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Alameda County
EMS Agency
EMERGENCY MEDICAL SERVICES
FOR CHILDREN SYSTEM PLAN
1000 San Leandro Blvd., Suite 200
San Leandro, CA 94577
www.ems.acgov.org
6/24/2024
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TABLE OF CONTENTS
1. Goals and Objectives 3
2. EMSC Program – Prevention, Prehospital, and Facility Information 3
• National Pediatric Readiness Project 5
• Prehospital Readiness Project 5
3. EMSC – Patient Flow 6
4. EMSC – Data Management and Quality Improvement 7
5. EMSC – Injury and Illness Prevention Planning 10
6. EMSC – Pediatric Surge Planning 12
7. EMSC Alameda County EMS Agency Staff 13
Exhibits
• Exhibit A – Pediatric Transport Volume – 2022 and 2023 14
• Exhibit B – Pediatric-Specific Equipment List 18
Attachments
• Attachment 1: Hospital Pediatric Data Collection Tool/NPRP 19
• Attachment 2: Prehospital Pediatric NPPRP Assessment 19
• Attachment 3: EMSC and Pediatric Clinical QI Committees 19
• Attachment 4: Pediatric Resources, Research/Pediatric Policies 19
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Goals and Objectives
The primary goal of Alameda County’s EMS for Children (EMSC) Plan is to develop a program
focusing on reducing pediatric disability and death through injury prevention efforts as well
as ensuring that prehospital providers and 911 receiving facilities are adequately prepared to
receive and care for pediatric patients for both day-to-day operations as well as in a disaster
or surge events. Alameda County EMS believes that all children – no matter where they live,
attend school, or travel in Alameda County – should receive the best care possible in any
emergent situation. Should an emergency or disaster occur, our goal is to ensure that
emergency personnel are properly trained in pediatrics, that ambulances and emergency
departments have the equipment, supplies, and medications needed to treat children of all
sizes, and that well-defined and evidence-based pediatric treatment protocols and
procedures are in place.
To deliver the best possible pediatric care, we must routinely evaluate our training and
knowledge to identify our strengths and weaknesses using appropriate and measurable
indicators. By doing so, we can systematically evaluate and improve our key processes and
foster our organizational learning and knowledge sharing.
The Alameda County EMS for Children System Plan has been written in accordance with Title 22,
Division 9, Chapter 14 of the California Code of Regulations.
EMSC Program – Prevention, Prehospital, and Facility Information
Alameda County has thirteen acute care receiving facilities to serve our community as noted in
the table below:
Receiving Facilities Pediatric
Trauma
Pediatric
Psych
Adolescent
Psych
NICU PICU
Alameda Hospital (Alameda Health System)
Alta Bates Summit – Berkeley
UCSF Benioff Children’s Hospital Oakland
Eden Medical Center
Highland Hospital (Alameda Health System)
Kaiser – Fremont
Kaiser – Oakland
Kaiser – San Leandro
San Leandro Hospital
(Alameda Health System)
St. Rose Hospital
Stanford Health Care Tri-Valley Hospital
Alta Bates Summit – Oakland
Washington Hospital
All of the facilities, have emergency departments which routinely care for pediatric patients. Two
facilities – UCSF Benioff Children’s Hospital-Oakland and Willow Rock – are pediatric specific
receiving centers – seeing no adult patients – and one of the facilities, John George Psychiatric
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Pavilion, does not accept any pediatric patients.
Alameda County, with a population of just over 1.6 million residents of which, based upon
the 2022 U.S. Census, has 20.1% of the population under the age of 18. Only approximately
4% of all EMS transports in Alameda County are for patients less than 18 years of age. In 2022,
4,736 pediatric patients were transported via EMS: 769 with traumatic injuries, 3,823 with
medical complaints, and 144 with “unknown” reasons. With the limited exposure to pediatric
patients and the rarely encountered seriously ill or injured pediatric patient, it is critical to
continuously train our personnel to effectively manage this population by being prepared,
organized, and knowledgeable to take care of any emergent situation that may arise.
Emergency Medical Services for Children in Alameda County has four distinct and equally
important components. These components are injury prevention, prehospital care, definitive
care at receiving facilities and pediatric surge preparedness. Alameda County EMS works
collaboratively with our system partners to continually improve each of the four components.
