Pediatric Age Guidelines for EMS
Colorado Pediatric Prehospital Quality Council (CPPQC)
August 2014
Background
Pediatric patients historically represent less than 10% of Emergency Medical
Services (EMS) encounters in Colorado. Children are anatomically, physiologically
and developmentally different than adults and often require specialized equipment,
protocols and destination considerations. The CPPQC endorses the following
consensus guideline for statewide consideration of pediatric age-directed
prehospital considerations.
General
EMS patients under 18 years of age will be considered pediatric patients unless
otherwise specified.
Resuscitation
Pediatric resuscitation guidelines and related protocols should be applied to
pediatric patients up to 12 years of age. Length-based tape systems should be used
to guide therapy for all such patients.
Trauma Care
In accordance with the American College of Surgeons recommendations for trauma
centers, pediatric trauma care guidelines and related protocols should be applied to
patients less than or equal to 15 years of age.
Equipment
Pediatric patients require appropriately sized equipment for optimal care. Some
pediatric-sized equipment may also be useful for a subset of smaller adults. As such,
equipment should be 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 with flexible age
parameters.
Newborn / Neonatal
Neonatal- or newborn-specific protocols should be applied to infants less than 1
month of age.
Destination Guidelines
As a general rule, pediatric patients should be transported to the closest appropriate
hospital, critical access hospital (CAH) or community clinic with emergency care
(CCEC). Those facilities should ensure that they are adequately prepared to care for
pediatric patients including appropriate staff straining, equipment and policies.
EMS organizations with reasonable proximity to specialized children’s hospitals or
emergency departments staffed by pediatric emergency medicine physicians should
consider utilizing those facilities routinely as a destination of choice.
Pediatric patients greater than or equal to 15 years of who meet the requirements
for transport to a trauma center should be transported in accordance with RETAC
destination guidelines.
Pediatric patients with behavioral or mental health emergencies should be
transported to a pediatric facility with specialized mental health care practitioners
as time and conditions allow.
Patients of any age who present with existing ‘pediatric’ co-morbidities (Cystic
Fibrosis, Cerebral Palsy, childhood Cancer, etc.) and who continue to be primarily
followed by a pediatric subspecialty center should be transported to a specialized
pediatric facility.
Patients under the age of 18 presenting with pregnancy-related complaints should
be transported to a facility with the capacity to provide obstetric care.
Older adolescent patients that have become ill or injured as a result of adult-related
activity (i.e. alcohol, drugs, assault, etc.) may not be appropriate for transport to
specialized pediatric care facilities.
Consultation with medical control and/or specialized pediatric facilities is
encouraged when the appropriate destination is unclear.