Abstract

To reduce the morbidity and mortality of critically ill and injured children, comprehensive care must be provided. This includes effective services and treatment from the onset of the illness or injury through definitive care. Pediatricians should counsel families not only about prevention of disease and injury but also about access to pediatric emergency care resources in their region. If the interval between recognition of illness and delivery of care is to be reduced to a minimum, a prehospital protocol must be established. Parents as well as prehospital care providers must be knowledgeable about their community's prehospital protocol for life-threatening illness or injury. Primary care pediatricians need to establish networks with hospital-based pediatricians, emergency physicians, pediatric surgeons, and other pediatric medical and pediatric surgical specialists so that there is clearly assigned responsibility for provision of pediatric emergency care.1 When available, a pediatric surgeon should take charge of the child with multiple traumatic injuries. Optimally, the pediatric emergency care delivery system will be comprehensive and designed to meet the unique needs of children. The specific objectives of an emergency medical services for children (EMS-C) system should remain constant even though available resources may vary from region to region. For an EMS-C system to be most effective, practitioners need to develop the knowledge, skills, attitudes, and experience necessary to provide essential life support for ill and injured children. Many regions currently have well-developed emergency medical services (EMS) systems with outstanding capability and sophistication but most have been designed to meet the needs of adults.2

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