Emergency Preparedness for Children with Special Health Care Needs
August 1, 2000
Emergency Preparedness for Children with Special Health Care Needs
The American Academy of Pediatrics (AAP) in Elk Grove Village, IL, offers these recommendations:
1. A brief, comprehensive summary of information important for hospital or prehospital emergency management of a child with special health care needs should be formulated by the child’s caregivers, health care professionals, and all subspecialty providers.
2. The summary, or emergency medical data set, should be updated regularly and maintained in an accessible and usable format.
3. Parents, other caregivers, and health care professionals should be educated to optimize use of the summary. Parents and other caregivers should be encouraged to take the summary with them for all health care encounters.
4. Mechanisms to quickly identify children with special health care needs in an emergency should be established and should be available to local EMS and hospital personnel.
5. A universally accepted, standardized form should be used for summaries. See suggested form titled "Emergency Information Form for Children with Special Health Care Needs." (Editor’s note: The form is enclosed in this issue of ED Management.) Essential data elements include the patient’s name, birth date, date of last summary update, weight, guardian’s name, emergency contacts, pediatricians and other health care professionals, primary emergency department, major chronic illnesses and disabilities, baseline physical and mental status, baseline vital signs and laboratory studies, immunization history, medications, medication allergies, food allergies, and advance directives.* The AAP and its chapters should encourage local adoption of the American College of Emergency Physicians/AAP form.
6. Rapid 24-hour access to the summary should be ensured. Copies should be accessible at home, school, during transportation, and in the emergency department, in addition to a copy in the records of treating physicians. Linkage to an emergency telephone number such as 911 dispatch or some other method of ensuring rapid access is desirable. Especially important is identification of the most appropriate EMS squad to be called in areas without a 911 dispatch. Schools and child-care facilities should be encouraged to include the emergency summary as part of a child’s individual health plan.
7. Confidentiality of the form should be carefully maintained. Parental permission to establish the emergency information form and distribute it to appropriate agencies should be obtained and kept on file with the originator of the form or at a central repository.
* Most states have a standard advance directive form, which is required for EMS to honor the advance directive to withhold emergency life-saving measures; however, the emergency data set or summary can identify a need to look for the standard form.
Source: Used with permission of the American Academy of Pediatrics. Committee on Pediatric Emergency Medicine. Emergency preparedness for children with special health care needs. Pediatrics 1999; 104:1-6.
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