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EMSC History

The groundwork for change of EMS systems and improvement of pediatric emergency care was laid in the late 1970s when Calvin Sia, MD, president of the Hawaii Medical Association, urged members of the American Academy of Pediatrics to develop multifaceted EMS programs that would decrease morbidity and death in children.  Dr. Sia worked with U.S. Senator Daniel Inouye (D-Hawaii) and his staff assistant, Patrick DeLeon, Ph.D., to draft legislation for an initiative on EMS for children.
In 1983, one particular incident served to personalize the need for these services.  One of Senator Inouye’s senior staff members had an infant daughter who became critically ill.  Her treatment demonstrated the average emergency department’s (ED) shortcomings when faced with a child in crisis.  A year later U.S. Senators Orrin Hatch (R-Utah) and Lowell Weicker (R-Connecticut), supported by staff members with disturbing experiences of their own, joined Senator Inouye in sponsoring legislation to establish the EMSC Program.  C. Everett Koop, MD, then Surgeon General of the United States, strongly supported this measure, as did the American Academy of Pediatrics. 

The EMSC Program was established under the Preventive Health Amendments of 1984 (PL 98-555).  Administered by the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB), the Program supports projects in the states and territories to expand and improve emergency care for children who need treatment of life threatening illnesses or injuries.  The Program has funded pediatric emergency care improvement initiatives in every state, the District of Columbia, Guam, the Commonwealth of the Northern Marianas Islands, Puerto Rico, American Samoa, and the U.S. Virgin Islands. 

The overall program goal is to ensure that all children receive the highest quality of medical care when they are ill or injured, whether they are at home or traveling in other states.  This is accomplished through federal funding provided through the EMSC partnership grant program.  Today EMSC grants are used to meet national EMSC performance measures, which concentrate on:

ensuring that all ambulances have the necessary equipment to manage pediatric medical emergencies;

the availability of  pediatric medical direction to all EMS providers at the scene of an emergency;

a designation system of hospital facilities capable of handling  pediatric medical emergencies and trauma and assurance that all EMS providers are aware of such;

the immediate transfer of pediatric patients to hospitals capable of treating pediatric medical emergencies and pediatric trauma;

the assurance that EMS personnel are trained regularly in pediatrics;

the formation of coalitions to address children’s emergency healthcare issues of children; and

the assurance that pediatric emergency care concerns are addressed by including pediatric representation on state boards or advisory committees responsible for state EMS systems.