Emergency Medical Services systems began development in the late 1960's. These systems were largely derived from military experiences, which demonstrated that survival could be greatly enhanced through appropriate triage, timely transport and prehospital care. They tended, however, to focus primarily on adult care while specialized pediatric needs received limited attention at best. As a result, while outcomes for adults in emergency situations improved dramatically, children's outcomes did not keep pace.

Children are not "small adults". The ill and injured child has very special needs and requires a different approach to care. In the mid-1970's there grew recognition that the emergency care needs of the pediatric population were not being adequately addressed. This led to the establishment of the National Emergency Medical Services for Children (EMSC) program in 1985. This program, sponsored through the Maternal and Child Health Bureau and the National Highway Traffic Safety Administration, emphasizes the need for states to ensure the availability of appropriate resources and adequately trained personnel in order to effectively meet the emergency care needs of the critically ill and injured child. Federal funds are available to states to assist in improving the pediatric component of their EMS system.

The initial goal of EMSC is to prevent childhood illness and injury. When prevention fails, the goal is to make sure that all ill or injured children receive state-of-the-art emergency medical care from all the health care providers that children encounter in an emergency situation. EMSC programs and services strive to be culturally competent, family-centered, and accessible to consumers.

RELATED SITES TO VISIT
	National Emergency Medical Services for Children (EMSC)
	Maternal and Child Health Bureau
	National Highway Traffic Safety Administration
	American Academy of Pediatrics (AAP)
	Ohio Department of Health

The Ohio Chapter of the American Academy of Pediatrics (AAP) established the Emergency Care Committee (ECC) in 1979 to evaluate and improve emergency care for children in Ohio. In 1986, the ECC joined with the Maternal and Child Health Division of the Ohio Department of Health to address issues of mutual interest in the provision of emergency health care for children. In 1989, the ECC received funding from the Ohio Department of Health to conduct a comprehensive assessment of the statewide system for delivering care to seriously or critically ill or injured children. Information derived from this assessment was instrumental in developing an EMSC plan and recommendations for the future.

From this needs assessment, the EMSC program focused on development of ongoing training programs, linkages between rural hospitals and pediatric centers, generation of community support for the continuation of these programs and extension to all counties in the state. The needs assessment and the initial interventions were instrumental in the acquisition of an EMSC Demonstration grant from the Ohio Department of Health. This grant helped introduce EMSC in rural communities where the need was greatest.

The comprehensive statewide needs assessment completed in 1992, was instrumental in identifying a variety of pediatric emergency care needs within Ohio and provided the foundation for the establishment of a statewide EMSC. Over time, a number of fundamental activities have been orchestrated and key pediatric components have been institutionalized in the state.