the session to learn

about and discuss a variety of issues

concerning school safety, including

injury prevention, student violence,

emergency preparedness, and adolescent alcohol and drug prevention.

The following day, program participants had a choice of attending

four plenary sessions ranging in topic

from ethics in pediatric emergency

medicine and cultural competency to

evaluating pediatric outcome measures and emerging threats to children’s health. 

National Heroes Award

Luncheon 

Prior to the Congress’ plenary

sessions, more than 1,000 attendees,

special guests, and family members

crowded into the International Ballroom to honor nine exceptional individuals, a firehouse, and a state for

their outstanding efforts to improve

emergency medical services for children. For a detailed report on this

event, see page 2.

Concurrent Sessions

In addition to the conference’s

lively presentations and uplifting special events, attendees had the opportunity to participate in an additional 70

concurrent sessions, including seven

cutting-edge, original research platform programs,

five research

methodology sessions, and 30

poster presentations. According

to one conference

attendee, “The

only semi-negative thing I can

say about the

Congress is that

there were so

many different

sessions I wanted

to attend at the

same time. It would be nice to have

some of the more popular sessions

repeated next time.”

News Conferences

The EMSC National Resource

Center also conducted two news conferences during the Congress. On

March 28, Michael Gerardi, MD, of the

American Academy of Pediatrics, Al

Sacchetti, MD, of the American College of Emergency Physicians, and

Dighton Packard, MD, of the MedicAlert Foundation, announced the

availability of a new emergency information form to assist health care

providers in treating children with

complicated health problems. 

Later in the day, a second news

conference was held to introduce the

Basic Emergency Lifesaving Skills

(BELS) program. For additional information about BELS, see the corresponding article on page 5. 

Health care’s “funny man”, Dr. Patch Adams,

reminds us that “healing should be a loving 

human interchange, not a business transaction.”

Panelists discuss effective strategies for preventing

injuries, acts of violence, and adolescent alcohol and

drugs abuse during Monday’s School Safety Seminar.

Dr. Diann Uustall shares

her strategies for managing cumulative stress and

providing good patient

care during the 

concurrent session “Caring for Yourself – Caring

for Others: The Ultimate

Balance.”

6 EMSC News MAY/JUNE 2000 
PUBLIC POLICY UPDATE 

••• •••PUBLIC POLICY UPDATE••• •••

Poison Control Center

Legislation Becomes Law

One year after its introduction,

the Poison Control Center Enhancement and Awareness Act (S. 632)

was signed into law by President

Clinton on February 25, 2000.

In approving the act, the President said: “Today, I am pleased to

sign a bipartisan bill that will help

save lives by giving families immediate access to vital information

about poison control. Each year,

more than 2 million poisonings are

reported to the nation’s poison control centers, and more than half of

the victims are young children. The

Poison Control Center Enhancement and Awareness Act authorizes

$140 million over the next five

years to fund the nation’s poison

control centers, carry out a national media campaign, and establish a

national toll-free telephone poison

control hotline to give callers

immediate information if there 

is an accident in the home. This

new funding will help provide vital

resources and information to inform

the public about poison control and

assist parents in protecting the health

and safety of their children.”

The legislation was introduced

by Senator Michael DeWine (R-OH)

to provide assistance for poison prevention and to stabilize the funding of

regional poison control centers (PCCs).

The Act instructs the Secretary of

Health and Human Services to provide

coordination and assistance to regional PCCs for the establishment of a

nationwide toll-free telephone number

to access the centers. The appropriations are prohibited from funding 

private nationwide toll-free telephone

numbers that are used to provide

advice and other assistance for poisonings or accidental exposures. 

The new law also directs the Secretary to establish a national media campaign, educating the public about poison

prevention and the availability of local

poison control resources and to advertise the nationwide toll-free number. In

addition, the Act requires the Secretary

to award grants for certified regional

PCCs to achieve financial stability and

to prevent and provide treatment recommendations for poisoning incidents.

The new law also will establish PCC 

certification requirements.

To learn more about the PCC law,

please contact the EMSC National

Resource Center at (202) 884-4927 or

via e-mail at info@emscnrc.com, or

the American Association of Poison

Control Centers at (202) 362-7217.

The EMSC Program would like to

thank the following organizations for

their support in making the 2000

National Congress on Childhood 

Emergencies a success: Alberto-Culver

Company, American Integrated Training Systems, Kaiser Permanente,

National Fire Protection Association,

PowerTrain, The University of 

Maryland Hospital for Children, and

Video Software Associates. 

Dr. Al Sacchetti and daughter Christie answer a

reporter’s questions about the new emergency information form to assist health care providers in treating

children with special needs.

