improved training and education, provision of pediatric-specific equipment, and other aspects of EMS The program continues to work to ensure that pediatric issues are better integrated into the EMS system EMSC programs include state partnership grants, targeted issues grants, support of the Pediatric Emergency Care Applied Research Network (PECARN), state pediatric regionalization of care grants, and the EMSC Innovation and Improvement Center The EMSC program addresses the entire continuum of pediatric emergency services, from injury prevention and EMS access, all the way through to rehabilitation and reintegration back into the community In addition to addressing the entire spectrum, the guiding principles of the EMSC program are to promote state-of-the-art care and to ensure that pediatric services are well integrated into the EMS system as a whole and that resources are available to make this happen Additional goals of the program are to enhance the evidence base for the prehospital care of children and to spread improvements in the quality and outcomes of the emergency care of children through coordination of quality improvement activities among grantees History of EMS for Children Because early EMS systems were designed to provide rapid intervention for sudden cardiac arrest in adults and rapid transport for motor vehicle crash victims, the specialized care that children require was often overlooked The need to improve the capacity of EMS to manage sick and injured pediatric patients initially came from the providers themselves as well as the physicians who received those patients Pediatricians and pediatric surgeons, identifying poor outcomes among children receiving emergency medical care, became advocates on behalf of their patients They sought to obtain for children the same positive results that EMS had achieved for adults Shortfalls in provider training, pediatric-specific emergency equipment, established standards of care, and quality pediatric EMS research severely limited the advancement of the specialty In the late 1970s, Calvin Sia, MD, president of the Hawaii Medical Association, urged members of the AAP to develop multifaceted EMS programs that would decrease illness and death in children Dr Sia worked with U.S Senator Daniel Inouye (D-HI) and his staff assistant, Patrick DeLeon, PhD, to generate legislation for an initiative on pediatric EMS In 1984, Senators Orrin Hatch (R-UT) and Lowell Weicker (R-CT) joined Senator Inouye in sponsoring the first EMSC legislation C Everett Koop, MD, then Surgeon General of the United States, strongly supported this measure, as did the AAP The 1984 legislation led to the establishment of the EMSC program Two years later, Alabama, California, New York, and Oregon became the first recipients of federal grant money specifically earmarked to improve pediatric EMS Since then, EMSC grants have helped all 50 states, the District of Columbia, and five U.S territories Grant funds have improved the availability of child-appropriate equipment in ambulances and EDs; supported hundreds of programs to prevent injuries; and provided thousands of hours of training to EMTs, paramedics, and other emergency medical care providers The EMSC program’s support also has led to legislation mandating EMSC initiatives in several states, and to educational materials covering every aspect of pediatric emergency care The timeline in Figure 134.3 highlights some of the spotlight projects that EMSC has been involved in: 1984: EMS for Children authorized 1986: first grants were distributed 1987: PALS was introduced 1993: all 50 states and DC received EMS for Children funds 1998: Federal Interagency Committee on EMSC Research was established 2004: the IOM project examining emergency care in the United States was convened, and EMSC was specifically addressed ROLE OF THE PEDIATRICIAN/PEDIATRIC EM PROVIDER IN EMS FOR CHILDREN Pediatric-focused clinicians, including physicians and other advanced healthcare providers, should be encouraged to become involved in the EMSC system in their community, especially those who work in emergency medicine, critical care, pediatrics, surgery, and family medicine On a local, regional, or state level, practitioners can serve as advocates for the pediatric needs within their systems A list of grantees by state can be found at https://emscimprovement.center/emsc-grantee-contact-list , including contact information for the program managers The state Office of EMS or its equivalent can be contacted for a schedule of local community medical services meetings This is a good way for an interested physician to learn more about the issues facing his or her