Kathleen Adelgais, MD, MPH, discusses key findings in EMS pediatric readiness

A recent study led by Kathleen Adelgais, MD, MPH, professor at the University of Colorado Anschutz, has provided the most comprehensive assessment to date of pediatric care within United States emergency medical services (EMS) agencies.

In this interview, Adelgais discusses the critical findings from a survey of nearly 7,000 agencies across all 50 states and various territories. The survey, which used a 207-question assessment, evaluated agencies across 8 specific regions of readiness, including staff training, equipment availability, medication safety, and family-centered care. The results revealed a median Pediatric Readiness Score of 65.5 out of 100, a figure that the investigators categorize as only moderate overall.

One of the most significant barriers identified in the study is the infrequency of pediatric encounters. Approximately 75% of the surveyed EMS agencies report seeing fewer than 8 pediatric patients per month.

This low volume makes it exceptionally difficult for first responders to maintain the specialized skills and operational systems required for high-quality pediatric care. While agencies scored well in areas such as possessing the correct pediatric-sized equipment and establishing clear protocols, they lagged significantly in more complex coordination, including family-centered care, quality improvement tracking, and integration with broader public health systems.

The most vital finding highlighted by Adelgais is the transformative impact of having a pediatric emergency care coordinator (PECC). Despite the clear benefits, only 38% of EMS agencies currently have a designated PECC. The data show that agencies with this dedicated leadership are significantly more likely to excel across all readiness domains. Specifically, agencies with a PECC were 5 times more likely to achieve top scores in quality improvement and more than 5 times as likely to possess high-level coordination with health systems. These coordinators ensure that pediatric-specific training, equipment checks, and family-centered policies remain a priority rather than an afterthought.

Looking forward, Adelgais and her colleagues recommend a nationwide expansion of the PECC role to bridge the current gaps in care. The study advocates a focused effort to improve pediatric quality measurement, performance tracking, and disaster preparedness. Because children have unique physiological and developmental needs, ranging from specialized medication dosing to specific communication strategies, EMS systems must evolve to meet these needs consistently.

As Adelgais emphasizes, “When emergencies happen, readiness makes all the difference,” and increasing the prevalence of pediatric leadership is the most effective pathway to improving outcomes for the youngest and most vulnerable patients.

This video is part 2 of a 2-part series. Click here for part 1.

No relevant disclosures.

References

1. First national report finds strengths, gaps in emergency care for children before they reach the hospital. News release. University of Colorado Anschutz. February 26, 2026. Accessed March 4, 2026. https://www.eurekalert.org/news-releases/1117946
2. Adelgais KM, Remick KE, Hewes HA, et al. The National Pediatric Prehospital Readiness Project: first comprehensive assessment of United States emergency medical services agencies. Annals of Emergency Medicine. Published online February 20, 2026. doi:10.1016/j.annemergmed.2026.01.013