Number 47  March 1, 2012

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Availability of Pediatric Services and Equipment in 

Emergency Departments: United States, 2006

by Susan M. Schappert, M.A., and Farida Bhuiya, M.P.H. 

Division of Health Care Statistics

Abstract

Objectives—This report presents data on the availability of pediatric services, 

expertise, and supplies for treating pediatric emergencies in U.S. hospitals. 

Methods—Data in this report are from the Emergency Pediatric Services and 

Equipment Supplement (EPSES), a self-administered questionnaire added to the 2006 

National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS samples 

nonfederal short-stay and general hospitals in the United States. Sample data were 

weighted to produce annual estimates of pediatric services, expertise, and equipment 

availability in hospital emergency departments (EDs).

Results—In 2006, only 7.2 percent of hospital EDs had all recommended pediatric 

emergency supplies, and 45.6 percent had at least 85.0 percent of recommended 

supplies. EDs in children’s hospitals and hospitals with pediatric intensive care units 

(PICUs) were more likely to meet guidelines for pediatric emergency department 

services, expertise, and supplies. About 74.0 percent of these facilities had at least 

85.0 percent of recommended supplies, compared with 42.4 percent of other facilities. 

Among children’s hospitals and hospitals with PICUs, 66.0 percent had 24 hours a 

day, 7 days a week access to a board-certified pediatric emergency medicine attending 

physician; such access was uncommon in other types of hospitals. In general, little 

change was noted in the availability of emergency pediatric supplies between 2002–

2003, when the initial EPSES was conducted, and 2006. 

Keywords: children • emergency care • medical equipment • National Hospital 

Ambulatory Medical Care Survey

5.5 percent of EDs had all recommended 

supplies (2).A supplement to the 2006 

National Hospital Ambulatory Medical 

Care Survey (NHAMCS) was conducted 

to assess progress made since that time. It 

expanded upon the earlier survey by also 

including a panel of children’s hospitals. 

This report highlights results from 

the 2006 EPSES on the availability of 

pediatric services, expertise, and supplies 

in U.S. hospitals for treating pediatric 

emergencies. 

Methods

Data in this report are from EPSES, a 

self-administered questionnaire added to 

the 2006 NHAMCS. NHAMCS samples 

nonfederal short-stay and general 

hospitals in the United States. EPSES 

was also administered as part of the 2002 

and 2003 NHAMCS; the 2006 version 

incorporated some additional data items. 

The core EPSES content in each year was 

based on the 2001 guidelines for pediatric 

services, medical expertise, and smallsized supplies and equipment for EDs 

developed by the American Academy 

of Pediatrics (AAP) and the American 

College of Emergency Physicians 

(ACEP) (3). The 2006 EPSES response 

rate was 80.2 percent. Estimates were 

weighted to produce annual estimates 

of pediatric services, expertise, and 

equipment availability in EDs. 

Introduction

In 1993, the Institute of Medicine 

recommended that all agencies with 

jurisdiction over hospitals “require that 

hospital emergency departments...have 

available and maintain equipment and 

supplies appropriate for the emergency 

care of children” (1). In 2006, the 

Centers for Disease Control and 

Prevention’s (CDC) National Center 

for Health Statistics released data from 

the first Emergency Pediatric Services 

and Equipment Supplement (EPSES) 

conducted in 2002–2003. It showed that 

emergency departments (EDs) generally 

had 82.9 percent of recommended 

emergency pediatric supplies, but only 
Page 2 National Health Statistics Reports  Number 47  March 1, 2012

Results

Overview of ED pediatric 

utilization and inpatient 

pediatric services

● In 2006, there were an estimated 

26.3 million hospital ED visits in the 

United States by persons under age 

18, or 35.7 visits per 100 persons. 

Pediatric visits accounted for 22.1 

percent of all ED visits (Figure 1). 

● Of the 4,800 general and shortstay hospitals with 24-hour EDs in 

the United States during 2006, the 

majority (87.2 percent) admitted 

children, but only 10.1 percent were 

children’s hospitals or had pediatric 

intensive care units (PICUs). (Table 

1, Figure 2). Among those that did not 

admit pediatric patients, 48.5 percent 

were in counties that had a children’s 

hospital (not shown).

● About one-quarter (28.6 percent of 

emergency pediatric visits) occurred 

in children’s hospitals and those with 

PICUs, while 29.0 percent occurred 

in hospitals that either did not admit 

children or had no separate pediatric 

ward (Figure 3). 

Services for pediatric 

emergencies by type of 

hospital

● About one-tenth (10.4 percent) of 

EDs reported having pediatric 23-hour 

observation units, but the presence of 

such units ranged from 39.4 percent 

for children’s hospitals and hospitals 

with PICUs (Table 2) to 7.1 percent 

for all other hospitals (Figure 4).

● In general, only 11.0 percent of 

EDs reported that critically injured 

pediatric patients would be cared for 

in their hospital (Table 2).

● About one-fifth (19.3 percent) of 

EDs reported having pediatric trauma 

services; for children’s hospitals and 

hospitals with PICUs, this increased 

to about three-quarters (76.4 percent) 

(Table 2). 

● For hospitals without pediatric trauma 

services, about one-half had a written 

transfer agreement with another 

hospital (49.5 percent). Of those 

without written transfer agreements, 

about 8 of 10 (84.7 percent) stated 

that they would send critically injured 

pediatric patients to another hospital 

without such an agreement (Table 2).

● The majority (84.0 percent) of 

hospitals stated that they would send 

pediatric patients requiring intensive 

care to another hospital. About 

one-half (53.5 percent) of EDs had 

a written transfer agreement with 

facilities having a PICU, ranging from 

32.6 percent of children’s hospitals 

and hospitals with PICUs to 53.5 

percent of all other hospitals (Table 2, 

NOTE: Based on 119,191,000 emergency department visits. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2006.

Hospital emergency department visits

Under age 18

22.1%

18–24 years

12.7% 

25–44 years

29.4%

45–64 years

21.4% 

65–74

years

6.0%

75 years

and over

8.6%

Figure 1. Percent distribution of hospital emergency department visits, by patient age: 

United States, 2006

1

PICU is pediatric intensive care unit. Category includes children’s hospitals and hospitals with PICUs.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2006.

Does not

admit

children

12.9%

No separate

pediatric ward

46.3%

Separate

pediatric ward

30.8%

Children's/

PICU hospital1

10.1%

Hospital emergency departments

Figure 2. Hospital emergency departments, by inpatient pediatric structure: United States, 

2006
National Health Statistics Reports  Number 47  March 1, 2012 Page 3

Figure 4). [Note that hospitals with 

PICUs may have written transfer 

agreements to send pediatric patients 

to other hospitals with PICUs for 

a variety of reasons. For example, 

serious trauma may require a different 

type of care than is available in a 

regular PICU, some PICUs may be 

small and not equipped to handle 

certain types of patients, and some 

agreements to transfer may be based 

simply on capacity and the lack of 

available beds (4).]

Staffing expertise for 

pediatric emergencies by 

type of hospital

● The majority of hospitals had 24 hours 

a day, 7 days a week access either 

in-house or on-call to a board-certified 

emergency medicine attending 

physician (72.1 percent) or a boardcertified pediatric attending physician 

1

PICU is pediatric intensive care unit. Category includes children’s hospitals and hospitals with PICUs. 2

Excludes data for 2.2 million pediatric visits (8.4% of total pediatric visits) where inpatient pediatric structure was unknown.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2006.

Does not

admit

children

9.7%

No separate

pediatric ward

21.8%

Separate pediatric ward

39.9%

Children's/PICU hospital1

28.6%

Hospital emergency department visits2

 by persons under age 18

Figure 3. Pediatric visits to hospital emergency departments, by inpatient pediatric 

structure: United States, 2006

† Estimates for some categories are statistically unreliable and are not shown.

1

PICU is pediatric intensive care unit. Category includes children’s hospitals and hospitals with PICUs.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2006.

0

10

20

30

40

50

60

70

80

90

100

Percent of emergency departments

Children's/PICU hospitals All hospitals 1 Other hospitals

Pediatric 23-hour

observation unit

Pediatric trauma

service

Written transfer

agreement with

facility with PICU

This hospital Other hospital

with transfer

agreement

Other hospital

without transfer

agreement

Place of care for critically injured pediatric patients

† † †

Figure 4. Selected pediatric emergency services, by type of hospital: United States, 2006
Page 4 National Health Statistics Reports  Number 47  March 1, 2012

1

Significant difference (p < 0.05). 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2006.

0

10

20

30

40

50

60

70

80

90

100

Monitoring

supplies1

Vascular

access

Airway

management

Resuscitation

medications

Specialized

pediatric trays

Fracture

management

Miscellaneous

supplies

All supplies

Percent of emergency departments

Pediatric supplies

2002–2003 2006

Figure 5. Emergency departments fully supplied with recommended pediatric emergency supplies, by year: United States, 2002–2003 and 

2006

(59.4 percent). Such access was 

reported more frequently for children’s 

hospitals and hospitals with PICUs 

than for other hospitals (Table 3). 

● Among children’s hospitals and 

hospitals with PICUs, 66.0 percent 

had 24 hours a day, 7 days a week 

access to a board-certified pediatric 

emergency medicine attending 

physician; such access was uncommon 

in other types of hospitals (Table 3).

● While only 8.5 percent of EDs 

reported having a pediatrician on 

duty in the ED 24 hours a day, 7 days 

a week, 31.8 percent had a written 

protocol stating when a pediatrician 

would be called to the ED (Table 3). 

For definitions of each type of 

physician, see “Technical Notes.”

Availability of emergency 

pediatric supplies overall 

● In 2006, 7.2 percent of hospitals had 

all recommended pediatric supplies. 

This was not statistically different 

from the 5.5 percent of hospitals in 

2002–2003 (Table 4, Figure 5).

● About one-half of EDs (45.6 

percent) had at least 85.0 percent of 

recommended supplies (not shown). 

● EDs were most likely to have 

resuscitation supplies (95.5 percent). 

Least likely to be in full supply were 

airway management supplies (14.7 

percent) and vascular access supplies 

(15.8 percent) (Table 4, Figure 5). 

● For some supplies, smaller sizes 

were available less frequently than 

larger sizes. For example, size 10 

French nasopharyngeal airways were 

available at 59.9 percent of EDs, but 

the same item in size 28 was available 

at 75.6 percent of EDs. Similarly, 

tracheostomy tubes and Foley 

catheters were found more frequently 

in larger sizes (Table 4). 

