Annual EMSC Grantee Meeting

American Academy of Pediatrics Update

June 20 – 22, 2006

ROBERT SAPIEN: So, I’m actually giving two updates; the committee and the section on pediatrics emergency medicine but it’s not twice as long, so you don’t have to worry about that. The objectives are to update you on AAP activities, basically around the committee on pediatric emergency medicine and the section on pediatric emergency medicine. And update you in general on what the AAP offers for EMS for children. And COPEM is a 10-member committee. We’re appointed by the Board of Directors. There’s a nomination process that occurs and our primary role is advisory, we advise the AAP Board of Directors on various policies, procedures, et cetera. We also develop and generate our own policies and procedures that then go through an approval process, and we interface with other organizations such as the ones that Kathleen was talking about.

The members of COPEM hopefully have a geographic representation of the country. There’s also a specific expertise on the committee with specific interest such as patient safety, et cetera, and special skills are also some of the reasons that we’re on the committee. There’s also liaisons that come to our committee meetings.

These are the committee members for this year; Steve Krug from Children’s Memorial is our Chair, and we have two new members; Lou Hampers and Joel Fein is also joining us and as you can see, the rest of the committee members are from all over, from Hawaii, Massachusetts, et cetera.

The liaisons that come to our committee meetings; ACEP sends a liaison; Ghazala is the representative, Kathleen from NAEMSP. The College of Surgeons sends a pediatric surgeon, Dave Tuggle and there’s an MCHP representative. The National Resource Center has a representative and then we have two new representatives from the American Academy of Family Practitioners and the ENA. So, those are two, very good additions to the committee in the liaison role. And then our staff person for the AAP is Sue (inaudible) who does an incredible job. It’s actually (inaudible) is but--

The work of COPEM is a lot so we cover basically all of EMSCs, system of care for the AAP. We generate policies, guidelines, and technical reports. We also review policies, guidelines, et cetera, such as the bronchiolitis, one that we just finished reviewing. We also are involved in educational programs and developments. We also liaison with and collaborate with other organizations, American Heart Association, College of Surgeons, et cetera. And for being a small committee, we also are involved in a lot of political action through the AAP, of course.

Now, unlike Doctor Kupperman in California, in New Mexico, my use for an underwater camera would be limited to a swimming pool or a bathtub, which would be scary in itself so. Anyway, this is obviously not an underwater picture but it is from my digital camera.

Now, the section on Emergency Medicine is also in the AAP and anybody that belongs to the AAP can then pay an extra fee and belong to the section on Emergency Medicine as well. The membership is upwards of 1,200 members right now. They have several sub-committees such as pre-hospital care. Their newest one is Future Leaders in Pediatric Emergency Medicine, which is a really important sub-committee since all of us are getting older, and we all realize that we need to really develop the future leaders in pediatric emergency medicine, so that was a very good move on the academy’s part. The section is run by an executive committee elected by section members. So, this is an election process that occurs and again, wide geographic representation, California all the way to East Coast.

Again, not another underwater picture. Maybe centuries ago it was underwater. So, the AAP and EMSC and what kind of products come out of both of those and how do they cooperate, and what can the AAP do for EMS for children? One of the big ones, which you are all aware, much aware is the PEP course in one of the EMSC National Heroes Award. It’s developmental approach, case based. It is nice and a wonderful tool because it can be, obviously, disseminated to multiple levels of pre-hospital providers. The APLS scores in Advance Pediatric Life Support Course also a great resources in its fourth edition. The new format is all digital on the CDs, so you can take all the slides, add your own slides, edit some, and just make really nice presentations.

It’s also a flexible course and that you can take in components and use it, for example, we use it with our residents and spread it out over the whole year. PREPM is also a product of the AAP and the next one is in Washington, this next month actually. It’s held every other year and it is an intensive review of Pediatrics Emergency Medicine by the national experts. There’s a COPEM manual, which is a reference manual. It’s for all levels of emergency care. And there’s been a lot of discussion of what we’re going to do with this manual. Everything in the AAP needs to be either revised or retired or just redone completely every three years and this is coming up for review. And so we’re not sure if it’s going to stay in a book form. This might be a good time. Does anybody in the room use this manual in this form or use it at all? Show of hands. Very few. Okay. So, it probably needs to be updated quite a bit.

Family Readiness Kit just came out. It’s in it’s second edition. And it has fact sheets for families. It was generated for and by families actually for disaster planning. Another AAP product was the First Aid CPR Chart. It’s a wall chart on printed on both sides that you can turn it over. It also is accompanied by what to do in an emergency brochure. We just recently revised this for the AAP. We did the first aid part of the chart and Sue (inaudible) worked on the choking CPR, incorporating all the new panels, AHA guidelines and that will be out in the next couple of months. The AAP, of course, maintains on their website, website on terrorism in children and disasters and the site address is at the bottom there, has a list of questions, also had downloadable statements and other resources for pediatricians and families. This is the Rio Grande Gorge outside of Taos, New Mexico.

So, the other big part of a COPEM does is we look at, we generate and also review and provide opinion on a variety of statements. These ones were all ones that we have generated. One that came out last year, Pediatric Care Recommendations for Freestanding Urgent Cares, Role of the Pediatricians in Rural EMS for Children came out in December. We’ve done guidelines and technical reports on pain and anxiety. Of course, Dr. Krug did the overcrowding crisis in our nation’s emergency departments, which was just an incredible document. We’ve done, we’ve submitted one on patient safety. Thanks to the help of Dr. Frush.

Patient centered, family centered care and then we’ve done work on TIPP sheets for disaster care in the EMS activation, and then of course, the Choking Chart brochure that we talked about. We’ve also reviewed for the AAP, “A Parent’s Guide to Water Safety”, Acute Medical Management of Brain Injury in Children Transport Manual. We reviewed certain chapters in that and other statements that they’ve come up with such as the Model Contractual Language for Medical Necessity for Children, clinical report evaluating infants and young children with multiple fractures, SIDS, sedation guidelines, and the last one we did was the Bronchiolitis Clinical Practice Guideline, which will be out from the AAP soon.

On the horizon for COPEM, we are preparing statements and/or reports on preparation for office emergencies, mental health emergencies. We’re also working on that as an either technical report and working with other organizations as well. We’re continuing work with Disaster Bio Terrorism Preparedness, Pediatric Trauma. There’s probably going to be a statement coming out about that. Access to care and several documents on the AADs have been generated and worked on.

The other big asset for the AAP, especially for EMS for children is their political advocacy. They do have a Washington office. Cindy Pellegrini staffs that and is just really a go-getter when it comes to politics. They’ve really been pushing for Medicaid immunizations, access to care, total reform. And she’s done a great deal of work. I’m not sure if everybody in the room realizes how much work she’s actually done for EMS for children on the Hill. The document that she’s used, of course, and we’re all aware of, which was a wonderful document printed in April in four journals at the same time by Dr. Krug and Dr. Kupperman celebrating 20 years of EMSC.

So, what COPEM can do for you is we’re actually a direct link. Both COPEM and this section are directly into all 60,000 members of the AAP. Like any organization, there is a political structure within the AAP. So, we can help navigate that and introduce ideas, et cetera. So, let us know what you think we should be doing or what you think needs to be done. And also it’s a good link into further legislative issues because, like we said, now we’re talking 60,000 members. So, we can help with the Washington office as well as local offices. Any questions?