Targeted Issue

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In fiscal year 2013, the federal EMSC Program awarded the following six Targeted Issue grants, all of which focus solely on pediatric prehospital research. This represents one of the largest investments, $5.4 million over three years, in pediatric prehospital research. These newly-funded projects will either demonstrate the ability of EMS systems to conduct pediatric research or seek to improve the quality of care by increasing the base of pediatric prehospital research.

  • NEW HAMPSHIRE - Geisel School of Medicine and Dartmouth- Hitchcock Medical Center. Innovating and Improving Prehospital Pediatric Care in Rural New Hampshire and Vermont: The Center for Rural Emergency Services and Trauma (CREST) Network for EMS Providers (Principal Investigator: Scott Rodi, MD). EMS providers face many challenges in the delivery of pediatric prehospital care. Moreover, the infrequency of pediatric prehospital encounters makes it difficult for EMS providers to maintain the necessary knowledge and skills to care for pediatric patients. These challenges are exacerbated by a shortage of educational opportunities and medical direction often realized in the rural setting. The goal of this project is to improve care for pediatric prehospital patients in rural Northern New England through increasing the comfort, knowledge, skills, and competency of EMS providers.

  • NEW YORK - Hofstra North Shore-LIJ School of Medicine at Hofstra University. Prehospital Oral Steroids for the Treatment of Status Asthmaticus in Children (POSTSAC) Study (Principal Investigator: Robert Silverman, MD, MS). EMS personnel are currently limited to nebulizer treatments among pediatric asthmatics with acute exacerbations. In addition, children who present to the emergency department (ED) frequently encounter up to two hour wait times before supplemental steroids that may hasten recovery are administered. Allowing EMS personnel to administer steroids in the prehospital setting may prevent possible health consequences for the child, including increased hospital admissions and prolonged ED visits. The goals of this project are to: (1) determine if prehospital administration of oral steroids by paramedics to pediatric patients with moderate to severe asthma exacerbations decreases time spent in the ED and the need for hospitalization and (2) determine if advanced life support (ALS) providers can successfully administer oral steroids (prednisolone) to children with moderate-to-severe asthma.

  • KENTUCKY- University of Louisville Research Foundation. Compassionate Options for Pediatric EMS (COPE) (Principal Investigator: Mary Fallat, MD). EMS providers are often the first line to console grieving parents who have lost a child because of a traumatic event or illness outside the hospital. Moreover, the initial encounter with grieving parents of pediatric fatalities is overwhelming to EMS providers because they feel inadequately prepared to handle the incident which has resulted in EMS providers leaving the profession. The goal of this project is to develop a systems approach to out-of-hospital (OOH) pediatric death that equips EMS providers with the knowledge, tools and skill set needed to manage emotional and psychological effects for the grieving families they encounter as well as for themselves.

  • INDIANAIndiana University. Treat the Street: Prehospital Pediatric Asthma Intervention Model to Improve Child Health Outcomes (Principal Investigator: Andrew Stevens, MD). Significant gaps in care following an ED visit or hospital discharge are illustrated by repetitive ED visits among children with asthma. In addition, in-home asthma assessments have been successful in reducing repetitive ED visits or ED recidivism rates. Typically, in-home assessments are conducted by a public health nurse. However, the capacity for the public health system to absorb a large number of referrals is limited. Specially trained community paramedics are EMS professionals that help improve health outcomes by providing clinical preventive services, acute care, and post-acute care. Therefore, community paramedics are ideal candidates to conduct the in-home assessments. The goal of this project is to utilize a novel pediatric community paramedicine program to: (1) address identified gaps in pediatric asthma care, (2) reduce ED recidivism rates for children, (3) improve pediatric health outcomes, and (4) enhance paramedic provide roles in care delivery.

  • TEXASBaylor College of Medicine and Texas Children’s Hospital. Pediatric Evidence-Based Guidelines Assessment of EMS System Utilization in States (Principal Investigator: Manish Shah, MD). Reducing the variation in practice is an integral component of providing quality health care. Moreover, the standardization of prehospital interventions has been linked to an overall improvement in health outcomes. Prehospital care is usually standardized within an EMS system through the use of guidelines or protocols, also known as offline medical direction. However, offline medical protocols vary from one EMS agency to another, making standardization of care across EMS agencies challenging. The goal of this project is to improve the evidence base for pediatric prehospital care utilizing the National Prehospital Evidence-Based Guideline (EBG) Model Process.

  • WISCONSINMedical College of Wisconsin. Development of the Charlotte, Houston and Milwaukee Prehospital (CHaMP) Research Node (Principal Investigator: Brooke Lerner, PhD). EMS is a relatively new specialty and limited research exists on how to improve care in the prehospital setting. The scarcity in available EMS research is even greater for pediatric populations. Additionally, the ability to gather statistically significant data through sufficient sample sizes is difficult due to the relatively low number of pediatric EMS encounters across the country. The goal of this project is to develop an EMS Research Node Center (E-RNC) that will work in cooperation with the Pediatric Emergency Care Applied Research Network (PECARN) to conduct innovative and significant prehospital pediatric research.

A fact sheet describing each of these grants is available for download. For more information about current and past Targeted Issue grants, access the online searchable Targeted Issue Database.