● Although supplies may not have been 

directly available in the ED, several 

hospitals indicated resources were 

available from other in-house or 

“nearby” locations such as: neonatal 

intensive care unit, obstetrics and 

newborn nursery, central supply, 

pharmacy, “sister” pediatric hospitals, 

or children’s hospitals. 

Availability of emergency 

pediatric supplies by type of 

hospital

● A higher percentage of EDs in 

children’s hospitals and hospitals 

with PICUs compared with all other 

hospitals reported the availability 

of all monitoring supplies (82.2 

percent and 51.3 percent), vascular 

access supplies (39.2 percent and 
National Health Statistics Reports  Number 47  March 1, 2012 Page 5

† Percentage for “other hospitals” with all supplies is statistically unreliable and is not shown. 1

PICU is pediatric intensive care unit. Category includes children’s hospitals and hospitals with PICUs. 2

Significant difference (p < 0.05).

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, 2006.

0

10

20

30

40

50

60

70

80

90

100

Monitoring

supplies2

Vascular

access2

Airway

management

Resuscitation

medications

Specialized

pediatric trays2

Fracture

management

2

Miscellaneous

supplies2

All supplies

Percent of emergency departments

Pediatric supplies

Children's/PICU hospitals1 Other hospitals

†

Figure 6. Percentage of emergency departments with all recommended pediatric emergency supplies, by type of hospital: United States, 

2006

13.2 percent), specialized pediatric 

trays (48.8 percent and 22.7 percent), 

fracture management supplies (68.5 

percent and 44.1 percent), and 

miscellaneous supplies (79.5 percent 

and 45.5 percent) (Table 5, Figure 6). 

● No statistical differences were 

noted between hospital types in the 

percentages of EDs having all airway 

management supplies or resuscitation 

medication supplies, although there 

were differences for some specific 

items within these categories 

(Table 5). 

● In all, 16.2 percent of EDs in 

children’s hospitals and hospitals 

with PICUs were fully supplied. The 

corresponding percentage for other 

hospitals was statistically unreliable 

(Table 5).

● EDs in children’s hospitals and 

hospitals with PICUs were more likely 

to meet the AAP and ACEP guidelines 

for pediatric emergency department 

services, expertise, and supplies. 

Summary

In 2006, roughly one-half of EDs had 

85.0 percent or more of recommended 

pediatric supplies, but only 7.2 percent 

of EDs had all recommended pediatric 

supplies, suggesting that inventories 

could be improved at most EDs. EDs at 

children’s hospitals and those with PICUs 

were better prepared to treat pediatric 

emergencies than other types of hospitals, 

with 74.0 percent having at least 85.0 

percent of recommended supplies. Yet 

even within these hospitals, many AAP 

guidelines had not been met. 

While the AAP recommended that 

every ED should have a pediatrician 

for coverage 24 hours a day, 7 days a 

week, only 8.5 percent of EDs reported 

having a pediatrician in the ED 24 hours 

a day, 7 days a week in 2006. This is not 

statistically different than the 2002–2003 

figure of 9.0 percent. A total of 59.4 

percent of EDs had a board-certified 

pediatric attending physician not directly 

in the ED, but either in-house (within the 

hospital) or on-call. However, of those 

EDs without ED pediatric coverage 24 

hours a day, 7 days a week, only 31.8 

percent had written protocols stating 

when to call a pediatrician. This may 

leave staff without clarity as to when to 

most appropriately access these services.

The AAP encouraged all EDs to 

establish transfer agreements with 

facilities that have higher levels of 

pediatric care to ensure timely access to 

care for critically ill and injured children. 

Overall, 2006 data confirmed 2002–2003 

results that showed EDs are usually able 

to transfer critically injured pediatric 
Page 6 National Health Statistics Reports  Number 47  March 1, 2012

trauma patients and those requiring 

intensive care when the hospital of the 

ED is not equipped for such pediatric 

services. Admission and transfer of 

emergency pediatric cases, however, is 

a fairly rare outcome. Unpublished data 

from the 2006 NHAMCS indicate that 

only 5.6 percent of ED pediatric cases 

were either admitted to the hospital from 

the ED or transferred to another hospital; 

most patients were treated and released. 

Little change was seen when data 

were compared with results from the 

2002–2003 EPSES data. Very few 

statistically significant changes were 

noted between the two time periods, but 

this could be related to the relatively 

smaller sample size in 2006. The 

previous EPSES report compared 2002–

2003 findings with those from a study 

conducted in 1998 (5) by the Consumer 

Product Safety Commission on behalf 

of the Health Resources and Services 

Administration’s (HRSA) Emergency 

Medical Services for Children 

(EMSC) Program. A lack of significant 

improvement in the ability of hospitals 

to treat pediatric emergencies was noted 

between those time periods as well. 

Since the 2006 EPSES was 

conducted, the AAP issued a revised joint 

policy statement on guidelines for care of 

children in the ED (6).These guidelines 

are consistent with those issued by the 

Institute of Medicine (IOM) in 2006 (7), 

which called for regionalized systems of 

care and the appointment of coordinators 

for pediatric emergency care within 

hospitals and emergency medical services 

(EMS) systems. HRSA’s EMSC Program 

partners with states and territories to 

“fund activities that improve, refine, 

and integrate pediatric care within the 

state EMS system” (8). Since 2009, all 

grantees have been required to report 

on 10 performance measures that are 

consistent with IOM and AAP guidelines. 

The 2006 EPSES data suggest that EDs 

of children’s hospitals and those with 

PICUs may be better prepared than 

other types of hospitals to treat pediatric 

emergencies, yet most hospitals could 

improve their inventory of supplies 

to achieve full compliance with 

recommended guidelines. For additional 

information on NHAMCS and EPSES, 

see the Ambulatory Health Care Data 

website: http://www.cdc.gov/nchs/ahcd.

htm. 

References

1. Institute of Medicine, Committee on 

Pediatric Emergency Medical Services. 

Emergency Medical Services for Children. 

Durch JS, Lohr KN, eds. Washington, DC: 

National Academies Press. 1993.

2. Middleton KR, Burt CW. Availability 

of pediatric services and equipment in 

emergency departments: United States, 

2002–03. Advance data from vital and 

health statistics; no 367. Hyattsville, MD: 

National Center for Health Statistics. 

2006.

3. American Academy of Pediatrics. Care 

of children in the emergency department: 

Guidelines for preparedness. Pediatrics 

107(4):777–81. 2001. Available from: 

http://aappolicy.aappublications.org/

cgi/content/full/pediatrics;107/4/777

[Accessed 9/30/11].

4. Pitts S, Simon A, Niska R. Personal 

communication. 2011.

5. Athey J, Dean JM, Ball J, Wiebe R, 

Melese-d’Hospital I. Ability of hospitals 

to care for pediatric emergency patients. 

Pediatr Emerg Care 17(3):170–4. 2001. 

6. American Academy of Pediatrics. 

Joint policy statement—Guidelines 

for care of children in the emergency 

department. Pediatrics 124(4):1233–43. 

2009. Available from: http://aappolicy.

aappublications.org/cgi/content/abstract/

pediatrics;124/4/1233 [Accessed 9/30/11].

7. Institute of Medicine. The future of 

emergency care: Key findings and 

recommendations. Fact sheet. 2006. 

Available from: http://www.nremt.org/

nremt/downloads/IOM%20fact%20

sheet%20summary.pdf [Accessed 

9/30/11].

8. EMSC National Resource Center. 

Available from: http://www.

childrensnational.org/EMSC/ForGrantees/

Performance_Measures.aspx [Accessed 

9/30/11]. 
Table 1. Number and percent distribution of emergency departments, by hospital characteristics, according to inpatient pediatric structure: United State

Hospital characteristic Number of emergency departments (Standard error) Percent distribution (Standard error of percent) Total Does not admit children No separate pediatric ward 

Percent distribut

All EDs2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,800 (263.7) 100.0 ... 100.0 12.9 (1.9) 46.3 (3.9) 

Inpatient pediatric structure: Does not admit children . . . . . . . . . . . . . . . . . . . . . . 600 (99.2) 12.9 (1.9)

...

...

...

Admits children, no separate pediatric ward . . . . . . 2,200 (254.9) 46.3 (3.9)

...

...

...

Admits children, separate pediatric ward . . . . . . . . . 1,500 (151.1) 30.8 (3.4)

...

...

...

Children's hospital or has a PICU . . . . . . . . . . . . . . 500 (69.3) 10.1 (1.4)

...

...

...

ED pediatric visit volume:

Less than 4,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,300 (291.9) 48.8 (4.3) 100.0 * 75.4 (4.5) 

4,000–10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,700 (192.7) 36.2 (4.2) 100.0 * 23.7 (6.1) 

More than 10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . 700 (73.6) 15.0 (1.7) 100.0 * * 

Ownership:

Voluntary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,100 (215.6) 64.2 (4.6) 100.0 15.3 (2.6) 39.5 (4.1) Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,200 (247.8) 24.2 (4.5) 100.0 * 64.8 (9.5) Proprietary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600 (126.3) 11.7 (2.5) 100.0 * * 

Geographic region:

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600 (75.5) 13.6 (1.6) 100.0 12.9 (1.9) * 

Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,300 (166.0) 28.3 (2.8) 100.0 * 57.4 (6.2) 

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,900 (171.6) 40.2 (2.8) 100.0 * 49.3 (6.7) West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 900 (88.4) 18.0 (1.8) 100.0 * * 

MSA:

Metropolitan statistical area . . . . . . . . . . . . . . . . . . . 3,300 (245.3) 68.2 (3.6) 100.0 18.8 (2.7) 29.5 (4.3) 

Not a metropolitan statistical area . . . . . . . . . . . . . . 1,500 (193.7) 31.8 (3.6) 100.0 – 82.2 (5.6) 

Teaching hospital:

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,300 (167.3) 26.3 (3.3) 100.0 23.1 (4.9) * 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,500 (259.4) 73.7 (3.3) 100.0 * 57.2 (4.8) 

Trauma center levels:

Level 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400 (81.8) 7.9 (1.7) 100.0 * * Level 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,000 (129.1) 20.4 (2.7) 100.0 * * Level 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 900 (172.7) 18.2 (3.6) 100.0 * 63.8 (8.5) 

Other or missing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,600 (277.4) 53.5 (4.2) 100.0 15.8 (3.4) 50.9 (5.8) 

Children's hospital in same county:

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 800 (126.6) 17.4 (2.5) 100.0 35.8 (5.5) 21.8 (3.8) No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,900 (252.9) 82.6 (2.5) 100.0 8.0 (1.6) 51.4 (4.5) 

