title: Children with special health care needs: a template for prehospital protocol development.
abstract: There are 12 million children in the United States with special health care needs. Improvements in medical technology, managed care, and changing social views about the institutionalization of children have all contributed to an increasing number of children with special health care needs (CSHCN) residing primarily in their home communities. Because of the dynamic and fragile nature of the medical conditions typically borne by CSHCN, the need for emergency care is not uncommon and prehospital providers are increasingly likely to encounter this population. Few states have initiated emergency medical services (EMS) protocols addressing field assessment, management, and stabilization of CSHCN and existing model protocols have not yet incorporated a distinct CSHCN component. With the support of grant funding from the federal Emergency Medical Services for Children (EMSC) program, a project was undertaken by investigators in the Center for Prehospital Pediatrics at Children's National Medical Center to develop prehospital protocols for CSHCN. This report details the protocol development process, discusses suggestions for their use, and presents the detailed protocols. The protocols are intended to serve as a resource template for the development and/or revision of jurisdiction-specific, customized practice guidelines.
authors.affiliation: Center for Prehospital Pediatrics, Division of Emergency Medicine, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Tasmeen
authors.initials: T
authors.lastname: Singh
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Wright
authors.forename: Terry A
authors.initials: TA
authors.lastname: Adirim
mesh_terms: D002648:Child; D002662:Child Health Services / Q000592:standards*; D002985:Clinical Protocols; D018672:Community Health Planning / Q000458:organization & administration*; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D004219:District of Columbia; D004632:Emergency Medical Services / Q000592:standards*; D006301:Health Services Needs and Demand / Q000639:trends*; D006760:Hospitalization; D006801:Humans; D010865:Pilot Projects; D017410:Practice Guidelines as Topic