Review article http://dx.doi.org/10.3345/kjp.2011.54.12.477 Korean J Pediatr 2011;54(12):477-480 Regionalization of pediatric emergency care in Korea Do Kyun Kim, MD Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea Received: 11 November 2011, Accepted: 25 November 2011 Corresponding author: Do Kyun Kim, MD Department of Emergency Medicine, Seoul National Uni- versity College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea Tel: +82-2-2072-3257, Fax: +82-2-741-7855 E-mail: birdbeak@snuh.org In order to care for an ill or injured child, it is crucial that every emer- gency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide health- care system are urgently needed in Korea. Copyright © 2011 by The Korean Pediatric Society This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by- nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Key words: Emergency services, Pediatric, Regional hospital, Korea Introduction Despite a gradual reduction in the pediatric population in Korea due to low birth rates, the number of children’s visits to emergency departments (EDs) each year has been increasing1). According to the National Emergency Department Information System (NEDIS) data from 2008, the percentage of pediatric patients who visited EDs was about 31.2% of total ED patients (Fig. 1)2). This figure is larger even considering a proportion of pediatric aged population (<19 years) in Korea (23.8%) and higher than that of US data3). However, a significant number of children who visit an ED do not receive appropriate level of care and are pushed back on the priority list. This is because their symptoms are usually relatively mild compared to that of adult patients, and the care of children in ED is considered very time-consuming and cumbersome. Recently, due to a decreased number of pediatric residents, who are responsible for the care of the majority of pediatric patients in ED, the neglect of pediatric patients in ED has become an increasing concern. This situation is also exacerbated due to a lack of sufficient numbers of emergency physicians having adequate knowledge and skill to care of children. Current state of pediatric emergency medicine in Korea The results of a survey by the Korean Society of Pediatric Emergency Medicine in April 2010 revealed a lack of preparation for pediatric emergency care throughout the country4). Among 81 EDs that res- ponded to the survey, only a quarter were equipped with pediatric emergency carts, and just about 60% of the EDs had pediatric endotra- cheal tubes for every age. Intraosseous needles which are essential for vascular access in critically-ill children were prepared only in 40% of the EDs. Moreover, the nighttime or weekend consultations to pediatric departments were mainly addressed by relatively inexperienced resi- 477