... Category not applicable.* Figure does not meet standards of reliability or precision.– Quantity zero. 1PICU is pediatric intensive care unit. 2ED is emergency department.NOTE: Numbers may not add to totals because of rounding.
Table 2. Percentages of emergency departments with pediatric services, by inpatient pediatric structure: United States, 2006 Inpatient pediatric structure Pediatric services All EDs1 Does not admit children2 No separate pediatric ward3 Sepa

pediatric 

Percent (standard error) Hospital has pediatric 23-hour observation unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.4 (1.6) – * 18.3 (

Place of care for critically injured pediatric patients: In this hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.0 (2.0) – * 

In another hospital, with transfer agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48.5 (4.4) 63.3 (7.7) 50.8 (7.7) 52.9 (

In another hospital, without transfer agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.7 (4.8) * 46.7 (7.7) 35.0 (

Hospital has pediatric trauma service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 (3.0) * * 

Hospital has no pediatric trauma service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80.6 (3.0) 98.5 (1.4) 90.9 (4.0) 76.3 (For hospitals with pediatric trauma service: Critically injured pediatric trauma patients requiring hospitalization would be cared for: In this hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42.0 (7.3) * * 

In another hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.2 (7.4) * * 

For hospitals without pediatric trauma service: Written transfer agreement with a facility with pediatric trauma service . . . . . . . . . . . . . . . . . 49.5 (5.1) 54.5 (8.0) 41.1 (8.5) 62.0 

No written transfer agreement with a facility with pediatric trauma service . . . . . . . . . . . . . . 44.3 (5.4) * 53.3 99.3) 34.7 

For hospitals without pediatric trauma service but transfer agreement: Critically injured pediatric trauma patients requiring hospitalization would be cared for: In another hospital, per written transfer agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88.5 (3.7) 100.0 96.6 (2.6) 76.6 (For hospitals without pediatric trauma service and no transfer agreement: Critically injured pediatric trauma patients requiring hospitalization would be cared for: In another hospital, without written transfer agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84.7 (6.2) * 88.7 (6.8) 79.0 (1Pediatric patients requiring intensive care would be cared for: In pediatric ICU of this hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.1 (1.4) – – 

In adult ICU of this hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * – * 

In another hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84.0 (2.5) 100.0 92.7 (3.8) 91.9 (

Hospital has written transfer agreement with facility that has a pediatric intensive care unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.5 (4.0) 60.7 (7.8) 51.6 (5.9) 60.2 

– Quantity zero. * Figure does not meet standards of reliability or precision. 1ED is emergency department. Percentages are based on an estimated 4,800 EDs. 2Percentages are based on an estimated 600 EDs. 3Percentages are based on an estimated 2,200 EDs. 4Percentages are based on an estimated 1,500 EDs. 5PICU is pediatric intensive care unit. Percentages are based on an estimated 500 EDs.
Table 3. Percentages of emergency departments with pediatric expertise, by inpatient pediatric structure: United States, 2006 Inpatient pediatric structure Pediatric expertise All EDs1 Does not admit children2 No separate pediatric ward3 Sepa

pediatric 

Percent (standard error) Hospital has pediatrician on duty in the ED 24 hours a day, 7 days a week (24/7) . . . . . . . . . . 8.5 (1.4) * * 

If pediatrician is not on duty 24/7, hospital has written protocol stating when a pediatrician will be called to the ED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.8 (4.2) * 21.3 (5.4) 37.4 (ED has 24/7 access either in-house or on call to: Board-certified emergency medicine attending physician . . . . . . . . . . . . . . . . . . . . . . . . . . . 72.1 (3.8) 94.5 (4.0) 57.2 (7.4) 77.5 (

Board-certified pediatric attending physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59.4 (3.9) * 46.0 (6.0) 77.9 (Board-certified pediatric emergency medicine (PEM) attending physician . . . . . . . . . . . . . . 20.1 (2.5) * * 14.8 (

For EDs without 24/7 access to board-certified PEM attending physician: ED has 24/7 access to board-certified EM attending physician . . . . . . . . . . . . . . . . . . . . . . . 64.0 (4.9) 92.5 (5.2) 51.0 (8.4) 72.2 (

ED has 24/7 access to board-certified pediatric attending physician . . . . . . . . . . . . . . . . . . . 48.3 (4.6) * 38.2 (6.6) 72.9 (

* Figure does not meet standards of reliability or precision. 1ED is emergency department. Percentages are based on an estimated 4,800 EDs. 2Percentages are based on an estimated 600 EDs. 3Percentages are based on an estimated 2,200 EDs. 4Percentages are based on an estimated 1,500 EDs. 5PICU is pediatric intensive care unit. Percentages are based on an estimated 500 EDs.
Page 10 National Health Statistics Reports  Number 47  March 1, 2012

Table 4. Percentages of emergency departments with pediatric supplies: United States, 2002–2003 and 2006

2002–2003

All EDs1

2006

All EDs

Pediatric supplies Percent of EDs2

(Standard error

of percent) Percent of EDs

(Standard error

of percent)

Monitoring

Have all monitoring supplies** . . . . . . . . . . . . . . . . . . 65.3 (3.3) 54.4 (4.2)

Cardiorespiratory monitor . . . . . . . . . . . . . . . . . . . . 95.7 (4.4) 96.3 (1.9)

Defibrillator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97.5 (0.9) 95.1 (2.0)

Pediatric monitor electrodes . . . . . . . . . . . . . . . . . . 94.6 (1.9) 92.5 (3.0)

Pulse oximeter with newborn sensor . . . . . . . . . . . 91.7 (2.0) 87.2 (3.6)

Pulse oximeter with child sensor . . . . . . . . . . . . . . 93.8 (1.8) 93.4 (2.4)

Thermometer/rectal probe . . . . . . . . . . . . . . . . . . . 90.8 (1.7) 92.6 (2.8)

Doppler blood pressure device . . . . . . . . . . . . . . . 84.6 (2.5) 80.5 (4.2)

Blood pressure cuff: neonatal size . . . . . . . . . . . . . 90.6 (1.7) 86.6 (3.2)

Blood pressure cuff: infant size . . . . . . . . . . . . . . . 96.2 (1.5) 93.3 (2.9)

Blood pressure cuff: child size . . . . . . . . . . . . . . . . 98.0 (1.0) 97.9 (1.3)

Blood pressure cuff: small adult size . . . . . . . . . . . 97.5 (1.0) 97.0 (1.6)

Monitor for ET3 tube and placement . . . . . . . . . . . . 88.4 (2.2) 92.8 (2.2)

Sphygmomanometer4 . . . . . . . . . . . . . . . . . . . . . . . ... ... 88.6 (2.3)

Stethoscope4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... 90.0 (2.3)

Vascular access

Have all vascular access supplies . . . . . . . . . . . . . . . 12.4 (1.5) 15.8 (2.8)

Butterfly needles: 19g** . . . . . . . . . . . . . . . . . . . . . 72.0 (2.9) 60.5 (3.7)

Butterfly needles: 21g . . . . . . . . . . . . . . . . . . . . . . . 83.7 (2.8) 79.7 (3.6)

Butterfly needles: 23g** . . . . . . . . . . . . . . . . . . . . . 62.6 (2.7) 81.5 (3.2)

Butterfly needles: 25g** . . . . . . . . . . . . . . . . . . . . . 84.0 (2.0) 72.3 (4.0)

Catheter over needle: 16g . . . . . . . . . . . . . . . . . . . 92.8 (2.1) 94.0 (2.8)

Catheter over needle: 18g . . . . . . . . . . . . . . . . . . . 96.7 (1.3) 97.8 (1.6)

Catheter over needle: 20g** . . . . . . . . . . . . . . . . . . 69.6 (2.7) 97.8 (1.6)

Catheter over needle: 22g . . . . . . . . . . . . . . . . . . . 96.6 (1.3) 97.8 (1.6)

Catheter over needle: 24g short . . . . . . . . . . . . . . . 92.3 (2.3) 88.8 (3.1)

Catheter over needle: 24g long . . . . . . . . . . . . . . . 53.4 (2.9) 52.4 (4.1)

Infusion device . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97.6 (1.0) 98.0 (1.6)

Tubing for infusion device . . . . . . . . . . . . . . . . . . . . 97.4 (1.1) 96.7 (1.0)

Intraosseous needles: 16g . . . . . . . . . . . . . . . . . . . 83.4 (2.2) 76.2 (3.6)

Intraosseous needles: 18g . . . . . . . . . . . . . . . . . . . 80.5 (2.4) 81.6 (4.1)

Umbilical vein catheters: 3.5 Fr . . . . . . . . . . . . . . . 60.9 (3.3) 57.9 (4.6)

Umbilical vein catheters: 5 Fr . . . . . . . . . . . . . . . . . 64.9 (3.0) 62.5 (4.0)

Seldinger vascular access kit: 3 Fr catheter . . . . . . 24.7 (2.4) 26.6 (3.5)

Seldinger vascular access kit: 4 Fr catheter . . . . . . 29.6 (2.3) 31.6 (3.9)

Seldinger vascular access kit: 5 Fr catheter . . . . . . 28.1 (2.3) 34.5 (3.9)

Intravenous fluid and blood warmers4 . . . . . . . . . . ... ... 84.1 (2.5)

Portable oxygen regulators and canisters4 . . . . . . . ... ... 90.0 (2.3)

Airway management

Have all airway management supplies . . . . . . . . . . . 14.2 (1.5) 14.7 (2.7)

Preterm/neonatal oxygen masks** . . . . . . . . . . . . . 83.6 (2.5) 70.3 (4.0)

Infant oxygen masks . . . . . . . . . . . . . . . . . . . . . . . 95.3 (1.0) 90.4 (3.4)

Child oxygen masks . . . . . . . . . . . . . . . . . . . . . . . . 98.1 (0.5) 96.0 (2.6)

Infant non-rebreathing masks . . . . . . . . . . . . . . . . 75.9 (2.1) 75.0 (4.3)

Child non-rebreathing masks . . . . . . . . . . . . . . . . . 86.3 (1.8) 89.2 (3.4)

Oralpharyngeal airway: size 00 . . . . . . . . . . . . . . . 67.7 (3.0) 68.5 (3.9)

Oralpharyngeal airway: size 0 . . . . . . . . . . . . . . . . 84.9 (3.2) 79.3 (3.5)

Oralpharyngeal airway: size 1 . . . . . . . . . . . . . . . . 86.7 (3.0) 81.8 (3.8)

Oralpharyngeal airway: size 2 . . . . . . . . . . . . . . . . 87.7 (2.4) 83.3 (3.4)

Oralpharyngeal airway: size 3 . . . . . . . . . . . . . . . . 86.4 (2.4) 80.3 (3.6)

Nasopharyngeal airways: size 10 Fr............. 53.6 (2.6) 59.9 (4.8)

Nasopharyngeal airways: size 12 Fr . . . . . . . . . . . 60.3 (2.9) 63.8 (5.0)

Nasopharyngeal airways: size 14 Fr . . . . . . . . . . . 61.1 (2.9) 65.2 (4.8)

Nasopharyngeal airways: size 16 Fr . . . . . . . . . . . 62.5 (2.9) 68.4 (4.8)

Nasopharyngeal airways: size 20 Fr . . . . . . . . . . . 67.2 (3.5) 67.7 (4.8)

Nasopharyngeal airways: size 24 Fr . . . . . . . . . . . 67.9 (3.1) 72.9 (4.1)

Nasopharyngeal airways: size 28 Fr . . . . . . . . . . . 73.3 (3.2) 75.6 (3.5)

Bag-valve-mask-resuscitator . . . . . . . . . . . . . . . . . 92.6 (1.5) 94.0 (2.2)

See footnotes at end of table.
National Health Statistics Reports  Number 47  March 1, 2012 Page 11

Table 4. Percentages of emergency departments with pediatric supplies: United States, 2002–2003 and 2006—Con.

