Annual EMSC Grantee Meeting

National Updates:

American College of Emergency Physicians Update

June 20 – 22, 2006

KATHLEEN BROWN: Okay, the first update I’m going to do is for the American College of Emergency Physicians, Pediatric Emergency Medicine Committee. This is the list of the members of the committee. The committee is an appointed committee or appointed for one-year term, although many people in the committee have been on for much long than that. The chairs of the committee are Dr. Jill Baron from Pennsylvania and Dr. Ghazala Sharieff from Florida. And there’s representations of both pediatric emergency physicians and general emergency physicians who are interested in pediatric issues on the committee.

The committee is tasked with objectives by the ISA board each year and I’m going to go over the five objectives that we’re working on this year. The first is to finalize an information paper that we worked on last year and recommendations regarding patient’s safety and quality related to pediatric patients in the emergency department. I believe Dr. Frush referred to this earlier. The leaders of that were Dr. Isabel Barata and Dr. Lee Benjamin. Other people who worked on that were Dr. Herman and Dr. Mace. The policy was approved by the ACEP board last year and was submitted to Annals of Emergency Medicine and rejected but has been resubmitted to Pediatric Emergency Care and will be published sometime this year.

The second objective is to finalize another information paper and recommendations, and this one was on access to care and overcrowding issues as they affect pediatric emergency patients. The leader of that was Dr. Mark Hostetler and members were Dr. Finkler, Hernandez, Mace, and Brown. The recommendations were approved by the ACEP board last year, and that too was rejected by Annals of Emergency Medicine but resubmitted and accepted to Pediatric Emergency Care. You’ll see that in print this year also.

Objective three was to anticipate and develop a response or recommendation based on the IOM report on pediatric emergency medicine. This is one of the things I was tasked with, so we’ve been waiting and anticipating really, since the IOM report, which as you all know finally came out last week. And so, ACEP is on a number of things in response to the report, mainly interactions with the media. They’ve set up interviews with ACEP members and helped organize press releases. There are links on the ACEP website to help support legislation that will help improve access to emergency care.

The pediatric emergency committee was tasked by the board with coming up with the three top recommendations, the three things of the recommendations that were made by the report itself. They wanted us to come up with the three related to pediatrics that we thought were the most important and submit those to the board. And this was just done on Monday and the three things that we thought were most important: the first two are from the pediatric report, the growing pains report, and the third is from the EMS report or pre-hospital report.

So, the first is, you all should be happy to know is that Congress should increase funding for the federal EMSC program to 37.5 million per year for five years as recommended by the IOM committee. The second one is that emergency departments and EMS agencies should identify an individual to serve as a focal point to enhance pediatric present throughout the spectrum of emergency care. And third that state should strengthen the EMS work first by requiring pediatric court properties for pediatric EMS providers.

So, there was a lot of discussion about choosing these top three things because obviously, all of the recommendations we felt are very important. Other things that people thought were especially important and wanted to bring up to the board were disaster management and children and that, just like there should be a pediatric point person on any EMS agencies, and for general emergency departments, there should be pediatric point people involved in disaster management and planning committees. And also that ACEP was very keen to be involved with any plan for regionalization of pediatric emergencies. As you all are probably aware, most children who suffer acute illness or injury are seen in general emergency departments and only less than 10 percent of them are actually seen by pediatric emergency specialists at their initial visit.

The fourth objective was to build a virtual pediatric emergency medicine community anchored by the ACEP pediatric spring meeting, and to suggest strategies to increase membership. The leader of this was Dr. Al Sacchetti, members were Dr. Burbalys, I’m probably pronouncing that wrong, I’m sorry, Parikh and Schwartz. The things that they looked at doing was to create a communication list. They were hoping to do this at the spring meeting to get email from people who attended but however, that didn’t happen this year where they were hoping to do that next year.

Also next year they’re hoping to have a panel discussion highlighting the characteristics of different practice types. And by this they mean different people who take care of kids in acute injury, so the general emergency physicians practicing in general EDEs, pediatric emergency physicians practicing in general EDEs, pediatric emergency physicians practicing in children’s hospitals and midlevel providers practicing in all of those environments. And then also to facilitate small discussions between these different groups of providers and perhaps at lunch meetings.

The Pediatric Emergency Assembly last year was held, or this year actually was held April 24, April 26, just a couple of months ago in Chicago, Illinois. It was well received. There’s actually ongoing work to get feedback on that assembly to improve it for next year. And next year’s assembly will be in New York, New York, April 17 to 19. Again, our goal with this is to try and have a forum for experts on pediatric emergency medicine to come together and share knowledge and ideas.

The fifth objective was to develop a mechanism for tracking and disseminating current events and issues pertaining to pediatric emergency medicine. The leader of that was Dr. Trocinski, members were Dr. Ishimine and McCollough. Things that they have done this year are to write articles for ACEP news, for AEM, both of these were summarizing the new AHA guidelines, and to collaborate with physicians at MedWatch on doing pediatric MedWatch warnings.

There’s this objective I forgot, I’m sorry. So, this was to forward information on recently published fever guidelines to the clinical policies committee. ACEP’s clinical policies committee is looking at revising their clinical policy on pediatric fever, and so the pediatric committee wanted to have some input on that. So, our report was generated by Dr. McCullough and forwarded to them and they will consider that when they’re revising their guidelines. And some of the topics that were written on in the proposal are listed.

There’s also a couple of projects ongoing that ACEP is working on with AAP. The first one is that project funded by EMSC and headed by Dr. Marianne Gausche-Hill on the implementation evaluation of care in children and emergency department guidelines for preparedness. Dr. Sapien may talk a little bit more about that. And the second is that we’re working on a joint policy statement on a family centered care and ED with AAP, and hopefully that will be published sometime shortly.

And then finally just to put in a little plug for a scientific assembly this year is in New Orleans. ACEP decided to stay with New Orleans despite all of the issues of having a meeting there, so hopefully all will attend or many will attend. Thank you.