Families Urged to Keep Roads

Safe This Summer

Memorial Day weekend kicks

off the summer travel season

as families across America

take to the road for vacation. Unfortunately, the holiday is one of the

most dangerous times on the nation’s

roadways. Last year, approximately

1,700 children died in car crashes.

And of these children, six out of 10

were completely unrestrained. Hard

to believe? In every state, it is illegal

for children to ride unrestrained, yet

40% of children continue to ride

unbuckled every day. According to

the National Highway Traffic Safety

Administration (NHTSA), it is time for

the nation to establish “zero tolerance” for unbuckled children.

Most police officers would rather

issue 50 tickets to violators of a seat

belt law than encounter the death of

one unbuckled child. But law enforcement agents should not stand alone in

their commitment to keeping children

safe. They need visible and vocal community support for their efforts to

enforce child passenger safety laws. 

Individuals can help keep the

roads safe by wearing their seat belts

and voicing their support for Buckle Up

America and Operation ABC - Mobilizing America to Buckle Up Children,

with an “Endorsement for Enforcement.” Buckle Up America is a national

movement to increase seat belt use to

85% and reduce child crash fatalities to

15% by the year 2000. Operation ABC

is a national mobilization to protect

children by stepping up enforcement of

child passenger safety laws.

For more information about

Buckle Up America, Operation ABC,

or the “Endorsement for Enforcement” form, access NHTSA’s web site

at www.nhtsa.dot.gov.

EMSC News MAY/JUNE 2000 7
EMSC SYSTEMS SCOOP

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

needs is being conducted. The project

is being co-sponsored by the EMSC

Program and the Office of Rural

Health Policy. Results should be available by summer 2000.

In addition, the National Registry

of EMT’s recently released the results

of its EMT-Basic Re-registration Survey, which was sent to approximately

18,000 emergency technicians to

assess their knowledge of pediatric

skills and identify related education

needs. 

Data from these surveys will be

analyzed so that specific, scientifically

based objectives can be formulated for

future initiatives.

Child Transportation Issues

After approximately 15 months of

discussions, EMSC’s Safe Transport of

Pediatric Patients Committee has

released its initial recommendations

for the safe transport of ill and injured

children in ambulances. Initially, the

committee found that no scientific

data were available on the dynamics

of an ambulance crash. However, in

September 1999 the first U.S. dynamic crash test was conducted on an

ambulance patient compartment. The

preliminary results of this test are the

foundation of The Do’s and Don’ts of

Transporting Children in an Ambulance fact sheet, which is available as

a free downloadable document from

the EMSC web site at www.ems-c.org.

Once here, click on “Products and

Resources” then “downloadable files.” 

Questions about this follow-up or

other EMSC projects, should be directed

to Bob Waddell at (301) 650-8067 or

via e-mail at bwaddell@emscnrc.com.

The focus of this issue of Systems

Scoop is to revisit and provide an

update on the topics that have been

discussed over the past year. It is

important to remember that the

intrigue of future activities should

never be separated from the knowledge

of past experiences.

Disaster Issues

As states such as North Carolina

continue to be plagued by natural disasters, they remind us that children of

all ages are impacted by disaster as

much as adults, and potentially more

so. Once help has arrived, either during the acute or restoration phases,

rescuers often feel they are ill-equipped

to properly tend to the needs of children. Emergency Medical Services for

Children (EMSC) grantees and partners have developed several useful

“tools” to help the various types of rescuers who are faced with the challenge

of caring for children during a disaster.

One resource is the Pediatric Disaster Life Support course developed by

the University of Massachusetts Medical School. This two-day course provides information about the unique

needs of children as it relates to disaster planning, response, and mitigation.

Another possible tool is the Psychosocial Issues for Children and Families

in Disasters: A Guide for the Primary

Care Physician.

The practicing physician often is

an unrecognized, and largely unsolicited, part of the psychological recovery

process. This booklet attempts to provide physicians with information to

explore a variety of roles in disaster

response and recovery as well as tools

to better assess and treat the needs of

their patients. It was produced by the

American Academy of Pediatrics in

collaboration with the Federal Center

for Mental Health Services. The product is available as a free downloadable

file from www.mentalhealth.org/

publications.

Research Issues

As many have come to recognize,

numerous aspects of emergency medical care have little or no scientific

basis upon which they are founded.

Over the past few months, several

EMS-specific research projects have

been initiated. 

The Federal Inter–agency Committee on EMSC Research (ICER) is

actively addressing research issues

specific to EMSC. Although at the

time of this printing, details of this

group’s work have yet to be finalized,

it is an activity to watch closely. One

outcome of this effort was the noticeable representation of EMSC-related

research at the 2000 National Congress. Nearly 90 research abstracts

were submitted, and more than 40

were accepted for session or poster

presentation. 