2002–2003

All EDs1

2006

All EDs

Pediatric supplies Percent of EDs2

(Standard error

of percent) Percent of EDs

(Standard error 

of percent)

Nasal cannulae: infant . . . . . . . . . . . . . . . . . . . . . . 81.1 (3.4) 82.4 (4.4)

Nasal cannulae: child . . . . . . . . . . . . . . . . . . . . . . . 89.8 (1.8) 89.5 (4.3)

Uncuffed endotracheal tubes: size 2.5 . . . . . . . . . . 90.0 (2.4) 86.4 (3.7)

Uncuffed endotracheal tubes: size 3.0 . . . . . . . . . . 95.1 (1.3) 89.8 (3.2)

Uncuffed endotracheal tubes: size 3.5 . . . . . . . . . . 93.7 (1.8) 91.8 (3.1)

Uncuffed endotracheal tubes: size 4.0 . . . . . . . . . . 96.5 (1.2) 92.6 (2.6)

Uncuffed endotracheal tubes: size 4.5 . . . . . . . . . . 90.6 (1.9) 92.0 (2.5)

Uncuffed endotracheal tubes: size 5.5 . . . . . . . . . . 86.3 (2.6) 87.3 (3.0)

Uncuffed endotracheal tubes: size 5.5 . . . . . . . . . . 78.9 (2.4) 78.5 (3.7)

Uncuffed endotracheal tubes: size 6.0 . . . . . . . . . . 63.8 (2.5) 61.6 (4.1)

Uncuffed endotracheal tubes: size 6.5 . . . . . . . . . . 57.9 (2.4) 57.9 (3.8)

Uncuffed endotracheal tubes: size 7.0 . . . . . . . . . . 55.4 (2.6) 55.6 (4.2)

Uncuffed endotracheal tubes: size 7.5 . . . . . . . . . . 53.8 (2.5) 54.7 (4.0)

Cuffed endotracheal tubes: size 5.5 . . . . . . . . . . . . 81.8 (1.8) 84.9 (3.1)

Cuffed endotracheal tubes: size 6.0 . . . . . . . . . . . . 93.9 (1.4) 94.7 (2.1)

Cuffed endotracheal tubes: size 6.5 . . . . . . . . . . . . 92.1 (1.5) 95.2 (2.2)

Cuffed endotracheal tubes: size 7.0 . . . . . . . . . . . . 94.7 (1.5) 95.2 (2.1)

Cuffed endotracheal tubes: size 7.5 . . . . . . . . . . . . 93.5 (1.6) 94.4 (2.3)

Stylets: infant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83.3 (2.0) 84.5 (3.8)

Stylets: child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92.1 (1.9) 92.1 (2.8)

Laryngoscope handle, pediatric . . . . . . . . . . . . . . . 92.1 (1.6) 91.8 (2.4)

Curved laryngoscope blades: size 2 . . . . . . . . . . . 94.0 (1.7) 95.1 (1.9)

Curved laryngoscope blades: size 3 . . . . . . . . . . . 91.2 (1.5) 89.1 (2.8)

Straight laryngoscope blades: size 0 . . . . . . . . . . . 86.8 (2.8) 88.0 (3.3)

Straight laryngoscope blades: size 1 . . . . . . . . . . . 94.8 (1.5) 95.1 (2.6)

Straight laryngoscope blades: size 2 . . . . . . . . . . . 92.1 (2.2) 91.3 (3.0)

Straight laryngoscope blades: size 3 . . . . . . . . . . . 86.6 (2.0) 86.1 (3.2)

Magil forceps, pediatric . . . . . . . . . . . . . . . . . . . . . 76.0 (2.7) 73.1 (5.0)

Nasogastric tubes: size 5 Fr . . . . . . . . . . . . . . . . . . 77.7 (2.2) 77.4 (3.8)

Nasogastric tubes: size 6 Fr . . . . . . . . . . . . . . . . . . 57.2 (2.9) 65.2 (5.5)

Nasogastric tubes: size 8 Fr . . . . . . . . . . . . . . . . . . 87.1 (2.0) 85.2 (3.6)

Nasogastric tubes: size 10 Fr . . . . . . . . . . . . . . . . . 81.5 (2.6) 85.6 (4.3)

Nasogastric tubes: size 12 Fr . . . . . . . . . . . . . . . . . 87.3 (1.8) 87.8 (3.5)

Nasogastric tubes: size 14 Fr . . . . . . . . . . . . . . . . . 86.4 (1.7) 89.1 (3.7)

Flexible suction catheters: size 5/6 Fr . . . . . . . . . . 77.4 (2.7) 73.7 (4.7)

Flexible suction catheters: size 8 Fr . . . . . . . . . . . . 90.8 (2.4) 88.1 (4.3)

Flexible suction catheters: size 10 Fr . . . . . . . . . . . 92.2 (1.6) 90.5 (3.0)

Flexible suction catheters: size 12 Fr . . . . . . . . . . . 80.2 (2.3) 87.2 (3.3)

Chest tubes: size 8 Fr . . . . . . . . . . . . . . . . . . . . . . 40.8 (2.6) 47.2 (4.8)

Chest tubes: size 10 Fr . . . . . . . . . . . . . . . . . . . . . 63.9 (2.9) 58.4 (4.9)

Chest tubes: size 12 Fr . . . . . . . . . . . . . . . . . . . . . 63.5 (3.7) 63.1 (5.3)

Chest tubes: size 14 Fr . . . . . . . . . . . . . . . . . . . . . 48.9 (2.4) 49.5 (4.3)

Chest tubes: size 16 Fr . . . . . . . . . . . . . . . . . . . . . 78.3 (2.7) 69.2 (4.3)

Chest tubes: size 18 Fr . . . . . . . . . . . . . . . . . . . . . 54.4 (2.4) 54.2 (4.6)

Chest tubes: size 20 Fr . . . . . . . . . . . . . . . . . . . . . 80.2 (2.9) 75.0 (4.7)

Chest tubes: size 22 Fr . . . . . . . . . . . . . . . . . . . . . 59.5 (2.8) 58.5 (3.8)

Chest tubes: size 24 Fr . . . . . . . . . . . . . . . . . . . . . 82.6 (2.6) 80.4 (3.5)

Chest tubes: size 26 Fr . . . . . . . . . . . . . . . . . . . . . 64.9 (2.4) 64.9 (3.4)

Tracheostomy tubes: size 00 . . . . . . . . . . . . . . . . . 33.7 (2.5) 39.1 (4.5)

Tracheostomy tubes: size 0 . . . . . . . . . . . . . . . . . . 40.7 (2.6) 43.3 (4.7)

Tracheostomy tubes: size 1 . . . . . . . . . . . . . . . . . . 46.8 (3.1) 43.6 (4.4)

Tracheostomy tubes: size 2 . . . . . . . . . . . . . . . . . . 51.6 (2.5) 48.5 (4.6)

Tracheostomy tubes: size 3 . . . . . . . . . . . . . . . . . . 53.8 (2.5) 64.3 (5.2)

Tracheostomy tubes: size 4** . . . . . . . . . . . . . . . . . 64.1 (2.8) 74.6 (4.6)

Tracheostomy tubes: size 5 . . . . . . . . . . . . . . . . . . 53.7 (2.2) 61.3 (4.9)

Tracheostomy tubes: size 6 . . . . . . . . . . . . . . . . . . 68.6 (2.9) 67.1 (4.6)

Yankauer suction tip4 . . . . . . . . . . . . . . . . . . . . . . . ... ... 88.2 (2.6)

Bulb syringe4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... 90.3 (2.3)

See footnotes at end of table.
Page 12 National Health Statistics Reports  Number 47  March 1, 2012

Table 4. Percentages of emergency departments with pediatric supplies: United States, 2002–2003 and 2006—Con.

2002–2003

All EDs1

2006

All EDs

Pediatric supplies Percent of EDs2

(Standard error

of percent) Percent of EDs

(Standard error

of percent)

Resuscitation medications

Medication chart, tape, or other dose 

estimation system . . . . . . . . . . . . . . . . . . . . . . . . . 95.8 (1.1) 95.5 (1.9)

Specialized pediatric trays

Have all specialized pediatric trays . . . . . . . . . . . . . . 24.6 (1.9) 25.3 (3.5)

Thoracotomy tube with water seal . . . . . . . . . . . . . 65.9 (2.7) 62.1 (4.1)

Lumbar puncture with size 20g needle . . . . . . . . . 83.1 (3.2) 85.6 (4.1)

Lumbar puncture with size 22g needle . . . . . . . . . 88.7 (2.2) 88.5 (4.2)

Lumbar puncture with size 25g needle . . . . . . . . . 69.6 (2.8) 68.3 (4.2)

Pediatric foley catheter: size 5/6 Fr . . . . . . . . . . . . 57.2 (2.7) 62.4 (4.9)

Pediatric foley catheter: size 8 Fr . . . . . . . . . . . . . . 81.6 (2.5) 86.1 (3.5)

Pediatric foley catheter: size 10 Fr . . . . . . . . . . . . . 83.7 (2.8) 83.2 (4.0)

Pediatric foley catheter: size 12 Fr . . . . . . . . . . . . . 83.6 (2.8) 84.5 (3.8)

Obstetric pack . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91.1 (1.7) 88.8 (3.0)

Umbilical vessel cannulation supplies . . . . . . . . . . 71.1 (3.1) 72.7 (4.2)

Meconium aspirator . . . . . . . . . . . . . . . . . . . . . . . . 88.0 (1.6) 82.7 (3.3)

