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National EMS Education Standards Washington, DC: National Highway Traffic Safety Administration; 2009 Available online at http://www.ems.gov/pdf/811077a.pdf Accessed March, 2020 Remick K, Caffrey S, Adelgais K Prehospital provider scope of practice and implications for pediatric prehospital care Clin Pediatr Emerg Med 2014;15(1):9–17 Medical Oversight of EMS National Association of EMS Physicians Position statement: physician oversight of emergency medical services Prehosp Emerg Care 2016;21(2):281–282 Available online at https://doi.org/10.1080/10903127.2016.1229827 Emergency Medical Dispatch Bohm K, Rosenqvist M, Hollenberg J, et al Dispatcher-assisted telephone-guided cardiopulmonary resuscitation: an underused lifesaving system Eur J Emerg Med 2007;14:256–259 Clawson J, Olola C, Heward A, et al Cardiac arrest predictability in seizure patients based on emergency medical dispatcher identification of previous seizure or epilepsy history Resuscitation 2007;75:298–304 Forslund K, Kihlgren M, Sorlie V Experiences of adding nurses to increase medical competence at an emergency medical dispatch centre Accid Emerg Nurs 2006;14:230–236 Goto Y, Maeda T, Goto Y Impact of dispatcher-assisted bystander cardiopulmonary resuscitation on neurological outcomes in children with out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study J Am Heart Assoc 2014;3:e000499 You JS, Park S, Chung SP, et al The era of audiovisual dispatch using cellular phones with video telephony Resuscitation 2008;76:486–487 EMS Equipment and Modes of Transport American Academy of Pediatrics; American College of Emergency Physicians; American College of Surgeons Committee on Trauma; et al Equipment for ground ambulances Prehosp Emerg Care 2014;18(1):92–97 American College of Emergency Physicians and National Association of EMS Physicians Guidelines for air medical dispatch Policy Resource and Education Paper 2006 Available online at http://www.acep.org/uploadedFiles/ACEP/Practice_Resources/issues_by_category/Emergency_Medical_Servi ces/GuidelinesForAirMedDisp.pdf Updated August 22, 2008 Accessed August 10, 2015 Floccare DJ, Stuhlmiller DF, Braithwaite SA, et al Appropriate and safe utilization of helicopter emergency medical services: a joint position statement with resource document Prehosp Emerg Care 2013;17(4):521– 525 Thomas SH, Brown KM, Oliver ZJ, et al An evidence-based guideline for the air medical transportation of prehospital trauma patients Prehosp Emerg Care 2014;18(suppl 1):35–44 EMS Communication Charash WE, Caputo MP, Clark H, et al Telemedicine to a moving ambulance improves outcome after trauma in simulated patients J Trauma 2011;71(1):49–55 Merrell RC, Cone SW, Rafiq A Telemedicine in extreme conditions: disasters, war, remote sites Stud Health Technol Inform 2008;131:99–116 Qureshi A, Shih E, Fan I, et al Improving patient care by unshackling telemedicine: adaptively aggregating wireless networks to facilitate continuous collaboration AMIA Annu Symp Proc 2010;2010:662–666 Talbot R, Bleetman A Retention of information by emergency department staff at ambulance handover: standardized approaches work? Emerg Med J 2007;24:539–542 Wurster FW Mnemonic device helps patient hand-offs JEMS 2011 Available online at http://www.jems.com/articles/print/volume-36/issue-7/training/mnemonic-device-helps-patient-hand-offs.html Accessed August 10, 2015 EMS Culture of Safety American College of Emergency Physicians Strategy for a national EMS culture of safety 2013 Available online at http://www.emscultureofsafety.org/ Accessed August 12, 2015 Hoyle JD Jr, Davis A, Trytko J, et al Medication dosing errors in pediatric patients treated by emergency medical services Prehosp Emerg Care 2012;16:59–66 Johnson TD, Lindholm D, Dowd MD Child and provider restraints in ambulances: knowledge, opinions, and behaviors of emergency medical services providers Acad Emerg Med 2006;13:886–892 Kaji AH, Gausche-Hill