At the request of Claude Earl

Fox, MD, administrator of the Health

Resources and Services Administration, an assessment of rural EMS

8 EMSC News MAY/JUNE 2000
“Leading Health Indicators”

Include EMS Objectives

I

n January 2000, U.S. Department of

Health and Human Services’ 

Secretary Donna Shalala and Surgeon General David Satcher released

Healthy People 2010, a national health

promotion and disease prevention initiative that identifies 28 focus areas and

467 objectives to improve the health of

all Americans. 

More than 350 national organizations, 270 state agencies, and thousands

of health care experts were involved in

the plan’s development, each vying for

their own special interest. After countless hours of hard work, the Emergency

Medical Services for Children (EMSC)

Program is pleased to announce that it

succeeded in ensuring that the plan’s

final version included the following two

EMSC-related objectives:

• to increase the number of states

and the District of Columbia that have

implemented statewide pediatric protocols for online medical direction; and

• to increase the number of states

and the District of Columbia that have

adopted and disseminated pediatric

guidelines that categorize acute care

facilities with the equipment, drugs,

trained personnel, and other resources

EMSC Succeeds in Getting the Needs of Children

Addressed by Healthy People 2010

necessary to provide varying levels of

pediatric emergency and critical care.

Healthy People 2010 also includes

the following objectives, which directly impact the overall organization and

delivery of emergency medical services:

• to reduce the proportion of persons who delay or have difficulty in

getting emergency medical care;

• to increase the proportion of persons who have access to rapidly

responding prehospital emergency

medical services;

• to establish a single toll-free telephone number for access to poison

control centers on a 24-hour basis

throughout the United States; and

• to increase the number of tribes,

states, and the District of Columbia

with trauma care systems that maximize survival and functional outcomes of trauma patients and help

prevent injuries from occurring.

The six objectives are listed

under the document’s “Access to

Quality Health Services” section.

Each objective has a target for achieving specific improvements by the year

2010. To review the entire Healthy

People 2010 document or the Healthy

Office where he evaluated the efficiency and effectiveness of a wide variety

of state-funded agencies and programs. 

Nordberg is NEDARC’s newest

systems analyst. He has more than

six years of experience in the computer industry, with expertise in database

design and analysis, web site design,

and system integration. 

In addition to hiring new personnel, NEDARC staff conducted several

workshops at the Annual EMSC

Grantee Meeting, which focused on

research design, trauma system outPeople 2010 Toolkit, which provides

examples of state and national experiences in setting and promoting the

objectives, refer to the site at

www.health.gov/healthypeople/.

News from NEDARC

T

he National EMSC Data Analysis

Resource Center (NEDARC) welcomes the addition of two new

staff members: Michael Ely, MA, and

Brian Nordberg. 

Ely will serve as NEDARC’s new

director. He brings to his position

more than nine years of experience in

management, financial analysis, and

consulting services. Most recently, he

worked for the Utah Auditor General’s

comes, and the Uniform Pre-Hospital

EMS Data Set. They also presented 10

research abstracts at the National

Congress and worked with staff of the

Maternal and Child Health Bureau and

the National Pediatric Trauma Registry to gather opinions on the registry’s accomplishments and future

directions. 

For additional information about

NEDARC’s activities, or to access its

data technical assistance services, call

(801) 581-6410.

T

he Leading Health Indicators

outlined in Healthy People 2010

reflect the major public health

concerns in the U.S. They were chosen based on their ability to motivate

action, the availability of data to measure their progress, and their relevance as broad public health issues.

For the first time ever, Emergency

Medical Services (EMS) objectives were

included as one of 10 sets of indicators.

The indicators serve as a link to

the 467 objectives identified in Healthy

People 2010 and as the basic building

blocks for community health initiatives. They are intended to help individuals understand the importance of

health promotion and disease prevention and to encourage widespread

efforts toward improving the nation’s

health over the next decade. To review

the EMS objectives, refer to the site at

www.health.gov/healthypeople/.

EMSC News MAY/JUNE 2000 9
Dr. Stenklyft is an associate professor

and the director of pediatric

emergency services at the University of Florida Health Science Center in Jacksonville,

FL. In her new role, Dr.

Stenklyft will work closely

with staff of the state’s

Department of Health and

EMS Bureau to identify and

prioritize statewide EMSC

issues and ensure continued

institutionalization of EMSC into

the Florida EMS system.

For additional information, 

contact Melia Jenkins via e-mail at

melia_jenkins@ dcf.state.fl.us.

Hawaii

Hawaii’s EMSC program is partnering with the Keiki Injury Prevention Coalition/Safe Kids Hawaii to

address unintentional childhood

injuries. In an effort to establish EMS

providers as injury prevention leaders

within the community, paramedics

throughout the state are being trained

in basic injury prevention and child

passenger safety. This spring, a paramedic ambulance unit on Kauai started providing free car seat installations.