Venous cutdown . . . . . . . . . . . . . . . . . . . . . . . . . . . 77.4 (2.1) 71.2 (4.3)

Surgical airway . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76.5 (3.4) 77.5 (4.4)

Needle cricothyrotomy tray4 . . . . . . . . . . . . . . . . . . ... ... 84.7 (2.9)

Fracture management

Have all fracture management supplies . . . . . . . . . . 46.8 (2.8) 46.6 (4.2)

Cervical immobilization: infant size . . . . . . . . . . . . 61.9 (2.7) 63.8 (4.5)

Cervical immobilization: child size . . . . . . . . . . . . . 86.4 (1.9) 86.4 (3.3)

Extremity splints . . . . . . . . . . . . . . . . . . . . . . . . . . . 88.6 (1.7) 91.5 (3.0)

Femur splint: child size . . . . . . . . . . . . . . . . . . . . . . 70.5 (1.9) 66.6 (3.8)

Miscellaneous

Have all miscellaneous supplies . . . . . . . . . . . . . . . . 52.4 (3.4) 48.9 (4.9)

Infant scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95.3 (2.1) 94.7 (2.6)

Infant formula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87.3 (2.7) 82.3 (4.1)

Oral rehydrating solutions . . . . . . . . . . . . . . . . . . . 95.0 (2.0) 94.9 (2.6)

Heating source, isolette . . . . . . . . . . . . . . . . . . . . . 77.8 (3.2) 77.0 (3.6)

Pediatric restraining devices . . . . . . . . . . . . . . . . . 85.4 (2.9) 81.5 (4.4)

Resuscitation board . . . . . . . . . . . . . . . . . . . . . . . . 89.8 (1.7) 89.9 (3.6)

Sterile linen for burn care . . . . . . . . . . . . . . . . . . . . 91.6 (1.7) 83.4 (4.4)

Medical photography capability . . . . . . . . . . . . . . . 79.5 (2.8) 79.7 (4.1)

Supplies

Percent of EDs fully supplied5 . . . . . . . . . . . . . . . . . . 5.5 (1.1) 7.2 (1.7)

** Difference is significant (p < 0.05).

... Category not applicable. 1

ED is emergency department. 2

Percentages are based on an estimated 4,800 EDs in both 2002–2003 and 2006. 3

ET is endotracheal. 4

New item in 2006. 5

Percentage of EDs having all recommended supplies.

NOTES: Fr is French, a scale used to indicate the outer diameter of catheters; g is gauge, a standard of measurement for needles.
National Health Statistics Reports  Number 47  March 1, 2012 Page 13

Table 5. Percentages of emergency departments with pediatric supplies, by type of hospital: United States, 2006

Children's hospital or has a pediatric

intensive care unit All other hospitals

Pediatric supplies Percent of EDs1,2

(Standard error

of percent) Percent of EDs3

(Standard error

of percent)

Monitoring

Have all monitoring supplies** . . . . . . . . . . . . . . . . . . 82.2 (4.6) 51.3 (4.4)

Cardiorespiratory monitor . . . . . . . . . . . . . . . . . . . . 98.8 (1.2) 96.0 (2.1)

Defibrillator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97.9 (2.1) 94.7 (2.3)

Pediatric monitor electrodes** . . . . . . . . . . . . . . . . 100.0 ... 91.7 (3.3)

Pulse oximeter with newborn sensor** . . . . . . . . . . 99.6 (0.4) 85.8 (3.9)

Pulse oximeter with child sensor** . . . . . . . . . . . . . 100.0 ... 92.7 (2.7)

Thermometer/rectal probe** . . . . . . . . . . . . . . . . . . 100.0 ... 91.7 (3.1)

Doppler blood pressure device** . . . . . . . . . . . . . . 99.2 (0.7) 78.4 (4.7)

Blood pressure cuff: neonatal size**............. 100.0 ... 85.1 (3.5)

Blood pressure cuff: infant size** . . . . . . . . . . . . . . 100.0 ... 92.5 (3.2)

Blood pressure cuff: child size . . . . . . . . . . . . . . . . 100.0 ... 97.7 (1.4)

Blood pressure cuff: small adult size . . . . . . . . . . . 100.0 ... 96.6 (1.8)

Monitor for ET4 tube and placement . . . . . . . . . . . . 96.5 (2.3) 92.4 (2.4)

Sphygmomanometer5 . . . . . . . . . . . . . . . . . . . . . . . 85.5 (4.2) 88.9 (2.6)

Stethoscope5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.9 (4.2) 90.5 (2.7)

Vascular access

Have all vascular access supplies** . . . . . . . . . . . . . 39.2 (7.2) 13.2 (2.9)

Butterfly needles: 19g** . . . . . . . . . . . . . . . . . . . . . 88.8 (3.6) 57.3 (4.0)

Butterfly needles: 21g** . . . . . . . . . . . . . . . . . . . . . 95.4 (2.9) 78.0 (4.0)

Butterfly needles: 23g** . . . . . . . . . . . . . . . . . . . . . 99.2 (0.9) 79.6 (3.5)

Butterfly needles: 25g** . . . . . . . . . . . . . . . . . . . . . 93.4 (4.6) 69.9 (4.4)

Catheter over needle: 16g . . . . . . . . . . . . . . . . . . . 98.8 (0.9) 93.5 (3.0)

Catheter over needle: 18g . . . . . . . . . . . . . . . . . . . 100.0 ... 97.5 (1.8)

Catheter over needle: 20g . . . . . . . . . . . . . . . . . . . 100.0 ... 97.5 (1.8)

Catheter over needle: 22g . . . . . . . . . . . . . . . . . . . 100.0 ... 97.5 (1.8)

Catheter over needle: 24g short** . . . . . . . . . . . . . 97.5 (1.5) 87.8 (3.4)

Catheter over needle: 24g long** . . . . . . . . . . . . . . 77.6 (9.5) 49.5 (4.3)

Infusion device . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 ... 97.8 (1.7)

Tubing for infusion device** . . . . . . . . . . . . . . . . . . 100.0 ... 96.4 (1.2)

Intraosseous needles: 16g** . . . . . . . . . . . . . . . . . 94.8 (2.5) 74.1 (4.0)

Intraosseous needles: 18g** . . . . . . . . . . . . . . . . . 94.2 (2.7) 80.1 (4.5)

Umbilical vein catheters: 3.5 Fr** . . . . . . . . . . . . . . 83.4 (9.8) 55.0 (4.8)

Umbilical vein catheters: 5 Fr** . . . . . . . . . . . . . . . 84.0 (9.8) 60.1 (4.2)

Seldinger vascular access kit: 3 Fr catheter** . . . . 65.4 (8.6) 22.2 (3.6)

Seldinger vascular access kit: 4 Fr catheter** . . . . 73.0 (9.1) 26.9 (3.9)

Seldinger vascular access kit: 5 Fr catheter** . . . . 71.6 (9.0) 30.4 (4.1)

Intravenous fluid and blood warmers5 . . . . . . . . . . 83.2 (4.4) 84.2 (3.0)

Portable oxygen regulators and canisters5 . . . . . . . 85.9 (4.2) 90.5 (2.7)

Airway management

Have all airway management supplies . . . . . . . . . . . 24.9 (5.7) 13.6 (2.9)

Preterm/neonatal oxygen masks** . . . . . . . . . . . . . 95.2 (2.4) 67.5 (4.4)

Infant oxygen masks** . . . . . . . . . . . . . . . . . . . . . . 98.5 (1.1) 89.5 (3.7)

Child oxygen masks . . . . . . . . . . . . . . . . . . . . . . . . 99.6 (0.4) 95.5 (2.9)

Infant non-rebreathing masks . . . . . . . . . . . . . . . . 81.3 (9.8) 74.3 (4.8)

Child non-rebreathing masks . . . . . . . . . . . . . . . . . 88.8 (10.1) 89.3 (3.7)

Oralpharyngeal airway: size 00 . . . . . . . . . . . . . . . 73.7 (9.3) 67.9 (4.4)

Oralpharyngeal airway: size 0 . . . . . . . . . . . . . . . . 85.1 (10.3) 78.6 (3.9)

Oralpharyngeal airway: size 1 . . . . . . . . . . . . . . . . 85.5 (10.3) 81.4 (4.2)

Oralpharyngeal airway: size 2 . . . . . . . . . . . . . . . . 85.5 (10.3) 83.0 (3.8)

Oralpharyngeal airway: size 3 . . . . . . . . . . . . . . . . 83.8 (10.2) 79.9 (4.0)

Nasopharyngeal airways: size 10 Fr............. 75.1 (9.4) 58.2 (5.2)

Nasopharyngeal airways: size 12 Fr . . . . . . . . . . . 74.1 (9.8) 62.6 (5.3)

Nasopharyngeal airways: size 14 Fr . . . . . . . . . . . 74.3 (9.8) 64.2 (5.2)

Nasopharyngeal airways: size 16 Fr . . . . . . . . . . . 74.7 (9.8) 67.7 (5.2)

Nasopharyngeal airways: size 20 Fr . . . . . . . . . . . 67.2 (9.5) 67.7 (5.2)

Nasopharyngeal airways: size 24 Fr . . . . . . . . . . . 77.8 (6.4) 72.4 (4.6)

Nasopharyngeal airways: size 28 Fr . . . . . . . . . . . 81.7 (5.9) 74.9 (3.9)

Bag-valve-mask-resuscitator . . . . . . . . . . . . . . . . . 98.3 (1.2) 93.5 (2.5)

See footnotes at end of table.
Page 14 National Health Statistics Reports  Number 47  March 1, 2012

Table 5. Percentages of emergency departments with pediatric supplies, by type of hospital: United States, 2006—Con.

