EMS for Children (EMSC)
The Emergency Medical Services for Children (EMSC) is a federally funded program designed to reduce childhood death and disability resulting from injury and illness. This is going to be accomplished through the needs assessment and evaluation to implement programs and projects related to injury prevention, public awareness, data collection, and education.
As you may be aware, Michigan has participated in multiple Federally-funded EMS for Children Research studies throughout the last decade. We are proud to have had many agencies throughout Michigan that have participated, including nonprofit, for profit, municipal, and fire based Life Support Agencies in the important CQI projects that included EMS information systems and medical simulations. Out of these projects a common theme emerged; pediatric drug dosing errors. Paramedic providers have limited experience with pediatric patients, and even more limited experience with pediatric drug dosing and administration. In the study findings, medications delivered to children in the prehospital setting by paramedics were frequently administered at doses outside of the proper weight range. Epinephrine for cardiac arrest was found to have an average of 61% error rate, for anaphylaxis, a 74% rate of error. A benzodiazepine for pediatric seizures was found to be administered incorrectly 65-79% of the time. Benadryl was administered in error 93% of the time, Solu-Medrol 95%. Caring for critically injured children is extremely stressful. Pediatric medication errors are a major concern; therefore we felt the need to develop a strategy for reducing pediatric medication dosing errors.
Through support from the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), EMS for Children State Partnership Program, and the Office of the Assistant Secretary for Preparedness Response (ASPR) Hospital Preparedness Program, the MI-Medic cards were developed by Western Michigan University School of Medicine's Center for EMS, Disaster, and Operational Medicine.
These cards were developed to work with the Broselow Pediatric Dosing tape and the corresponding color coding scheme. The cards have additional medications and drug dosing calculations that the Broselow tape provides. The MI-Medic cards were written based on State of Michigan protocols. The dosing recommendations may vary slightly from the standard mg/kg dose due to rounding for safer medication delivery.
- MI-MEDIC Memo to all Michigan ALS Agencies
- MI-MEDIC 2.0 PDF File (05/2018)
- Root Causes of Errors in Simulated Pre-Hospital Pediatric Emergencies (1/2012)
- Medication Dosing Errors in Pediatric Patients Treated by EMS (12/2011)
To access the free online education modules necessary on how to properly use the cards:
The role of the Committee on Pediatric Emergency Medicine (COPEM) is a joined effort to develop a coordinated approach to continue to implement and coordinate components of the EMSC system into the existing EMS system. Components include implementation of hospital and pre-hospital standards, enhancement of pediatric education for hospital and pre-hospital providers, mandatory continuing education for all levels of pre-hospital providers, implementation of and continued support of injury prevention programs, address health care issues within our schools and daycare centers and data collection. This will be accomplished through combined efforts with various professionals and organizations throughout the state including emergency medical services, fire departments, police departments, public health department, day care centers, nurses/school nurses and other state and local objectives.
The National EMSC requires that all EMSC State Partnership grantees collect data by surveying EMS agencies and hospitals with emergency departments to evaluate their level of achievement toward meeting performance measures. These performance measures were developed to document activities and accomplishments to improve the delivery of emergency services to children. The EMSC program appreciates everyone who participated in the surveys. Whether it was online or on paper, we appreciate your involvement. Because of you, we were able to exceed our goal of 80% response rate. The information collected helps the Michigan EMSC know how to best serve the needs of children in our state. This report of the 2010-11 EMSC data collection outcomes for Michigan assesses Michigan's current status in relationship to the National EMSC.