Plans are underway to train additional

paramedics throughout the state to

operate fitting stations and to educate

the public about other injury prevention programs.

For additional information, contact Donna Maiava via e-mail at

dmmaiava@camhmis.health.state.hi.us.

Idaho

The Idaho EMSC Task Force

recently had a successful first meeting, where members unanimously

agreed to proceed with activities on

an exclusively data-driven basis. The

EMSC Task Force Data Subcommittee

met with the National EMSC Data

Analysis Resource Center’s Mike

Dean, MD, PhD, in April to evaluate

the current EMS data collection

process and to formulate additional

research questions and data collection

methodologies. For additional information, contact Boni Carrell via email at gainord@dhw.state.id.us.

Illinois

The goals of the Illinois EMSC

project are: 

• to develop a School Health

Emergency Program (SHEAP) course

that focuses on educating school staff

members who are most likely to initially assess an ill or injured child, in

the absence of a school nurse; and 

• to improve access to medical

care for children who become ill or

are injured at school.

The course will include guidelines

for assessing children with an illness

or injury occurring at school and for

identifying common chronic conditions, including asthma, allergies,

seizure disorders and diabetes mellitus. The first course is scheduled for

May 2000.

For additional information, contact Vidya Chande, MD, via e-mail at

v-chande@nwu.edu

. 

New York

The Center for Pediatric Emergency Medicine was awarded a new

targeted issues grant for its National

Child Protection Education Project. A

primary objective of the project is to

conduct a nationwide study of EMTs

and paramedics to assess their knowledge of child abuse recognition, treatment, and state reporting requirements. The study’s results will be used

to develop a relevant educational

resource. Meanwhile, the PARAMEDIC

TRIPP (Teaching Resource for Instructors in Pre-hospital Pediatrics) project

Colorado

The Colorado EMSC project has

successfully achieved its objective to

develop a curriculum for teaching

emergency care skills to primary

health care providers in the Colorado

public school system. In addition, project staff have developed an 8-hour

pilot training course that emphasizes

hands-on practice. Realistic emergency scenarios are created in the

school environment, using children in

practical stations, for teams of school

staff trainees to improve their skills in

assessment, shock and bleeding control, spinal stabilization, cardiopulmonary resuscitation, and airway

management.

Pilot programs have been completed in western Colorado. Additional

trials are being scheduled in cities and

towns located in the eastern part of

the state. 

For additional information, contact Michael Merrill via e-mail at

michael.merrill @state.co.us.

Florida 

Last winter, Robert Brooks, MD,

secretary of the Florida Department of

Health, appointed Phyllis Stenklyft,

MD, as the new chairperson of the

Florida EMSC Advisory Committee.

10 EMSC News MAY/JUNE 2000
continues, awaiting the American Hospital Association’s new standards. The

resource should be available this fall.

A draft of the core chapters and

graphic elements can be viewed at

www.cpem.org.

For additional information, contact Marsha Treiber via e-mail at

mt31@is6.nyu.edu.

P e n n s y l v a n i a

TraumaLink is a comprehensive

pediatric trauma research center

based at The Children’s Hospital of

Philadelphia and the University of

Pennsylvania. In December 1999,

TraumaLink published an EMSC-funded study about post-traumatic stress

disorder (PTSD), which found that

25% of children and 15% of their parents who experienced a traffic crash,

suffered intrusive thoughts, hyperarousal, and avoidance symptoms that

affected their daily lives, more than

seven months after the incident.

These rates for PTSD are comparable

to those following violent incidents.

For additional information, contact Flaura Winston, MD, PhD, via email at flaura@mail.med.upenn.edu.

The Pennsylvania EMSC Advisory

Committee recently designed and distributed a survey tool for school nurses to develop services and provide

resources for children with special

health care needs. The committee also

developed an injury prevention survey

that was distributed to all of the state’s

EMS services, fire departments, and

injury prevention programs. The survey will produce a statewide resource

guide to injury prevention programs in

the Commonwealth, categorized by

specific location and injury prevention

activity.

Project staff also are exploring the

feasibility of creating an interactive

“CHAT” forum, with several different

Medical Services for Children in a

Managed Care Environment,” which

was published in the March 2000

issue. The series was developed to

address the impact of managed care

on the emergency medical care system for children and adolescents. 

Its primary purpose is to generate

discussions among managed care

organizations, health care providers,

and the public that will lead to

improvements in the child and adolescent medical care system. According to Peter van Dyck, MD, MPH,

associate administrator for maternal

and child health of the Health

Resources and Services Administration, “the overarching principle of the

papers is that children must have

unobstructed access to quality emergency medical services regardless of

the families’ method of payment.”

