Pediatric emergency medicine trisk 4631 4631
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TABLE 134.7
PECARN PRIORITIES FOR PEDIATRIC PREHOSPITAL RESEARCH
Clinical topics
System topics
Rank
Topic
Rank
Topic
1
Airway management
1
2
3
4
Respiratory distress
Trauma
Asthma
2
3
4
5
Head trauma
Effectiveness of out-of-hospital
interventions
Knowledge and skill deterioration
Patient outcomes
Evaluation of the impact of overall
EMS
system changes on children
6
7
8
9
10
11
Shock
Pain
Seizures
Respiratory arrest
C-spine immobilization
Cardiac arrest
5
Training effectiveness
12
13
Injury prevention
Children with special healthcare
needs
Poisoning
Abuse and neglect
14
15
Successful EMS researchers have noted the large investment in relationship building that is necessary between
the research team and administrators at EMS agencies and receiving facilities. Other recommendations include
soliciting prehospital provider input during the planning phase, demonstrating to agencies and providers the
benefits of participating in the study, and providing education regarding research and human studies to the
agencies. Providing results of data collected in the field back to the EMS providers and media recognition of the
EMS agency’s research participation are also means for building strong research relationships with EMS systems.
The paucity of scientific scrutiny of EMS highlights the need for future research focusing on both EMS and
EMSC. The establishments of the federal EMSC program under the U.S. Department of Health and Human
Services, as well as the federally funded EMS for Children Innovation and Improvement Center, were important
steps to assist EMS academicians in defining a research agenda around EMSC. The PECARN has established a
research node made entirely of EMS agency research sites, as well as added EMS affiliates to each of the other
six research nodes. These efforts assist in performing needed research, as well as providing avenues for funding
these projects. As the discipline evolves, EMS leaders should resist the temptation to quickly add or require new
technologies, procedures, and protocols to prehospital care without ensuring that these modalities have proven
efficacy. There is a real concern that in an effort to aid one patient, others will suffer from unnecessary
intervention or inappropriate allocation or utilization of resources.
Research agendas have been proposed and priorities have been addressed by consensus groups, including the
IOM reports, the National EMS Research Agenda, the EMS Outcomes Project, Knowledge Translation in the
EMS, the EMS Subcommittee of the Society of Academic Emergency Medicine, and a priority list from
PECARN ( Table 134.7 ). A recent gap analysis prepared for FICEMS noted that the literature in the prehospital
setting is less rigorous than in other medical disciplines and that many prehospital interventions lack scientific
evidence, having been extrapolated from the adult hospital emergency care environment. Authors of this analysis
also reported that the majority of research agendas have been unmet, with specific deficiencies noted in
pediatrics, trauma, patient safety and quality, and education and competency assessment. The analysis serves to
