The National Pediatric Prehospital Readiness Project: First Comprehensive Assessment of United States Emergency Medical Services Agencies

STUDY OBJECTIVE: The National Prehospital Pediatric Readiness Project aims to optimize pediatric out-of-hospital care by emergency medical services (EMS). The current report details the findings of the first national assessment of pediatric readiness among US EMS agencies. METHODS: We performed a cross-sectional study of data collected from 911-responding EMS agencies in the United States via a scored web-based survey developed based on national guidelines for out-of-hospital care. The survey contained 207 questions across 8 domains of out-of-hospital readiness: education, equipment, safety, family-centered care, pediatric coordination, interaction with systems, policies, and quality improvment. The primary outcome was the Prehospital Pediatric Readiness Score (range 0-100); secondary outcomes were median domain scores and the effect of a pediatric emergency care coordinator on scores. RESULTS: Overall, 6,989/15,293 (46%) agencies responded; 2,661 (38%) reported having a pediatric emergency care coordinator. Median Prehospital Pediatric Readiness Score was 65.5 (interquartile range [IQR] 50.9 to 78.8). Domain scores were highest for equipment (median 12.0, IQR [12 to 12], range 0 to 12), policies (11.5, IQR [10 to 12], range 0 to 13), and safety (11.5, IQR [7 to 14], range 0 to 14) and lowest for family-centered care (5.8, IQR [2 to 8], range 0 to 10), quality improvement (5.7, IQR [3 to 9], range 0 to 12), and interactions with systems (4.9, IQR [3 to 7], range 0 to 10). Presence of a pediatric emergency care coordinator was associated with a perfect score in all domains. CONCLUSION: A national assessment of EMS agencies revealed strengths and gaps in pediatric readiness. Pediatric emergency care coordinators are associated with higher readiness scores. Future work should address barriers to pediatric readiness and the effect of higher readiness on patient outcomes.