Project Coordinator Jean MoodyWilliams, RN, MPP, said “the concepts

and recommendations described in the

papers can only become a reality if

states begin to discuss them with key

groups and individuals within the comm u n i t y.” Reprints of the white papers

can be requested from the EMSC

Clearinghouse at (703) 902-1203 or

via e-mail at emsc@circsol.com.

Managed Care White Papers 

( f rom page 1) . . . . . . . . . . . . . .

Printed with permission from Steve Berry.

topic rooms, for real-time communication at its web site. Look for the

interactive forum this summer at

www.pehsc.org.

For additional information, contact Peggy Trimble via e-mail at ptrimble@health.state.pa.us.

V i r g i n i a

The Virginia EMSC program is

pleased to announce that Margaret

Dolan, MD, associate professor of pediatrics and emergency medicine at Virginia Commonwealth University and

principal investigator for the Virginia

EMSC program, received the first-ever

“Governor’s Award for Outstanding

Contribution to EMS for Children.”

Her years of dedication and service to

the children of the Commonwealth

and efforts to advance EMS education,

service, and research were recognized

this past winter at the 20th Annual

EMS Symposium in Norfolk, VA. More

than 1,600 emergency medical professionals rose to their feet, applauding

Dr. Dolan for her continuous advocacy

and dedication to children.

For additional information, 

contact Petra Menzel via e-mail at 

pmenzel@hsc.vcu.edu.

EMSC News M AY /J UNE 200 0 1 1
EMSC PRODUCT UPDATE

cians and other child health specialists identify post-concussive (mild

brain) disorders after discharge from

the emergency department or hospital. It addresses four common signs

that may indicate a more serious

problem: problems with health (i.e.,

headaches and other pains, problems

with balance and sleep, and sensory

changes); changes in behavior and

feelings; trouble with thinking; and

difficulty in communicating. This publication is a downloadable document

from the EMSC web site at www.emsc.org. Look for product #826. For

hard copies, the first 100 are free,

with additional sets of 100 costing $5.

Traumatic Brain Injury in

Children and Teens: A

National Guide for Families

By the New Hampshire EMS for 

Children (1999)

This guide is intended to help

parents of children who have sustained

brain injuries understand and cope

with their child’s injury and treatment, locate appropriate health care

services, and find ways to pay for

short- and long-term care. Divided

into seven chapters, the guide takes

parents through each step of their

child’s recovery from the hospital to

the home. It is also downloadable

from the EMSC web site at www.emsc.org or available in hard copy for $6.

Request product #839.

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.

•••••••• •••••••• ••••••••WHAT’S NEW? An EMSC Product Update An EMSC Product Update An EMSC Product Update•••••••• •••••••• ••••••••

can significantly decrease the likelihood of a crash, and in the event of a

crash or near collision, significantly

decrease the risk of pediatric injury.

These guidelines for good practice are

recommended until pending research

and consensus outcomes are resolved.

The document is available as a downloadable .pdf file from the EMSC web

site at www.ems–c.org. Once here,

click on “Products and Resources,”

then “downloadable files.” Look for

product #841. The cost for a hard

copy is .10¢.

!Urgente! 

By the EMSC National Resource 

Center (2000)

Published in Spanish, this twopage fact sheet presents 10 succinct

hints and reminders for the general

public to aid in emergencies. The list

includes a definition of an emergency

situation, emergency contact information, and immediate steps to take in

common childhood emergencies. The

document is available as a downloadable .pdf file from the EMSC web site at

www.ems–c.org. Once here, click on

“Products and Resources,” then “downloadable files.” Select product #846.

The cost for a hard copy is .10¢. 

Product #803 is the English version of

this fact sheet.

The following products are related

specifically to Traumatic Brain Injury:

When Your Child’s Head Has

Been Hurt

By the Traumatic Brain Injury Technical Assistance Center (1999)

This two-page fact sheet is designed

to help families, school nurses, pediatriBereavement Practice

Guidelines for Health Care

Professionals in the

Emergency Department

By the National Association of Social

Workers (1999)

These practice guidelines assist

emergency department staff in providing family-centered care to family

members and emergency department

staff coping with the death of a child.

It covers all phases of care from

preparing the emergency department

with protocols and procedures to follow-up with the family and staff. The

cost is $2.90. Ask for product #822.

Children with Special Health

Care Needs: An EMS

Challenge 

By the Arizona Emergency Medicine

Research Center (1997)

This CD-ROM introduces health

care providers to general respiratory,

cardiovascular, and neuromuscular challenges of children with special health

care needs. It provides system reviews

of the normal differences between adult

and pediatric anatomy and physiology,

as well as case scenarios. The appendix

contains helpful printable files on 13 different medical conditions that the

provider may encounter. The cost is $5.

Request product #838.

