A joint policy statement, "Pediatric Readiness in the Emergency Department," details the critical steps emergency departments can take to be fully prepared for children in emergencies.
The statement outlines what every emergency department (ED) needs to be ready to care for children and adolescents—an effort that could save more than 2,100 lives nationwide each year.
The American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), the Emergency Nurses Association (ENA), and the American College of Surgeons (ACS) collaborated on the
policy statement and an accompanying
technical report that outlines the scientific evidence supporting each recommendation. Both documents serve as an update to recommendations previously revised in 2018 and 2009.
Being fully prepared to care for kids & focusing on their unique health needs
"More than 80% of children who come to an emergency department go to a local community hospital, not a children's hospital," said Kate Remick, MD, FAAP, FACEP, FAEMS, lead author of the statement. "Every emergency department should be fully prepared for kids, no matter how often they see them. These recommendations save lives."
More than 35 million children and families go to emergency departments for medical care each year, most often in local hospitals that may see fewer than 10 children a day. A child's chance of recovery in an emergency depends on whether the hospital has the right tools, staff and training.
Emergency departments that are equipped to treat children have much better outcomes, reducing the risk of death by 76% for those who are extremely sick and 60% for those with serious injuries.
The cost needed to reach the top 25% of high pediatric readiness is relatively low, between $4 to $48 per pediatric patient, depending on patient volume. Yet more must be done to make sure every U.S. emergency department can fully meet national standards. Widespread strain on the health care system makes it challenging for departments to resource and fully focus on kids' unique health needs.
The statement informs the work of the National Pediatric Readiness Project, an initiative of the Emergency Medical Services for Children (EMSC) Program—part of the Department of Health and Human Services' Health Resources and Services Administration—in collaboration with multidisciplinary organizations. The NPRP aims to support the more than 5,000 EDs nationwide in improving pediatric capabilities through self-assessments, benchmarking, checklists, quality dashboards, and other resources.
Recommendations for all emergency departments
These recommendations are intended for all emergency departments that provide care for children, including freestanding emergency departments, rural emergency hospitals, critical access hospitals and low-volume emergency departments.
The recommendations continue to emphasize the importance of appointing both nurse and physician pediatric emergency care coordinators to lead readiness efforts within emergency departments. Updates include:
Increased focus on pediatric-specific clinical practice guidelines and decision support tools for common conditions to standardize care;
A list of nationally vetted, pediatric quality measures, including targeted measures by condition;
New emphasis on the need for multidisciplinary review of all pediatric deaths and adverse events to assist emergency departments in local quality improvement efforts;
A deeper focus on pediatric mental health, including universal suicide screening in teens;
Reinforcement of the importance of immediately available, portable, weight-based pediatric resuscitation carts and use of medication dosage tools to avoid manual calculations; and
Broader expectations for pediatric considerations in disaster preparedness.
To help emergency departments implement these recommendations, the statement includes a Pediatric Readiness Checklist.
Identifying room for improvement
The new statement sets the stage for the upcoming nationwide NPRP Assessment period, slated to open on March 3, 2026. Emergency departments will be assessed on a 100-point scale and receive a score for benchmarking and a gap report identifying areas for improvement.
The previous assessment published in 2023 noted improvements in five of six categories measured since 2013, including an increase in the number of emergency departments with pediatric equipment and supplies (90% to 97%) and the number of emergency departments with a pediatric mental health care policy (44.1% to 73.1%).
"The 2026 assessment is our chance to see where we stand—and where we can do better," said Marianne Gausche-Hill, MD, co-author of the statement. "By participating in the National Pediatric Readiness Project Assessment, emergency care teams are leading efforts to quantify the progress made and improvements needed to optimize emergency care for the nation's children."
Emergency Nurses Association President Dustin Bass, DNP, MHA, RN, CEN, NEA-BC, said, "Every minute counts for parents and caregivers seeking emergency care when their child suffers a sudden illness or injury. Improving pediatric readiness in all emergency departments offers reassurance to families, while instilling confidence in emergency care providers, that these young patients will receive the appropriate, necessary treatment as quickly as possible. The updated recommendations, which include a pediatric readiness checklist, are vital to ensuring EDs are ready for those crucial moments when kids need us most."
The policy statement and technical report is published in the February 2026 Pediatrics; the Annals of Emergency Medicine (ACEP); Journal of Emergency Nursing (ENA); and Journal of the American College of Surgeons (ACS).
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