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  • The EMSC program is a federal program whose purpose is to improve the quality of pediatric emergency care using a variety of Internet resources and a multidisciplinary consortium of organizations.
  • The first link in the chain of prehospital care is preparedness in the pediatrician's office and caregiver's knowledge of CPR and the 911 EMS system.
  • The National EMS Education Standards is a blueprint for a proposed novel EMS education system comprising scope of practice, training curricula, and evolving standards of care.
  • Appropriate specialized and pediatric-sized equipment and supplies are essential for prehospital providers and community emergency departments.
  • Online medical direction of EMS is dependent on proper communication. Offline direction is dependent on readily identified, previously agreed-upon defined clinical scenarios.
  • Minors cannot refuse treatment and transport in an emergency situation.
  • Joint policies endorsed by the AAP and ACEP have been published regarding community hospital emergency department preparedness for emergency care for children.
  • Particular attention must be focused on stabilizing the patient with suspected significant traumatic brain or cervical spine injuries.
  • Special considerations must be taken into account in disaster management and terrorism conditions, children with special health care needs, situations where child maltreatment is suspected, and psychiatric emergencies.
  • There are several controversial areas in pediatric prehospital care that deserve further research. Fortunately, there are resources, such as PECARN and NEDARC, which can assist those interested in conducting high-quality investigations.

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Historical Perspective

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Organized emergency medical services (EMS) had their beginning with the Department of Transportation (DOT), created by the Highway Safety Act of 1966, which contributed to initial state development of regional EMS systems and training courses for emergency care providers. Federal guidelines and funding for specific components of EMS systems were established by the Emergency Medical Services Act of 1973.

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EMS funding became more of the states' purview with the Omnibus Budget Reconciliation Act of 1981, which consolidated federal funding into the Preventive Health and Health Services block grant program of the Department of Health and Human Services (DHHS).

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Emergency Medical Services for Children

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The Emergency Medical Services for Children (EMSC) Act of 1984 created the EMSC Program, which is administered by the U.S. DHHS's Health Resources and Services Administration (HRSA), along with the U.S. DOT's National Highway Traffic Safety Administration (NHTSA). The EMSC program is the only federal program whose purpose is to improve the quality of pediatric emergency care.

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The Health Resources and Services Administration–Maternal and Child Health Bureau (HRSA–MCHB) funded the Institute of Medicine (IOM) Committee on Pediatric Emergency Medical Services, which produced a report on pediatric EMS, prehospital emergency care, and hospital-based emergency and trauma care in 1993, Emergency Medical Services for Children.1 The IOM study was the first comprehensive investigation that helped delineate the state of pediatric emergency care, the shortcomings and deficiencies of the system, and an overall vision for overcoming the problems identified.

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The IOM's Committee ...

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