The Do’s and Don’ts of

Transporting Children in an 

Ambulance 

By the EMSC National Resource 

Center (1999)

Each year, approximately 6 million children are transported by EMS

vehicles in the United States. This fact

sheet identifies certain practices that

12 EMSC News MAY/JUNE 2000
EMSC News MAY/JUNE 2000 13

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

Notable EMSC-Related Articles:

• Abrunzo, Thomas; Gerardi,

Michael; Dietrich, Ann; Lampell, Mark;

Sanford, W. Craig; and Smith, Deborah

Mulligan. “The Role of Emergency

Physicians in the Care of the Child in

School.” Annals of Emergency Medicine.

35, No. 2 (2000): 155-61.

• Bechtel, Gregory and Davidhizar,

Ruth. “A Cultural Assessment Model for

ED Patients.” Journal of Emergency

Nursing. 25, No. 5 (1999): 377-80.

• Cool, Lisa Collier. “Emergency!”

Good Housekeeping. (1999): 71-78.

• Committee on Pediatric Emergency Medicine, American Academy of

Pediatrics. “Access to Pediatric Emergency Medical Care.” Pediatrics. 105,

No. 3 (2000): 647-49.

• Dickinson, Edward; Verdile, Vincent; Duncan, Timothy; and Bryant,

Kerry. “Managed Care Enrollee Utilization of 911 Medical Services.” Prehospital Emergency Care. 3, No. 4 (1999):

321-24.

• Gausche, Marianne, et al. “Effect

of Out-of-Hospital of Pediatric Endotracheal Intubation on Survival and Neurological Outcome.” JAMA. 283, No. 6

(2000): 783-90.

• Gausche, Marianne and Seidel,

James. “Out-of-Hospital Care of Pediatric Patients.” Pediatric Clinics of

North America. 46, No. 6 (1999):

1305-27.

• Hodge, Dee, III. “Managed Care

and the Pediatric Emergency Department.” Pediatric Clinics of North

America. 46, No. 6 (1999): 1329-40.

• Ireys, Henry and Perry, Jamie.

“Development and Evaluation of a

Satisfaction Scale for Parents of Children with Special Health Care Needs.”

Pediatrics. 104, No. 5 (1999): 1182-91

• Jager, TE; Weiss, HB; Coben, JH;

and Pepe, PE. “Traumatic Brain

Injuries Evaluated in U.S. Emergency

Departments, 1992-1994.” Academic

Emergency Medicine. 7, No. 2 (2000):

134-40.

• Junkins, Edward, et al. “Epidemiology of School Injuries in Utah: A

Population-Based Study.” Journal of

School Health. 69, No. 10 (1999): 409-12.

LATEST LIBRARY ADDITIONS

• Krug, Steven. “Access and Use

of Emergency Services: Inappropriate Use Versus Unmet Need.” Clinical Pediatric Emergency Medicine. 1,

No. 1 (1999): 35-44.

• Markenson, David and Foltin,

George. “The New Emergency Medical Technician-Paramedic and Emergency Medical Technician-Intermediate Curricula: History, Changes, and

Controversies.” Clinical Pediatric

Emergency Medicine. 1, No. 1 (1999):

54-69.

• Moore, Lori. “Measuring Quality

and Effectiveness of Prehospital

EMS.” Prehospital Emergency Care.

3, No. 4 (1999): 325-31.

If any interesting publication or

product (written or produced within

the last 18 months) has crossed your

desk, please contact the EMSC

National Resource Center Medical

Librarian, Kathryn Willis, at 

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

kwillis@emscnrc.com.

System-wide Changes Recommended to Prevent Death and

Injury from Medical Errors

Arecent report from the Institute

of Medicine, entitled, “To Err Is

Human: Building A Safer Health

System,” revealed that between

44,000 and 98,000 Americans die

each year from preventable medical

errors. This estimate makes preventable medical errors the eighth

leading cause of death in the United

States — above car crashes, breast

cancer, and AIDS. These errors occur

in about two out of every 100 hospital

admissions. 

Moreover, while medical errors

may be more easily detected in hospitals, they occur in every health care

setting, including outpatient service

centers, retail pharmacies, nursing

homes, and individual patient homes.

“These stunningly high rates of medical errors that result in deaths, permanent disability, and unnecessary

suffering are simply unacceptable in a

medical system that promises first to

‘do no harm,’” said William Richardson, chair of the committee that wrote

the report and president and chief

executive officer of the W.K. Kellogg

Foundation in Battle Creek, MI.

The report calls for rigorous

changes throughout the health care

system, including mandatory reporting requirements. It includes a comprehensive strategy for government,

industry, consumers, and health care

providers to reduce medical errors,

and urges Congress to create a national patient safety center to develop new

tools and systems for addressing persistent problems. The federal government’s goal is to cut the incidence of

medical errors in half over the next

five years. A copy of the entire report

is available as a downloadable file at

www.nap.edu. 
?

