PREAMBLE

The purpose of these guidelines for the classification of pediatric emergency services is (a) to allow any given community to identify the level of care available for the critically injured or ill pediatric patient, and (b) provide guidance to hospitals and EMS systems as to the resources necessary to provide optimal care to these children. This is a necessary step in the development of EMS systems that meet the needs of the pediatric patient.

These systems require (1) patient and parent recognition of when to access the system and knowledge of how to access the system; (2) prehospital care providers with appropriate expertise in the assessment and treatment of infants, children, and adolescents; (3) regional networking of hospitals at varying levels of pediatric sophistication with transport systems to ensure that the critically ill or injured child is promptly identified, stabilized, and brought to the tertiary pediatric center; (4) primary and secondary centers that have the level of expertise to care for the bulk of pediatric patients; (5) the development of pediatric tertiary care facilities with pediatric subspecialist availability for the complex patients; (6) pediatric rehabilitation and long term care programs; and (7) audit and quality assurance programs to review the care rendered.

This document only addresses one part of a system, the classification of hospital capabilities. The systems implementation process involves a triphasic approach:

1. The identification of the capabilities of an institution by that institution which will provide information on its compliance with the guidelines.

2. Verification of a given hospital's compliance or noncompliance with the guidelines by outside, noninvolved individuals, the verification site review.

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