L. A. County Pediatric Emergency System Turns 25

Parents across Los Angeles County can rest a little easier knowing that if their child ever requires emergency medical care, a highly specialized network of public and private hospitals are designated to receive such children under the 911 ambulance transport system. A total of 44 hospitals are currently designated as ‘Emergency Department Approved for Pediatrics’, or EDAPs, by the Los Angeles County Emergency Medical Services (EMS) Agency, which coordinates the 911 system.  An EDAP is a licensed emergency department approved to receive pediatric patients ages 14 and under following treatment by paramedics in the field.“Kids are different from adults, and often need specialized care either because of the injuries they sustain or their smaller size,” says Marianne Gausche-Hill, MD, a physician at Harbor-UCLA Medical Center, a public hospital located in Torrance.  Gausche-Hill was the first emergency physician in the nation to complete sub-specialty training in pediatric emergency medicine and was a leader in establishing the EDAP system.  “The sickest kids will be delivered to an EDAP hospital where the medical team is specially trained and equipped to treat children in great distress, and that correlates to better outcomes.”

Gausche-Hill sees a range of serious injuries coming in the door on any given day, such as the four year-old with a small super-ball lodged in the airway blocking respiration, the two year-old who fell out of a third story window suffering traumatic head injury, and the nine year-old with a high fever and low blood pressure battling septic shock. These cases required specialized interventions, she says, and parents and other L.A. County residents need to be aware of the value of the EDAP system in saving precious lives.

About EDAP

Designation and participation in the EDAP program is voluntary.  EDAPs must adopt and maintain rigorous standards and policies for personnel, equipment, training and quality emergency treatment of children.  To obtain designation, hospitals must collaborate with the EMS Agency and submit required application and supporting documentation.  An on-site review and inspection is conducted, and if approved, EDAP status is valid for a period of three years.

“Los Angeles was the first County in the nation to adopt an EDAP system, which has proven time and again to save lives by routing children to the right hospital the first time,” says EMS director Cathy Chidester.  “Every EDAP hospital has gone through a rigorous review process to ensure that they are meeting established standards.”

Because EDAPs see many more children on a routine basis, they are more experienced in treating serious pediatric injury or illness than non-EDAP hospitals.  Harbor-UCLA Medical Center, which established one of the first fellowship training programs for emergency physicians in pediatric emergency medicine, sees approximately 23,000 visits a year in its Pediatric Emergency Department.

While basic emergency rooms are able to handle pediatric emergencies, EDAPs offer a higher level of care by ensuring 24-hour physician coverage, a 75 percent or higher level of physicians who are board certified in emergency medicine or pediatric emergency medicine, and a 75 percent or higher level of nursing staff certified in Pediatric Advance Life Supports (PALS), among other requirements.  EDAP hospitals must also have equipment that takes into account the size and stage of development of children that basic emergency rooms may not have.