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Priorities for Pediatric Prehospital Research

Foltin, George L. MD, FAAP, FACEP*; Dayan, Peter MD, MSc; Tunik, Michael MD*; Marr, Mollie BSA*; Leonard, Julie MD, MPH; Brown, Kathleen MD§; Hoyle, John Jr MD; Lerner, E. Brooke PhD

doi: 10.1097/PEC.0b013e3181fc4088
Review Article

Up to 3 million US children are cared for by emergency medical services (EMSs) annually. Limited research exists on pediatric prehospital care. The Pediatric Emergency Care Applied Research Network (PECARN) mission is to perform high-quality research for children, including prehospital research. Our objective was to develop a pediatric-specific prehospital research agenda.

Methods: Representatives from all 4 PECARN nodes and from EMS agency partners participated in a 3-step process. First, participants ranked potential research priorities and suggested others. Second, participants reranked the list in order of importance and scored each priority using a modified Hanlon method (prevalence, seriousness, and practicality of each research area were assessed). Finally, the revised priority list was presented at a PECARN EMS summit, and consensus was sought.

Results: Forty-two representatives participated, including PECARN representatives, EMS agency leaders, and nationally recognized prehospital researchers. Consensus was reached on the priority ranking. The prioritization processes resulted in 2 ranked lists: 15 clinical topics and 5 EMS system topics. The top 10 clinical priorities included (1) airway management, (2) respiratory distress, (3) trauma, (4) asthma, (5) head trauma, (6) shock, (7) pain, (8) seizures, (9) respiratory arrest, and (10) C-spine immobilization. The 5 EMS system topics identify methods to improve prehospital care on the system level.

Conclusions: PECARN has identified high-priority EMS research topics for children using a consensus-derived method. These research priorities include novel EMS system topics. The PECARN EMS pediatric research priority list will help focus future pediatric prehospital research both within and outside the network.

From the *Departments of Pediatrics and Emergency Medicine, Division of Pediatric Emergency Medicine, Bellevue Hospital Center, New York University School of Medicine, New York, NY; †Department of Pediatrics, Columbia University College of Physicians and Surgeons, The Children's Hospital of New York - Presbyterian, New York, NY; ‡Department of Pediatrics, Washington University School of Medicine, St Louis, MO; §Departments of Pediatrics and Emergency Medicine, George Washington School of Medicine, Children's National Medical Center, Washington, DC; ∥Department of Emergency Medicine, Helen DeVos Children's Hospital, Grand Rapids, MI; and ¶Departments of Emergency Medicine and Population Health, Medical College of Wisconsin, Milwaukee, WI.

Reprints: George L. Foltin, MD, FAAP, FACEP, Center for Pediatric Emergency Medicine, Bellevue Hospital and NYU Medical Centers, and New York University School of Medicine, New York, NY (e-mail:

Participants who contributed to the development of the priorities are listed in Appendix A.

The Pediatric Emergency Care Applied Research Network is supported by cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, and U03MC00008 from the Emergency Medical Services for Children program of the Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services.

© 2010 Lippincott Williams & Wilkins, Inc.