Colorado Prehospital
Pediatric Quality Council
Best Practice Guideline
Topic:
Pediatric Age Guidelines for EMS Protocol Development
Date Issued / Revised:
November 11, 2014
Background:
Pediatric patients historically represent less than 10% of Emergency Medical
Services (EMS) encounters in Colorado. Children are anatomically, physiologically
and developmentally different from adults and often require specialized care,
equipment, and protocols. The CPPQC endorses the following consensus guidelines
for development of prehospital pediatric protocols.
Guideline:
General
EMS patients up to 18 years of age (ages 0 – 17) should be considered pediatric
patients unless otherwise specified in this guideline.
Resuscitation
Pediatric resuscitation guidelines and related protocols should be applied to
pediatric patients up to 12 years of age (ages 0 -11). Length-based tape systems
should be used to guide therapy for all such patients and have been established as
reliable from 1 week up to 12 years of age.1
Trauma Care
In accordance with the Colorado Board of Health regulations for the designation of
Trauma Facilities, pediatric trauma care guidelines and related protocols should be
applied to patients up to 15 years of age (ages 0 – 14).2,3
Equipment
Pediatric patients require appropriately sized equipment for optimal care. As such,
recommend equipment4 should be available on ambulances and other medical
response vehicles and used in accordance with the manufacturer’s guidelines.
Typically, such guidelines are based upon height, weight or other anatomic criteria.
Behavioral and Mental Health
Behavioral and mental health emergencies in children are commonly encountered
by EMS. Children have specialized care needs based on their level of emotional,
physical and behavioral development. Protocols related to behavioral and mental
health emergencies should be developmentally appropriate for patients up to 18
years of age (ages 0 -17) in order to direct younger patients to the most appropriate
care.5
Newborn / Neonatal
Neonatal or newborn-specific protocols should be applied to infants up to 4 weeks
of age (ages 0 - 28 days).
References:
1
Lubitz, Deborah S., et al. "A rapid method for estimating weight and resuscitation drug
dosages from length in the pediatric age group." Annals of emergency medicine 17.6
(1988): 576-581.
2
Colorado Department of Public Health and Environment, Health Facilities and
Emergency Medical Services Division, 6 CCR-1015-4 – Chapter 3 – Designation of
Trauma Facilties, Effective June 30, 2011, Section 300 (5).
Colorado Department of Public Health and Environment, “Health Facilities and
Emergency Medical Services Division, 6 CCR-1015-4 – Chapter 3 – Designation of
Trauma Facilities,” Effective March 02, 2011, Section 202 (D).
3
4
American Academy of Pediatrics, et. al.. "Equipment for ground ambulances."
Prehospital Emergency Care 18, no. 1 (2014): 92-97.
http://informahealthcare.com/doi/pdfplus/10.3109/10903127.2013.851312,
Accessed on October 30, 2014.
5
Dolan, Margaret A., and Joel A. Fein. "Pediatric and adolescent mental health
emergencies in the emergency medical services system." Pediatrics 127, no. 5 (2011):
e1356-e136