AAP Policy on Pediatric Emergency Care

Author: Monica Preboth
Date: Oct 1, 2000

The Committee on Pediatric Emergency Medicine of the American Academy of Pediatrics (AAP) has issued a policy statement on access to pediatric emergency medical care. The policy statement appears in the March 2000 issue of Pediatrics.

Every day in the United States, thousands of children and adolescents seek emergency care. However, many of these young persons must face significant barriers that limit access to emergency care, at times resulting in significant morbidity. According to the AAP committee, long standing issues related to these barriers include the following: lack of universal understanding and application of a definition of "emergency"; lack of third-party payment for medical care; lack of reasonable access to alternative sources of health care until the emergency department is left as the only place that will see everyone; the misconception that freestanding urgent care centers provide comprehensive emergency services; variability in pediatric training and experience among physicians in the emergency department; and lack of access to pediatric emergency medical care in rural areas.

The first AAP policy on access to emergency medical care was published in 1992. Since that time, the following substantial advances have occurred:

* Significant increase in emergency medicine residency programs that include pediatric emergency training.

* Improvements in pediatric training and experience for emergency department residents.

* Increasing dissemination of pediatric emergency education courses, including requirements by some hospitals that certain of these courses be studied to practice in the emergency department.

* Improvements in pediatric education for emergency medical technicians.

* Increased availability of physicians with specific training and certification in pediatric emergency care.

The AAP committee states that all children should have access to emergency care and recommends that local, state and federal agencies guarantee prompt and appropriate access to pediatric emergency care for all children and increase public awareness about the magnitude of the barriers to such access.

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