Children's hospital or has a pediatric

intensive care unit All other hospitals

Pediatric supplies Percent of EDs1,2

(Standard error

of percent) Percent of EDs3

(Standard error

of percent)

Nasal cannulae: infant** . . . . . . . . . . . . . . . . . . . . . 97.9 (2.1) 80.6 (4.8)

Nasal cannulae: child** . . . . . . . . . . . . . . . . . . . . . 98.5 (1.5) 88.4 (4.7)

Uncuffed endotracheal tubes: size 2.5** . . . . . . . . 95.9 (2.6) 85.4 (4.1)

Uncuffed endotracheal tubes: size 3.0** . . . . . . . . 97.9 (2.1) 88.9 (3.5)

Uncuffed endotracheal tubes: size 3.5** . . . . . . . . 99.6 (0.4) 90.9 (3.4)

Uncuffed endotracheal tubes: size 4.0** . . . . . . . . 100.0 ... 91.7 (2.8)

Uncuffed endotracheal tubes: size 4.5 . . . . . . . . . . 97.5 (2.1) 91.3 (2.7)

Uncuffed endotracheal tubes: size 5.0** . . . . . . . . 100.0 ... 85.9 (3.2)

Uncuffed endotracheal tubes: size 5.5** . . . . . . . . 98.1 (1.1) 76.3 (4.0)

Uncuffed endotracheal tubes: size 6.0** . . . . . . . . 81.1 (9.6) 59.5 (4.5)

Uncuffed endotracheal tubes: size 6.5 . . . . . . . . . . 70.3 (8.7) 56.5 (4.3)

Uncuffed endotracheal tubes: size 7.0 . . . . . . . . . . 63.7 (9.0) 54.7 (4.6)

Uncuffed endotracheal tubes: size 7.5 . . . . . . . . . . 63.3 (9.0) 53.7 (4.3)

Cuffed endotracheal tubes: size 5.5** . . . . . . . . . . 94.2 (1.2) 83.9 (3.5)

Cuffed endotracheal tubes: size 6.0** . . . . . . . . . . 99.6 (0.4) 94.1 (2.3)

Cuffed endotracheal tubes: size 6.5 . . . . . . . . . . . . 98.8 (0.9) 94.8 (2.4)

Cuffed endotracheal tubes: size 7.0** . . . . . . . . . . . 100.0 ... 94.7 (2.3)

Cuffed endotracheal tubes: size 7.5 . . . . . . . . . . . . 98.8 (0.9) 93.9 (2.5)

Stylets: infant** . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96.7 (1.2) 83.1 (4.2)

Stylets: child** . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99.6 (0.4) 91.3 (3.1)

Laryngoscope handle, pediatric . . . . . . . . . . . . . . . 93.8 (2.6) 91.5 (2.7)

Curved laryngoscope blades: size 2** . . . . . . . . . . 100.0 ... 94.5 (2.1)

Curved laryngoscope blades: size 3** . . . . . . . . . . 99.6 (0.4) 87.9 (3.1)

Straight laryngoscope blades: size 0** . . . . . . . . . . 97.1 (2.2) 87.0 (3.7)

Straight laryngoscope blades: size 1 . . . . . . . . . . . 100.0 ... 94.6 (2.8)

Straight laryngoscope blades: size 2** . . . . . . . . . . 100.0 ... 90.3 (3.3)

Straight laryngoscope blades: size 3** . . . . . . . . . . 100.0 ... 84.5 (3.5)

Magil forceps, pediatric** . . . . . . . . . . . . . . . . . . . . 92.1 (4.2) 70.9 (5.4)

Nasogastric tubes: size 5 Fr . . . . . . . . . . . . . . . . . . 84.2 (4.8) 76.7 (4.1)

Nasogastric tubes: size 6 Fr . . . . . . . . . . . . . . . . . . 79.0 (9.4) 63.7 (6.0)

Nasogastric tubes: size 8 Fr . . . . . . . . . . . . . . . . . . 85.7 (9.9) 85.1 (4.0)

Nasogastric tubes: size 10 Fr . . . . . . . . . . . . . . . . . 88.8 (10.1) 85.3 (4.8)

Nasogastric tubes: size 12 Fr . . . . . . . . . . . . . . . . . 97.9 (2.1) 86.7 (3.8)

Nasogastric tubes: size 14 Fr . . . . . . . . . . . . . . . . . 95.2 (3.0) 88.4 (4.0)

Flexible suction catheters: size 5/6 Fr . . . . . . . . . . 83.8 (9.4) 72.6 (5.0)

Flexible suction catheters: size 8 Fr**............ 100.0 ... 86.8 (4.7)

Flexible suction catheters: size 10 Fr** . . . . . . . . . . 100.0 ... 89.4 (3.3)

Flexible suction catheters: size 12 Fr** . . . . . . . . . . 97.9 (1.2) 86.0 (3.6)

Chest tubes: size 8 Fr** . . . . . . . . . . . . . . . . . . . . . 74.3 (9.5) 44.1 (5.2)

Chest tubes: size 10 Fr** . . . . . . . . . . . . . . . . . . . . 91.7 (3.1) 54.7 (5.3)

Chest tubes: size 12 Fr** . . . . . . . . . . . . . . . . . . . . 90.5 (3.2) 60.0 (5.7)

Chest tubes: size 14 Fr** . . . . . . . . . . . . . . . . . . . . 73.9 (9.2) 46.8 (4.6)

Chest tubes: size 16 Fr** . . . . . . . . . . . . . . . . . . . . 93.6 (2.6) 66.5 (4.7)

Chest tubes: size 18 Fr** . . . . . . . . . . . . . . . . . . . . 75.9 (9.3) 51.7 (5.0)

Chest tubes: size 20 Fr** . . . . . . . . . . . . . . . . . . . . 96.9 (1.7) 72.5 (5.1)

Chest tubes: size 22 Fr . . . . . . . . . . . . . . . . . . . . . 73.9 (9.3) 56.8 (4.1)

Chest tubes: size 24 Fr** . . . . . . . . . . . . . . . . . . . . 94.8 (2.8) 78.8 (3.8)

Chest tubes: size 26 Fr . . . . . . . . . . . . . . . . . . . . . 74.1 (9.2) 63.8 (3.9)

Tracheostomy tubes: size 00 . . . . . . . . . . . . . . . . . 51.9 (8.2) 37.7 (4.9)

Tracheostomy tubes: size 0 . . . . . . . . . . . . . . . . . . 59.5 (8.8) 41.5 (5.1)

Tracheostomy tubes: size 1** . . . . . . . . . . . . . . . . . 62.0 (9.3) 41.5 (4.7)

Tracheostomy tubes: size 2** . . . . . . . . . . . . . . . . . 71.4 (9.0) 45.9 (5.0)

Tracheostomy tubes: size 3** . . . . . . . . . . . . . . . . . 89.4 (2.7) 61.4 (5.7)

Tracheostomy tubes: size 4** . . . . . . . . . . . . . . . . . 96.7 (2.3) 72.1 (5.0)

Tracheostomy tubes: size 5** . . . . . . . . . . . . . . . . . 90.9 (2.6) 58.0 (5.3)

Tracheostomy tubes: size 6** . . . . . . . . . . . . . . . . . 91.1 (4.2) 64.4 (5.0)

Yankauer suction tip5 . . . . . . . . . . . . . . . . . . . . . . . 85.5 (4.2) 88.5 (3.0)

Bulb syringe5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.9 (4.2) 90.7 (2.7)

See footnotes at end of table.
National Health Statistics Reports  Number 47  March 1, 2012 Page 15

Table 5. Percentages of emergency departments with pediatric supplies, by type of hospital: United States, 2006—Con.

Children's hospital or has a pediatric

intensive care unit All other hospitals

Pediatric supplies Percent of EDs1,2

(Standard error

of percent) Percent of EDs3

(Standard error

of percent)

Resuscitation medications

Medication chart, tape or other dose

estimation system . . . . . . . . . . . . . . . . . . . . . . . . . 95.2 (4.7) 95.5 (2.1)

Specialized pediatric trays

Have all specialized pediatric trays** . . . . . . . . . . . . . 48.8 (8.1) 22.7 (3.7)

Thoracotomy tube with water seal . . . . . . . . . . . . . 76.3 (9.3) 60.6 (4.5)

Lumbar puncture with size 20g needle** . . . . . . . . 96.1 (2.5) 84.4 (4.5)

Lumbar puncture with size 22g needle . . . . . . . . . 96.5 (2.1) 87.6 (4.6)

Lumbar puncture with size 25g needle . . . . . . . . . 72.4 (9.5) 67.9 (4.4)

Pediatric foley catheter: size 5/6 Fr** . . . . . . . . . . . 82.6 (5.2) 60.1 (5.4)

Pediatric foley catheter: size 8 Fr** . . . . . . . . . . . . 96.9 (2.5) 84.9 (3.9)

Pediatric foley catheter: size 10 Fr . . . . . . . . . . . . . 90.2 (5.1) 82.4 (4.5)

Pediatric foley catheter: size 12 Fr . . . . . . . . . . . . . 92.3 (4.7) 83.6 (4.1)

Obstetric pack . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93.2 (4.3) 88.4 (3.3)

Umbilical vessel cannulation supplies . . . . . . . . . . 85.1 (10.0) 71.3 (4.6)

Meconium aspirator** . . . . . . . . . . . . . . . . . . . . . . . 96.1 (1.1) 81.2 (3.6)

Venous cutdown** . . . . . . . . . . . . . . . . . . . . . . . . . 96.7 (3.3) 68.4 (4.7)

Surgical airway** . . . . . . . . . . . . . . . . . . . . . . . . . . 94.0 (4.0) 75.7 (4.8)

Needle cricothyrotomy tray . . . . . . . . . . . . . . . . . . . 85.3 (4.3) 84.6 (3.3)

Fracture management

Have all fracture management supplies** . . . . . . . . . 68.5 (8.6) 44.1 (4.5)

Cervical immobilization: infant size** . . . . . . . . . . . 91.9 (3.6) 60.6 (4.9)

Cervical immobilization: child size** . . . . . . . . . . . . 96.9 (2.3) 85.3 (3.6)

Extremity splints** . . . . . . . . . . . . . . . . . . . . . . . . . 98.3 (1.2) 90.7 (3.3)

Femur splint: child size . . . . . . . . . . . . . . . . . . . . . . 73.4 (9.1) 65.8 (4.2)

Miscellaneous

Have all miscellaneous supplies** . . . . . . . . . . . . . . . 79.5 (9.6) 45.5 (5.2)

Infant scales** . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 ... 94.1 (2.9)

Infant formula** . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 ... 80.3 (4.6)

Oral rehydrating solutions . . . . . . . . . . . . . . . . . . . 99.6 (0.4) 94.3 (2.9)

Heating source, isolette** . . . . . . . . . . . . . . . . . . . . 100.0 ... 74.4 (3.9)

Pediatric restraining devices** . . . . . . . . . . . . . . . . 97.1 (2.1) 79.7 (4.8)

Resuscitation board . . . . . . . . . . . . . . . . . . . . . . . . 97.3 (2.1) 89.1 (4.0)

Sterile linen for burn care** . . . . . . . . . . . . . . . . . . 97.9 (1.3) 81.8 (4.8)

Medical photography capability . . . . . . . . . . . . . . . 82.2 (9.7) 79.4 (4.5)

Supplies

Percent of EDs fully supplied6 . . . . . . . . . . . . . . . . . . 16.2 (4.7) * ...

** Difference is significant (p < 0.05).

... Category not applicable.

