Emergency Medical Services for Children

The Emergency Medical Services for Children (EMSC) program is a US federal government health initiative. It is administered by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA), and the Maternal and Child Health Bureau (MCHB). Its aim is to reduce child and youth disability and death due to severe illness or injury by increasing awareness among health professionals, provider and planners and the general public of the special (physiological and psychological) needs of children receiving emergency medical care.

In the Korean and Vietnam wars, medical experience demonstrated that survival rates improved dramatically when patients were stabilized in the field and transported immediately to a well-equipped emergency facility. During the 1960s, civilian medical and surgical communities recognized the possibility of applying this principle to an EMS system.

In 1973, Congress passed the Emergency Medical Services Systems Act of 1973. Managed by the HRSA, it provided funding for more comprehensive state and local government EMS systems. Between 1975 and 1979, state EMS systems dramatically improved outcomes of adult patients but not those of pediatric patients. In 1979, Calvin C.J. Sia, MD, then-president of the Hawaii Medical Association, requested that the members of the American Academy of Pediatrics (AAP) develop EMS programs designed to decrease disability and death in children. Dr. Sia was joined by José B. Lee, then-executive officer of the Hawaii Medical Association Emergency Medical Services Program in requesting that U.S. Senator Daniel K. Inouye introduce legislation to establish, implement and fund a national initiative designed to address emergency medical services for children systems development. Soon after, Senator Daniel Inouye (D-HI) responded to this request by introducing a legislative vehicle in the United States Senate. His staff assistant and chief of staff Patrick DeLeon's daughter was hospitalized with meningitis. The girl's treatment demonstrated the shortcomings of an average emergency department when treating a critically ill child. Senators Orrin Hatch(R-UT) and Lowell Weicker(R-CT) also gave their support. In 1984, Congress enacted legislation (Public Law 98-555) authorizing the use of federal funds for emergency medical services for children (EMSC). By this law, and through the administration of the MCHB, the EMSC program obtained funds to improve the pediatric capabilities of existing emergency medical services systems. In 1985, Congress designated initial funding for the EMSC program and in 1986, the first federal grants were utilized in Alabama, California, New York, and Oregon.

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