M, Conrad H, et al Emergency medical services system changes reduce pediatric epinephrine dosing errors in the prehospital setting Pediatrics 2006;118:1493–1500 Lammers RL, Byrwa MJ, Fales WD, et al Simulation-based assessment of paramedic pediatric resuscitation skills Prehosp Emerg Care 2009;13:345–356 EMS Medical–Legal Issues Frew SA, Giese K Quick Risk and Compliance Answers 2nd ed Racine, WI: Johnson Insurance Services, LLC; 2008 Haines CJ, Lutes RE, Blaser M, et al Paramedic initiated non-transport of pediatric patients Prehosp Emerg Care 2006;10:213–219 Kannikeswaran N, Mahajan PV, Dunne RB, et al Epidemiology of pediatric transports and non-transports in an urban emergency medical services system Prehosp Emerg Care 2007;11:403–407 Silvestri S, Rothrock SG, Kennedy D, et al Can paramedics accurately identify patients who not require emergency department care? Prehosp Emerg Care 2002;6:387–390 Regionalization of Pediatric Care American Academy of Pediatrics, Committee on Pediatric Emergency Medicine American College of Critical Care Medicine and Society of Critical Care Medicine, Pediatric Section, Task Force on Regionalization of Pediatric Critical Care Consensus report for regionalization of services for critically ill or injured children Pediatrics 2000;105:152–155 Prehospital Airway Management DiRusso SM, Sullivan T, Risucci D, et al Intubation of pediatric trauma patients in the field: predictor of negative outcome despite risk stratification J Trauma 2005;59:84–90 Ehrlich PF, Seidman PS, Atallah O, et al Endotracheal intubations in rural pediatric trauma patients J Pediatr Surg 2004;39:1375–1380 Gausche M, Lewis RJ, Stratton SJ, et al Effect of out-of-hospital pediatric endotracheal intubation on survival and neurological outcome: a controlled clinical trial JAMA 2000;283:783–790 Ostermayer DG, Gausche-Hill M Supraglottic airways: the history and current state of prehospital airway adjuncts Prehosp Emerg Care 2014;18:106–115 Youngquist ST, Henderson DP, Gausche-Hill M, et al Paramedic self-efficacy and skill retention in pediatric airway management Acad Emerg Med 2008;15:1295–1303 Children With Special Healthcare Needs Kaziny BD The prehospital care of children with special health care needs Clin Pediatr Emerg Med 2014;15:89–95 Spaite DW, Karriker KJ, Seng M, et al Training paramedics: emergency care for children with special health care needs Prehosp Emerg Care 2000;4(2):178–185 Emergency Preparedness National implementation of the model uniform core criteria for mass casualty incident triage 2014 Available online at http://www.nhtsa.gov/staticfiles/nti/pdf/811891Model_UCC_for_Mass_Casualty_Incident_Triage.pdf Accessed August 10, 2015 EMS for Children Program Gausche-Hill M, Barata I, Baren J, et al The role of the emergency physician in emergency medical services for children Ann Emerg Med 2003;42:206–215 Huddleston KC Pediatric health policy analysis: the Emergency Medical Services for Children (EMSC) Act and the Wakefield Act, utilizing social construction of target populations Pediatr Nurs 2006;32:167–172 Institute of Medicine Reports http://www.iom.edu/Reports/2006/Emergency-Care-for-Children-Growing-Pains.aspx http://www.iom.edu/Reports/2006/Emergency-Medical-Services-At-the-Crossroads.aspx http://www.iom.edu/Reports/2006/Hospital-Based-Emergency-Care-At-the-Breaking-Point.aspx EMS Research Adelgais KM, Hansen M, Lerner EB, et al Establishing the key outcomes for pediatric emergency medical services research Acad Emerg Med 2018;25(12):1345–1354 Cone DC Knowledge translation in the emergency medical services: a research agenda for advancing prehospital care Acad Emerg Med 2007;14(11):1052–1057 EMSC National Resource Center, Children’s National Medical Center Gap analysis of EMS related research Report to the Federal Interagency Committee on EMS 2009 Available online at http://www.emscnrc.org/Files/PDF/EMSC_Resources/Gap_Analysis_of_EMS_Related_Research.pdf Accessed August 12, 2015 