Massachusetts
Emergency Medical Services for Children
The EMSC Program: Taking Action, Saving Lives
The federal Emergency Medical Services for Children (EMSC) program supports projects in the states to
expand and improve emergency medical services for children who need treatment for life threatening
illnesses or injuries. The program has funded pediatric emergency care improvement initiatives in every
state, the District of Columbia, and five U.S. territories. Some examples of cutting-edge work
accomplished with support from the EMSC program are:
 The development of pediatric emergency care training programs for EMTs, paramedics, and
hospital emergency department staff;
 The design of national, evidence-based quality measures for assessing care to children who have
suffered serious injuries;
 The inclusion of pediatric protocols and standards in the development of state trauma systems; and
 The inclusion of pediatric needs in the development of state disaster plans.
Why Do We Need a Special Focus on Children?
There are 31 million child and adolescent visits to the nation's emergency departments every year, and most
of these visits are made by children under the age of three. Because children are not just small adults, they
need specialized care in an emergency. Their care providers need to be trained in pediatrics and supplied
with child-size equipment.
In the U.S. we are lucky to have a network of high quality children’s hospitals. Nevertheless, 90% of
children requiring emergency care are seen in general, or community, hospitals rather than children's
hospitals. In a typical community hospital emergency department, one-quarter to one-third of the patients
are children. Severe asthma and respiratory distress are the most common emergencies for pediatric
patients, representing nearly one-third of all hospitalizations among children under the age of 15 years.
Seizures, shock, and airway obstruction are other common pediatric emergencies, followed by cardiac arrest
and severe trauma.
Prior to the authorization of the EMSC Program in 1985, children in an emergency had poorer outcomes
than did adults, despite the progress that emergency care had made since its beginnings in the 1960’s.
Congress funded EMSC to remedy this discrepancy, and since that time, much has been done to improve
emergency care for children.
EMSC in Massachusetts
In Massachusetts, EMSC has been active for 12 years. During that time we have had three major goals that
have been pursued through a number of successful activities:
Goal 1: The integration of pediatric care improvement into all initiatives and priorities of the greater
Massachusetts emergency medical services (EMS) system
 Pediatric care standards were accepted as an important part of the state’s authorizing legislation,
EMS 2000.

Pediatric care advocates participate actively as voting members of the Emergency Medical Care
Advisory Board and its five working committees and were critical participants in the recent drafting
of the state’s trauma care system plan.
Goal 2: The enhancement of pediatric emergency care at the prehospital and hospital levels and in
the community
 Pediatric prehospital treatment protocols and ambulance equipment standards have been developed
and are now in use.
 Pediatric care guidelines for hospital emergency departments were developed and distributed to all
acute care hospitals in the state.
 EMT and paramedic training curricula were developed and are now in use.
 Funding was made available to subsidize training in pediatrics for over 250 emergency department
nurses.
 A video was developed for, and distributed to, emergency departments on providing familycentered care to children with complex medical conditions.
 School emergency planning guidelines were developed with active participation by the school nurse
community.
 Emergency readiness guidelines for the primary care pediatrician were developed and distributed,
on request, to more than 250 primary care physicians in Massachusetts and across the United
States.
Goal 3: The prevention of pediatric trauma at the community level.
 Small grants have been made to community ambulance service providers to carry out injury
prevention activities in their communities.
 Over $44,000 was distributed to nine communities in 2004; an additional $60,000 will be awarded
in 2005.
 Community projects have included child car safety seat checkpoints, injury prevention education
for teenage drivers, education for children and families involved in recreational activities, and home
safety visits in rural communities.
 The EMSC Project Director has actively supported and participated in the new Child Fatality
Review Team program mandated by the state legislature to review child deaths for the purpose of
preventing future deaths.
EMSC is a Critical Program to Ensure:







A consistent voice advocating for the emergency care needs of all Massachusetts children
Support to community hospitals seeking to upgrade their services to children
Assistance to emergency department nurses seeking to enhance their pediatric skills
Support for childhood injury prevention in the community
Support for family-centered emergency care for children with complex medical conditions
Assistance to school nurses advocating for emergency planning in their schools
Linking services to provide for the needs of children in a disaster or an act of terrorism.
For Further Information:
Janet Berkenfield
Director, Massachusetts EMSC Project
Mass. Dept. of Public Health
617-624-5088
janet.berkenfield@state.ma.us
http://www.mass.gov/dph/fch/emsc/maemsc.htm
Federal EMSC Program: http://mchb.hrsa.gov/programs/emsc
2