Roving Reporter

Shauna Spears, pediatric trauma coordinator for The Johns Hopkins Hospital Children’s Center, takes time out of her busy schedule to explain the

special features of the Center’s 24-hour pediatric emergency department,

which cares for more than 30,000 patients each year. The Center is also

home to a 16-bed intensive care unit and a 36-bed neonatal intensive

care unit. The tour was just one of many scheduled offsite events offered

during the National Congress on Childhood Emergencies, which was

held March 27-29, 2000, in Baltimore, MD. 

YOUR QUESTION COUNTS!

?

••••••••••• ••••••••••• •••••••••••YOUR OUR QUESTION UESTION UESTION COUNTS OUNTS!••••••••••• ••••••••••• •••••••••••

?

Q: Why Does NHTSA Jointly

Administer the EMSC

Program?

A:The Emergency Medical Servicesfor Children (EMSC) web site

and printed materials state that the

EMSC Program is jointly administered

by two federal agencies—the U.S.

Department of Health and Human Services’ Health Resources and Services

Administration, Maternal and Child

Health Bureau (MCHB) and the U.S.

Department of Transportation’s

National Highway Traffic Safety

Administration (NHTSA). Although

some may think this dual-reporting

and administration function is unproductive and somewhat overlapping, it

actually is very much the opposite. 

NHTSA’s mission is to reduce

death and disability as well as health

care costs resulting from motor vehicle crashes, medical emergencies, or

other injury incidents. This is accomplished by setting national standards

for EMS provider training, establishing

emergency response vehicle equipment standards, conducting consumer

information campaigns on motor vehicle safety and emergency assistance,

?

and much more. In basic terms,

NHTSA is the EMS expert, whereas

MCHB is the child health care expert.

Each agency needs to access the

strength, knowledge, and resources of

the other to effectively and efficiently

address the special needs of children

in the emergency medical system. By

working together, the agencies avoid

the duplication of efforts.

Q: How has the EMSC

Program Benefited from

NHTSA’s Involvement?

A:NHTSA’s approach to EMSC is

“what ever is done to improve

EMS will be designed to improve EMSC

and vice versa.” In demonstration of

this belief, NHTSA has implemented

many initiatives to improve the care of

children in emergency situations.

In cooperation with the EMS community, NHTSA revised the EMT-Basic,

EMT-Intermediate, and EMT-Paramedic

National Standard Curricula and associated refresher course revisions, as

well as the Emergency Medical Dispatcher curricula, to include pediatric

components. It also developed several

national public information cam-

?

paigns, such as Make the Right Call

and First There, First Care, to promote public understanding and appropriate use of the EMS system. Both

campaigns address the unique needs

of children and/or the role children

play in accessing or providing emergency care.

In collaboration with the National

Association of Emergency Medical

Physicians, NHTSA developed a

National Standard Curriculum on

Medical Direction for states to use in

implementing training programs and

establishing standards for medical

direction. These standards include

provisions for pediatric emergency

care. In addition, NHTSA’s EMS Agenda for the Future, which sets the pace

for all EMS activities, includes the

special needs of children in every

aspect of EMS system development.

The NHTSA State EMS Assessment

Survey also has been revised to

include questions about pediatric

emergency care readiness. These are

just a few of the many EMSC–related

activities NHTSA has implemented

over the past several years. Numerous

other initiatives are expected in the

near future.

14 EMSC News MAY/JUNE 2000
STATISTICUtilization of Ambulatory Health Care by Setting and Selected Characteristics for Children age 17 and Under

Statistic of the Quarter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Characteristic (N) in Thousands Percent with at Least One

Office-based Visit Hospital-based Visit Emergency Department Visit

Total Age 71,479 71.5 18.2 12.9

Less than 1 y 3, 740 78.0 17.5 6.7

1 to 4 y 16, 072 84.1 24.1 18.0

5 to 9 y 19, 864 72.2 16.0 11.2

10 to 14 y 19, 478 64.2 16.1 11.7

15 to 17 y 12, 325 63.7 17.4 13.1

Race/ethnicity

White 46, 483 77.3 20.1 14.4

Black 11, 182 59.0 14.6 10.3

Hispanic 10, 625 62.6 14.9 11.1

Other 3, 187 61.5 13.0 7.2

Health insurance 

Private 49, 002 76.2 18.1 12.5

Public Only 14, 877 66.8 20.6 15.5

Uninsured 7, 601 50.7 13.6 10.8

In addition to Families First — a

statewide welfare reform program —

Governor Sundquist reformed the way

Tennessee cares for its children in need

by consolidating all of the state’s services into one department. Under his

governorship, the state’s child immunization rate has reached an all-time

high, while its teen pregnancy and

infant mortality rates have declined to

record lows. The governor also was

instrumental in establishing a state

health insurance program for children

without access to health coverage.