Foltin GL, Dayan P, Tunik M, et al.; Prehospital Working Group of the Pediatric Emergency Care Applied Research Network Priorities for pediatric prehospital research Pediatr Emerg Care 2010;26:773–777 Leonard JC, Scharff DP, Koors V, et al A qualitative assessment of factors that influence emergency medical services partnerships in prehospital research Acad Emerg Med 2012;19:161–173 Evidence-Based Guidelines Brown KM, Hirshon JM, Alcorta R, et al The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services Prehosp Emerg Care 2014;18(suppl 1):45–51 Brown KM, Macias CG, Dayan PS, et al The development of evidence-based prehospital guidelines using a GRADE-based methodology Prehosp Emerg Care 2014;18(suppl 1):3–14 Gausche-Hill M, Brown KM, Oliver ZJ, et al An evidence-based guideline for prehospital analgesia in trauma Prehosp Emerg Care 2014;18(suppl 1):25–34 Model EMS clinical guidelines project Available online at https://www.nasemso.org/Projects/ModelEMSClinicalGuidelines/index.asp Accessed August 10, 2015 Shah MI, Macias CG, Dayan PS, et al An evidence-based guideline for pediatric prehospital seizure management using GRADE methodology Prehosp Emerg Care 2014;18(suppl 1):15–24 CHAPTER 135 ■ TECHNOLOGY-ASSISTED CHILDREN ELLEN G SZYDLOWSKI, KATHLEEN M CRONAN, JOEL A FEIN, JILL C POSNER INTRODUCTION Nearly one-fourth of the visits to a pediatric emergency department (ED) are for complaints associated with chronic illness Many children with chronic illness have indwelling medical devices, such as tracheostomy tubes, cerebrospinal fluid (CSF) shunts, venous catheters, and gastrostomy tubes (G-tubes) Medical technology has enabled these children, who in the past would have required specialized inpatient or intensive care, to thrive at home Emergency physicians must be able to diagnose and treat the common problems associated with these devices and recognize when it is appropriate to consult other specialists Devices most commonly found in the pediatric population include CSF shunts, tracheostomy tubes, venous catheters, and percutaneous gastrointestinal (GI) and urologic catheters This chapter familiarizes the emergency clinician with the equipment and with the clinical manifestations and management of the common problems related to these devices APPROACH TO THE CARE OF THE TECHNOLOGYASSISTED CHILD The evaluation of the technology-assisted child who visits the ED may, at times, seem overwhelming First, these children are often assisted by several pieces of equipment Second, the history can be difficult to obtain because of its inherent complexity or a lack of consistent caretakers related to care at a long-term facility or care by home healthcare nurses who work in shifts Finally, a thorough physical examination may be impeded by the technology When a common illness is superimposed on a chronic condition, the illness may appear more complex, misleading the examiner In addition, the ED visit may have been prompted by multiple reasons When a technology-assisted child arrives in the ED, early contact with the primary care provider may be helpful The primary care provider may be able to offer suggestions about the management of the child, potentially avoiding unnecessary tests and admission In many situations, a home health nurse may accompany the patient to the ED and can be a valuable source of information  ... who not require emergency department care? Prehosp Emerg Care 2002;6:387–390 Regionalization of Pediatric Care American Academy of Pediatrics, Committee on Pediatric Emergency Medicine American... Emergency Medicine American College of Critical Care Medicine and Society of Critical Care Medicine, Pediatric Section, Task Force on Regionalization of Pediatric Critical Care Consensus report for regionalization... J, et al The role of the emergency physician in emergency medical services for children Ann Emerg Med 2003;42:206–215 Huddleston KC Pediatric health policy analysis: the Emergency Medical Services