* Figure does not meet standards of reliability or precision. 1

ED is emergency department. 2

Based on an estimated 500 EDs. 3

Based on an estimated 4,300 EDs. 4

ET is endotracheal. 5

New item in 2006. 6

Percentage of EDs having all recommended supplies. The percentage for fully supplied EDs that were not in children's hospitals or hospitals with a pediatric intensive care unit could not be shown 

because of insufficent sample size. However, 32 percent of these hospitals did report that at least 90 percent of the recommended supplies were available.

NOTES: Fr is french, a scale used to indicate the outer diameter of catheters; g is gauge, a standard of measurement for needles.
Page 16 National Health Statistics Reports  Number 47  March 1, 2012

Technical Notes

The Emergency Pediatric Services 

and Equipment Supplement (EPSES) 

was conducted in conjunction with the 

2002–2003 and 2006 National Hospital 

Ambulatory Medical Care Survey 

(NHAMCS). NHAMCS is an annual 

national probability sample survey 

of nonfederal short-stay and general 

hospitals and is designed to produce 

national estimates of visits to emergency 

departments (EDs) and outpatient 

departments, including facility, patient, 

and visit characteristics.

NHAMCS utilizes a multistage 

sampling design including geographic 

primary sampling units (PSUs), hospitals 

within PSUs, clinics within hospitals, and 

patient visits within emergency services 

areas and selected outpatient clinics. For 

2006, an additional panel of 25 children’s 

hospitals was added to the sample design 

to improve the resulting estimates for this 

group. The four-stage probability sample 

was combined with a supplemental threestage probability sample of children’s 

general hospitals. The three-stage 

children’s hospital supplement sampled 

children’s hospitals regardless of PSU, 

but the design of the sample within 

hospitals was identical to that of the rest 

of the panel. 

The 2006 NHAMCS was conducted 

from January 2, 2006 through December 

31, 2006 and consisted of a sample of 486 

hospitals, of which 414 had eligible EDs. 

Of the eligible EDs, EPSES data were 

completed for 332 facilities resulting in 

an 80.2 percent response rate. As with the 

first EPSES data collection in 2002–2003, 

the 2006 data were collected as a brief 

(30-minute) self-report supplement to the 

2006 NHAMCS. The form consists of 

10 questions regarding hospital pediatric 

inpatient services and pediatric expertise, 

and a list of 131 emergency pediatric 

supplies grouped into seven categories: 

monitoring, vascular access, airway 

management, resuscitation medication, 

specialized pediatric trays, fracture 

management, and miscellaneous. For 

each supply category, respondents were 

asked to indicate the presence or absence 

of specific equipment. An additional 

checklist of seven items not included in 

the 2002–2003 EPSES was administered 

during postsurvey phone interviews with 

hospital staff (see Figure 7). 

Data analyses were performed 

using the statistical packages SAS 

version 9.2 (SAS Institute, Cary, 

N.C.) and SUDAAN version 9.0 (RTI 

International, Research Triangle Park, 

N.C.). Comparisons were made between 

estimates from 2002–2003 and 2006 

using the two-tailed t test. The Bonferroni 

procedure was used to establish the 

critical value for statistically significant 

differences (0.05 level of significance) 

based on the number of possible 

comparisons within a particular variable 

(or combination of variables) of interest. 

All differences noted in the report were 

statistically significant. Differences not 

mentioned in the text may or may not be 

statistically significant.

Definition of terms

Board-certified emergency medicine 

physician—A physician who has 

completed medical school plus a 3-year 

residency focusing on adults, usually 

with 3–4 months of pediatrics rotations. 

Board-certified pediatric attending 

physician—A physician who has 

completed medical school plus 3 years 

of general pediatrics residency. Many of 

these specialize for 2 or more years in a 

subspecialty, such as hematology.

Board-certified pediatric emergency 

medicine attending physician—A 

physician who has completed medical 

school plus 3 years of general pediatrics 

residence and 3 years of pediatric 

emergency medicine residency (and 

which may include a few rotations on 

adult emergency medicine services). 

Such physicians are often employed by 

dedicated pediatric hospitals. 

Pediatric patient—A patient under 

age 18 who is treated in the emergency 

department or admitted to the hospital.

Pediatric ward or department—A 

hospital inpatient unit exclusively for 

pediatric patients.

Pediatric trauma service—An 

organized multidisciplinary team that 

provides coordinated care of severely 

injured children from the ED, through 

care in the operating room, intensive care 

unit, inpatient unit of the hospital, and 

rehabilitation.

Transfer agreement—A written 

guideline for the transfer of pediatric 

patients from one specified hospital 

facility to another specified hospital 

facility, often to get the child moved 

from a community hospital to a tertiary 

hospital with pediatric intensive care 

capability or specialty physician 

expertise.

Critical injury—An injury that is 

potentially or actually life-threatening 

without rapid resuscitation and surgical 

or intensive care intervention.

Intensive care—A hospital unit that 

provides high-technology monitoring and 

medical intervention for life-threatening 

illnesses and injuries or the postsurgical 

care of such children.
National Health Statistics Reports  Number 47  March 1, 2012 Page 17

burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road, MS E-11, Atlanta, GA 30333, ATTN: PRA (0920-0278). 

FORM 

(7-13-2005) NHAMCS-901 

U.S. DEPARTMENT OF COMMERCE Economics and Statistics Administration 

U.S. CENSUS BUREAU ACTING AS DATA COLLECTION AGENT FOR THE 

NATIONAL CENTER FOR HEALTH STATISTICS 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

NATIONAL HOSPITAL AMBULATORY 

MEDICAL CARE SURVEY 

Emergency Pediatric Services and 

Equipment Supplement 

2a. Hospital contact information 

1. Label 

b. ED contact information 

Name 

Title 

Name 

Title 

Telephone Area code Number Telephone Area code Number

Disposition — To be completed by Census Field Representative 

1 

2 

Complete Supplement 

STOP! Return to RO 

2006 Panel 

instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An 

agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control 

number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this 

Hospital HAS an eligible ED – 

Hospital does NOT have an eligible ED – 

Form Approved OMB No. 0920-0278 Exp. Date 05/31/2007 

NOTICE – Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing 

A message from the National Center for Health Statistics . . . 

Children requiring care for serious and life-threatening emergencies have unique and special 

needs. Over the past ten years, guidelines for pediatric preparedness have been developed by 

various pediatric and emergency medicine associations, most recently in April of 2001. In order to 

gather current information on hospital emergency department readiness for the care of children, 

based in part on the April 2001 guidelines, this supplement has been reintroduced to the 2006 

National Hospital Ambulatory Medical Care Survey (NHAMCS). The form will take about 30 

minutes to complete. 

INSTRUCTIONS FOR COMPLETING THE FORM 

The form consists of a short set of questions related to hospital characteristics and services, 

followed by a list of pediatric equipment from the 2001 guidelines. If you have any questions or 

need assistance completing this form, you may contact 

at 

• Questions 

Please answer only the questions that apply based on the "skip instructions" next to specific 

check boxes. If there is no skip instruction following a check box, proceed to the next question. 

• Equipment List 

Please mark (X) "Yes" only for the equipment and supplies that are actually present in the 

emergency department in your hospital, otherwise mark (X) "No." If you have a separate 

pediatric emergency department, please answer these questions for that location only. If 

possible, you are encouraged to physically verify the presence of each of these items when you 

complete the list. 

DEFINITIONS OF TERMS 

• Pediatric patient – A person less than 18 years old who is treated in the emergency 

department or admitted to the hospital. 

• Pediatric ward/department – A hospital inpatient unit exclusively for pediatric patients. 

• Pediatric trauma service – An organized multidisciplinary team that provides coordinated 

care of severely injured children from the emergency department, through care in the 

operating room, intensive care unit, inpatient unit of the hospital, and rehabilitation. 

• Transfer agreement – A written guideline for the transfer of pediatric patients from one 

specified hospital facility to another specified hospital facility, often to get the child moved 

from a community hospital to a tertiary hospital with pediatric intensive care capability or 

specialty physician expertise. 

• Critical injury – An injury that is potentially or actually life threatening without rapid 

resuscitation and surgical or intensive care intervention. 

• Intensive care – A hospital unit that provides high technology monitoring and medical 

intervention for life-threatening illnesses and injuries or the post-surgical care of such children. 

Thank you . . . . . . 

. . .for taking time from your busy schedule to contribute to this important 

study. The success of this survey depends on the cooperation of people like you. 

Figure 7. 2006 National Hospital Ambulatory Medical Care Survey: Emergency Pediatric Services and Equipment Supplement
Page 18 National Health Statistics Reports  Number 47  March 1, 2012

1 

2 

Yes 

No – SKIP to question 3 

PLEASE CONTINUE WITH SECTION II ON NEXT PAGE. 

These first questions are about hospital procedures and services related to treating and 

caring for children. 

1. 

2. 

4. 

5. 

6. 

In the pediatric ICU in your hospital 

In the adult ICU in your hospital 

In another hospital 

7. 

8. 

9. 

Does your hospital admit pediatric patients 

("Admit" means for an overnight stay in 

the hospital of at least 24 hours)? 

Does your hospital have a pediatric trauma 

service, that is, coordinated trauma care for 

a pediatric patient from admittance to 

discharge? 

Does your hospital have a written transfer 

agreement with a facility that has a pediatric 

trauma service? 

Generally, critically injured pediatric trauma 

patients requiring hospitalization would be 

cared for: 

Mark (X) one 

In your hospital 

Pediatric patients requiring intensive care 

(such as brain injury, multiple severe 

traumatic injuries, meningitis, and 

respiratory failure requiring intubation) 

would be cared for: 

Mark (X) one 

Does your hospital have a separate pediatric 

ward or department, that is, one intended for 

exclusively treating children? 

1 

2 

Yes 

No 

1 

2 

Yes 

No 

In another hospital, per written transfer 

agreement 

In another hospital, but no written transfer 

agreement exists 

1 

2 

3 

1 

2 

3 

Does your hospital have a written transfer 

agreement with a facility that has a pediatric 

intensive care unit? 

Does your emergency department have 24 

hour 7 day a week access to the following 

attending physicians (either in-house or on 

call)? 

Board certified emergency medicine 

attending physician 

Do you have written protocols stating under 

what conditions a pediatrician will be called 

to the emergency department? 

1 

2 

Yes 

No 

1 

2 

3 

Yes 

No 

Board certified pediatric emergency medicine 

attending physician 

Board certified pediatric attending physician 

a. 

b. 

c. 