EMSC Lifetime Achievement

Award—James Seidel, MD,

PhD

James Seidel has

been a tireless

advocate for EMSC

since the program’s

1984 inception.

Serving as the principal investigator of

one of the original four EMSC grants

awarded within the U.S., he estabEMSC National Heroes (from page 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

lished a research coalition with the

EMS Authority for the State of California and the Los Angeles EMS Agency,

which still functions today. In 1991,

he received a grant to develop the

National EMSC Resource Alliance,

which is one of only three EMSC

resource centers in the nation. Under

his leadership, the Center developed

the first national EMSC newsletter,

web site, library, and series of interactive products and programs that continue to be used throughout the country.

Dr. Seidel helped develop the first

Pediatric Advanced Life Support

(PALS) guidelines, which continue to

serve as the national standard for

training health professionals in pediatric resuscitation. He also established

the National Conference for Pediatric

Emergency Medicine Fellows and has

served as member and chair of numerous boards and committees at the

local, regional, and national levels. In

addition, he has authored more than

19 books and 75 journal articles.

Source: McCormick, Marie; Kass, Barbara; et al. “Annual Report on Access to and Utilization of Health Care for Children and Youth in the US-1999”

Pediatrics, 105: 1 ( January 2000)

Recently reproduced by North Dakota’s

EMSC project, the product soon may

be translated into Spanish by Puerto

Rico’s EMSC program.

EMSC State Legislator Award

— Governor Don Sundquist

In 1998, Governor

Don Sundquist

signed into law the

Emergency Medical

Services for Children Act and a host

of other bills supporting child services. During the

same year, he 

hosted the first-ever Governor’s Summit on Tennessee’s Children, bringing

together families, businesses, churches,

schools, and volunteers who are committed to brightening the future for

Tennessee children. An outcome of

the Summit, the Governor’s TNkids Initiative, stresses prevention, early intervention, and coordination of services

for families and children at the state

and local levels. 

Martha Sundquist

accepted the award

on the Governor’s

behalf.

EMSC News MAY/JUNE 2000 15
16

n

2000

May 15-18

ACEP’s Leadership and Legislative

Issues Conference

Washington, DC

Contact: (800) 798-1822

May 18

Enhancing Advocacy in the NICU:

Sharing Bad News with Parents

Loyola Stritch School of Medicine

Maywood, IL

Contact: (708) 216-3236

May 25-29

American Pediatric Surgical 

Associations’

2000 Annual Meeting

Orlando, FL

Contact: (978) 526-8330

June 8-10

American Academy of Pediatrics’

(AAP) Conference on Neonatal/Pediatric Critical Care Transport

Chicago, IL 

Contact: cme@aap.org

June 10-11

AAP’s Transport Leadership:

Evolution, Current Status, and Planning for the Future

Chicago, IL

Contact: cme@aap.org

June 22-25

Mountain Rescue Association 42nd

Annual Conference

Nordegg, Alberta, Canada

Contact: Tim Kovacs 

at (602) 973-0166

June 23-27

Kiwanis 85th International 

Convention

Miami Beach, FL

Contact: Leah Campbell 

at (317) 875-8755, Ext. 134

June 28 – July 1

National Association of School Nurses’

Annual Conference

Milwaukee, WI

Contact: Susan Wurzburg 

at (973) 267-8938 

July 16-20

National Conference of State 

Legislatures Annual Meeting

Chicago, IL

Contact: LeAnn Hoff 

at (303) 830-2200

August 12-17

PREP: EM (An intensive review course

of pediatric emergency medicine)

Seattle, WA

Contact: AAP at (800) 433-9016,

Option 3

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

May

Asthma and Allergy Awareness Month

Contact: Colleen Horn of the Asthma

and Allergy Awareness Foundation of

America at (800) 7-asthma

May

National Trauma Awareness Month

Contact: American Trauma Society 

at (800) 798-1822

May 6-13

Safe Kids Week 

Contact: National Safe Kids Campaign

at (202) 662-0600

May 12-16

Ambulatory Pediatrics Association

Annual Meeting

Boston, MA

Contact: (703) 556-9222

May 14-18

National Fire Protection Association 

Annual Meeting

Denver, CO

Contact: Kathy Phillips 

at (617) 770-3000

May 14-20

National Emergency Medical 

Services Week

Contact: Rick Murray of the American

College of Emergency Physicians

(ACEP)

at (800) 798-1822

EMSC National Resource Center

Children’s National Medical Center

111 Michigan Avenue, N.W.

Washington, DC 20010

BULK RATE

Postage and

Fees

Paid HRSA

Permit No. G-286

EMSCNEWS MAY/JUNE 2000