If there is one word to describe pediatric
emergency care in 2006, it is uneven. As mentioned in Chapter 1, the
specialized resources available to treat seriously ill or injured children vary
greatly based on location. Some children have access to children’s hospitals
and hospitals with separate pediatric inpatient capabilities, which tend to be
well prepared for pediatric emergencies; others must rely on hospitals with
limited pediatric medical expertise and equipment (Middleton and Burt, 2006).
Requirements for pediatric continuing medical education for EMTs vary
emergency care in 2006, it is uneven. As mentioned in Chapter 1, the
specialized resources available to treat seriously ill or injured children vary
greatly based on location. Some children have access to children’s hospitals
and hospitals with separate pediatric inpatient capabilities, which tend to be
well prepared for pediatric emergencies; others must rely on hospitals with
limited pediatric medical expertise and equipment (Middleton and Burt, 2006).
Requirements for pediatric continuing medical education for EMTs vary
greatly
across states. Some states and communities have organized trauma systems and
designated pediatric facilities, while others do not. As a result, not all
children have access to the same quality of care. While data on system
performance are not routinely collected, it appears that where a child lives
has an important impact on whether the child can survive a serious illness or
injury.
The day-to-day presentation of pediatric patients
is challenging enough for emergency care systems in some areas; addressing new
and emerging threats to children’s health may be beyond the capabilities of the
current system. Experience has shown that the outbreak and management of
contagious diseases, such as new strains of influenza and severe acute
respiratory syndrome (SARS), can cause a major disruption in the emergency care
system (Augustine et al., 2004). The effect of these new health threats on
children is not yet well understood. Several case studies of SARS have been
published, but most of the clinical, laboratory, and radiological information
available is based on adult patients (Bitnun et al., 2003). Some case studies
suggest that while children are susceptible to SARS, symptoms of the disease
may be milder in young children as compared with adolescents and adults (Fong
et al., 2004; Leung et al., 2004). However, these studies are based on a very
small sample. The efficacy of pediatric treatment for SARS requires additional
evaluation; indeed, no pediatric treatment regime for SARS currently exists
(Leung et al., 2004).
is challenging enough for emergency care systems in some areas; addressing new
and emerging threats to children’s health may be beyond the capabilities of the
current system. Experience has shown that the outbreak and management of
contagious diseases, such as new strains of influenza and severe acute
respiratory syndrome (SARS), can cause a major disruption in the emergency care
system (Augustine et al., 2004). The effect of these new health threats on
children is not yet well understood. Several case studies of SARS have been
published, but most of the clinical, laboratory, and radiological information
available is based on adult patients (Bitnun et al., 2003). Some case studies
suggest that while children are susceptible to SARS, symptoms of the disease
may be milder in young children as compared with adolescents and adults (Fong
et al., 2004; Leung et al., 2004). However, these studies are based on a very
small sample. The efficacy of pediatric treatment for SARS requires additional
evaluation; indeed, no pediatric treatment regime for SARS currently exists
(Leung et al., 2004).
Avian influenza is another emerging threat that
could put children at particular risk. Children may be more susceptible to the
disease because of their increased proximity to one another at schools and day
care centers. They may also be more likely to come into contact with poultry or
bird fecal matter while playing. It is unknown whether immunity differences in
children have any significance in their susceptibility to avian influenza,
since it is presumed that the vast majority of humans have no immunity against
the H5N1 virus, the strain of greatest concern (U.S. Department of State,
2006).
could put children at particular risk. Children may be more susceptible to the
disease because of their increased proximity to one another at schools and day
care centers. They may also be more likely to come into contact with poultry or
bird fecal matter while playing. It is unknown whether immunity differences in
children have any significance in their susceptibility to avian influenza,
since it is presumed that the vast majority of humans have no immunity against
the H5N1 virus, the strain of greatest concern (U.S. Department of State,
2006).