1 

2 

Yes 

No 

1 

2 

Yes 

No 

1 

2 

Yes 

No 

3. Does your hospital have a 23 hour 

observation area exclusively for pediatric 

patients, that is, an area for pediatric 

patients who are not admitted to the 

hospital but whose condition following 

treatment may warrant further assessment 

before being admitted or discharged? 

1 

2 

Yes 

No 

1 

2 

Yes – SKIP to question 6 

No 

4 Other – Explain

4 Other – Explain

10. 

Department 24 hours, 7 days per week. 

Section I YOUR HOSPITAL 

NA – Have a pediatrician on duty in Emergency 

FORM NHAMCS-901 (7-13-2005) Page 2 

Figure 7. 2006 National Hospital Ambulatory Medical Care Survey: Emergency Pediatric Services and Equipment Supplement—Con. 
National Health Statistics Reports  Number 47  March 1, 2012 Page 19

YES 

Please check the equipment and supplies listed below that are actually present in the emergency 

department in your hospital. If you have a separate pediatric emergency department, please 

answer these questions for that location only. It is anticipated that most facilities will NOT have all 

of the items listed in this table. You are also encouraged to physically verify the presence of each 

of these items in your emergency department when you complete this checklist. 

EMERGENCY SUPPLIES 

Monitoring 

Cardiorespiratory monitor with strip recorder 

A. NO

1. 

Child sensor size 

Thermometer/rectal probe with capability 

25° °C 

Infant size 

Child size 

Small adult size 

Method to monitor ET tube and placement1 

2. 

3. 

4. 

a. Newborn sensor size 

b. 

5. 

6. 

a. Neonatal size

b. 

c. 

d. 

7. 

8. 

Vascular Access 

Infusion device to regulate rate and volume 

Tubing for infusion device 

1 May be satisfied by a disposable ETCO2 detector, bulb, or feeding tube methods for endotracheal tube placement. 

B. 

19-gauge 

21-gauge 

23-gauge 

25-gauge 

a. 

b. 

c. 

d. 

1. 

16-gauge 

18-gauge 

20-gauge 

22-gauge 

24-gauge short 

24-gauge long 

a. 

b. 

c. 

d. 

e. 

f. 

2. 

3. 

4. 

5. 

16-gauge 

18-gauge 

a. 

b. 

Umbilical vein catheters3 

Size 3.5 Fr 

Size 5 Fr 

a. 

b. 

Size 3 Fr catheters 

Size 4 Fr catheters 

Size 5 Fr catheters 

a. 

b. 

c. 

2 May be satisfied by standard bone marrow aspiration needles, 13- or 15-gauge. 

3 Available within the hospital 

YES NO 

Defibrilator (0-400 J capability) with 4.5 cm 

paddles 

Pediatric monitor electrodes 

Doppler blood pressure device 

Intraosseous needles2 

6. 

7. 

C. 

1. 

2. 

3. 

4. 

a. 

b. 

5. 

6. 

7. 

8. 

a. 

b. 

c. 

d. 

a. 

b. 

c. 

d. 

e. 

f. 

Airway Management 

Oralpharyngeal airways– 

Bag-valve-mask resuscitator, self-inflating, 

450 mL size 

Stylets – 

Laryngoscope handle, pediatric 

Preterm/neonatal size 

Infant size 

Child size 

Infant size 

Child size 

Sizes 00 

Size 0 

Size 1 

Size 2 

Size 3 

Size 10 Fr 

Size 12 Fr 

Size 14 Fr 

Size 16 Fr 

Size 20 Fr 

Size 24 Fr 

Size 28 Fr 

Infant size 

Child size 

Size 2.5 

Size 3.0 

Size 3.5 

Size 4.0 

Size 4.5 

Size 5.0 

Size 5.5 

Size 6.0 

Size 6.5 

Size 7.0 

Size 7.5 

Size 5.5 

Size 6.0 

Size 6.5 

Size 7.0 

Size 7.5 

Infant size 

Pediatric size 

c. 

a. 

b. 

c. 

d. 

e. 

e. 

f. 

g. 

g. 

h. 

i. 

j. 

k. 

a. 

b. 

a. 

b. 

c. 

d. 

e. 

a. 

b. 

a. 

b. 

9. 

10. 

Size 0 

Size 1 

Size 2 

Size 3 

Size 2 

Size 3 

Please continue in next column 

11. 

12. 

a. 

b. 

a. 

b. 

c. 

d. 

Section II YOUR HOSPITAL EMERGENCY DEPARTMENT 

Pulse oximeter with – 

C to 44 

Blood pressure cuffs – 

Butterfly needles – 

Catheter-over-needle devices – 

Seldinger technique vascular access kit – 

Clear oxygen masks – 

Non-rebreathing masks – 

Nasopharyngeal airways – 

Nasal cannulae – 

Uncuffed endotracheal tubes – 

Cuffed endotracheal tubes – 

Curved laryngoscope blades – 

Straight laryngoscope blades – 

FORM NHAMCS-901 (7-13-2005) Page 3 

Figure 7. 2006 National Hospital Ambulatory Medical Care Survey: Emergency Pediatric Services and Equipment Supplement—Con. 
Page 20 National Health Statistics Reports  Number 47  March 1, 2012

C. YES NO

13. 

a. 

b. 

YES NO 

a. 

b. 

Please continue in next column 

Magil forceps, pediatric 

Resuscitation medications 

Medication chart, tape, or other system 

for dose estimations 

Specialized pediatric trays 

Tube thoracotomy with water seal 

drainage capability 

Urinary catheterization w/pediatric Foley 

catheters 

Venous cutdown 

Surgical airway kit4 

Size 5 Fr ["smaller sizes"] 

Size 6 Fr 

Size 8 Fr 

Size 10 Fr 

Size 12 Fr 

Size 14 Fr 

14. 

c. 

d. 

e. 

f. 

a. 

b. 

Size 5/6 Fr 

Size 8 Fr 

Size 10 Fr 

Size 12 Fr 

c. 

d. 

15. 

Size 8 Fr ["smaller sizes"] 

Size 10 Fr 

Size 12 Fr 

Size 14 Fr 

Size 16 Fr 

Size 18 Fr 

Size 20 Fr 

Size 22 Fr 

Size 24 Fr 

Size 26 Fr 

a. 

b. 

c. 

d. 

e. 

f. 

g. 

h. 

i. 

j. 

16. 

Size 00 ["smaller sizes"] 

Size 0 

Size 1 

Size 2 

Size 3 

Size 4 

Size 5 

Size 6 

17. 

a. 

b. 

c. 

d. 

e. 

f. 

g. 

h. 

D. 

E. 

1. 

Spinal needle size 20-gauge 

Spinal needle size 22-gauge 

Spinal needle size 25-gauge 

a. 

b. 

c. 

2. 

Size 8 Fr 

Size 10 Fr 

Size 12 Fr 

Umbilical vessel cannulation supplies 

Meconium aspirator 

7. 

F. Fracture management

Extremity splints 

Femur splints: child size 

Miscellaneous 

Infant size5 

Child size 

1. 

a. 

b. 

2. 

3. 

G. 

Infant scales 

Infant formula 

Oral rehydrating solutions 

4 May include any of the following items: tracheostomy tray, cricothyreotomy tray, ETJV (needle jet). 

5 

Heating source (infrared lamps or overhead 

warmer), Isolette 

Pediatric restraining devices 

Resuscitation board 

Sterile linen (available within hospital for 

burn care) 

Medical photography capability 

1. 

2. 

3. 

4. 

5. 

6. 

7. 

8. 

Remarks 

Size 5/6 Fr 

Obstetric pack 

3. 

4. 

5. 

6. 

a. 

b. 

c. 

d. 

Section II YOUR HOSPITAL EMERGENCY DEPARTMENT Continued 

EMERGENCY SUPPLIES – Continued 

Airway Management – Continued 

Nasogastric tubes – 

Chest tubes – 

Tracheostomy tubes – 

Lumbar puncture – 

Newborn kit – 

Flexible suction catheters – 

Cervical immobilization equipment – 

Many types of cervical immobilization devices are available. These include wedges and collars. The type of device 

chosen depends on local preference and policies and procedures. Whatever device is chosen should be stocked in 

sizes to fit infants, children, adolescents and adults. The use of sandbags to meet this requirement is discouraged 

because they may cause injury if the patient has to be turned. 

FORM NHAMCS-901 (7-13-2005) Page 4 

Figure 7. 2006 National Hospital Ambulatory Medical Care Survey: Emergency Pediatric Services and Equipment Supplement—Con. 
National Health Statistics Reports  Number 47  March 1, 2012 Page 21

NHAMCS-90 I (ADD!N) (8/1 5106) 

Form Approved OMB No. 0920-0278 Exp. Date 0513112007

Section II - YOUR HOSPITAL EMERGENCY DEPARTMENT - 

Continuation Sheet

Instructions: Please complete this continuation sheet for the supplies/equipment 

specified.

Item Yes No

1. Sphygmomanometer

2. Stethoscope

3. Intravenous fluid and blood warmers *

4. Portable oxygen regulators and canisters

5. Yankauer suction tip

6. Bulb syringe

7. Needle cricothyrotomy tray

* This includes essential equipment that may be shared with the nursery, pediatric 

ward, or other inpatient service but is readily available to the ED.

THANK YOU!

Reason For Continuation Sheet: The National Center For Health Statistics

identified these additional supplies/equipment after the supplement had gone to 

print. 

Remarks:

Hospital ID Number:

Figure 7. 2006 National Hospital Ambulatory Medical Care Survey: Emergency Pediatric Services and Equipment Supplement—Con. 
U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, MD 20782

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

FIRST CLASS MAIL

POSTAGE & FEES PAID

CDC/NCHS

PERMIT NO. G-284

National Health Statistics Reports  Number 47  March 1, 2012

Acknowledgments 

The authors acknowledge Kathi Huddleston, Alan Simon, and Catharine Burt for their comments on earlier drafts of this report, and Stephen 

Pitts and Richard Niska for providing definitions of the types of ED physicians and other technical assistance.

Suggested citation

Schappert SM, Bhuiya F. Availability 

of pediatric services and equipment in 

emergency departments: United States, 

2006. National health statistics reports; no 47. 

Hyattsville, MD: National Center for Health 

Statistics. 2012.

For e-mail updates on NCHS publication releases, subscribe online at: http://www.cdc.gov/nchs/govdelivery.htm.

For questions or general information about NCHS: Tel: 1–800–232–4636 • E-mail: cdcinfo@cdc.gov • Internet: http://www.cdc.gov/nchs

DHHS Publication No. (PHS) 2012–1250 • CS228851

Copyright information

All material appearing in this report is in the 

public domain and may be reproduced or 

copied without permission; citation as to 

source, however, is appreciated.

National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate Director 

for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director