Prevention
Alameda County EMS is the only EMS Agency in the State of California to have an injury
prevention division. Alameda County EMS Injury Prevention (ALCO EMS IP), while also
providing Senior Injury Prevention, has a significant focus on Childhood Injury and is the lead
agency for Safe Kids Alameda County, a member of Safe Kids Worldwide as well as other
national and community organizations. ALCO EMS IP provides education, training, and safety
equipment to enhance pediatric safety and reduce potential injuries. Efforts include:
• Car Safety Seat and Booster Installation Instruction
• Car Safety Seat and Booster Distributions
• Child Bicycle Helmet Education
• Child Bicycle Helmet Distributions
• Teen Impact Driver Safety Instruction
• Child Pedestrian Safety Education
• Annual Safe Kids Day Health and Wellness Fair
Prehospital Providers
Alameda County Emergency Medical Services are provided by our fire department first
response advanced life support, fire transport in the cities of Alameda, Albany, Berkeley, and
Piedmont, and with a private transport provider utilized in the remaining portions of the
county. The EMS Agency Medical Director and EMS Agency Coordinators oversee the system
and collaborate with individual prehospital care providers. The majority of fire departments
and the private provider have medical directors, educators, and liaisons responsible for
overseeing their individual organizations and report to the Alameda County EMS Agency
regularly. Prehospital pediatric care is supported by written policies, protocols, plans,
pediatric specific equipment (Exhibit B), and online medical control whenever needed.
Annual EMS prehospital training is provided on pediatric policies and procedures.
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Hospital Pediatric Receiving Centers – Definitive Care
California State Regulations define a Pediatric Receiving Center (PedRC) as a licensed general
acute care hospital with, at a minimum, a permit for standby or basic emergency services that
has been formally designated as one of four types of PedRCs pursuant to Title 22, sections
100450.218 through 100450.222, by the local EMS agency for its role in an EMS system.
Currently, Alameda County receiving facilities are all considered pediatric ED receiving centers.
Formal hospital PedRC designations such as Comprehensive, Advanced, or General, per
regulations, have not yet been assigned and approved. However, all hospitals have been given
the EMS for Children regulation requirements and are aware of the intent to formally designate
in the near future. This plan outlines the requirements for our facilities to apply for designation
pursuant to the standards set forth by the above-mentioned EMS for Children regulations. It is
the intention of the Alameda County EMS Agency to have all receiving facilities with emergency
rooms in Alameda County to meet at least the General PedRC level requirements for designation.
Additionally, we believe that UCSF Benioff Children’s Hospital would meet the Comprehensive
PedRC level requirement and that Kaiser Oakland would meet the Advanced or Comprehensive
PedRC level requirement.
National Pediatric Readiness Project (NPRP)
Alameda County EMS Agency will begin its efforts to assess and designate official EMSC
statuses with hospital executed agreements, in alignment with regulations, for our receiving
facilities in 2024. We have been actively working with our facilities through the National
Pediatric Readiness Project (NPRP) initiative. All of our receiving facilities with emergency
rooms have successfully completed the NPRP evidence-based survey in 2023 and identified
the Pediatric Emergency Care Coordinators (PECCs). Upon receipt of their NPRP survey
results, and in partnership with UCSF Benioff Children’s Hospital Oakland, Alameda County
EMS schedules pediatric readiness site visits at each hospital every two years. During the EMS
pediatric readiness site visit session, NPRP and surge capacities are reviewed with a robust
simulation training and assessment. The goal is to identify effective pediatric capabilities and
readiness strengths as well as opportunities to enhance their care for pediatric patients day
to day and in a pediatric surge event. Following the Hospital Pediatric Readiness Site Visits,
each hospital is provided with an executive summary and resource packet customized to
their needs.
Pediatric SMEs from the Western Regional Pediatric Emergency Management Alliance
(WRAP-EM) and the Pediatric Pandemic Network (PPN) including the Alameda County EMS
EMSC Coordinator lead and facilitate the Pediatric Readiness Hospital Site Visits. Ongoing
communication, training, and follow-up virtual calls (to provide assessment feedback,
identify gaps and future resource needs) are offered to the hospital PECCs, pediatric
hospitalists, and others as needed.
Prehospital Pediatric Readiness Project (NPPRP)
In 2024, Alameda County EMS is extending the pediatric readiness process to the prehospital
setting by using the NPPRP evidence based prehospital assessment tools with customization
as needed for our prehospital care providers and incorporating a similar review and
simulation training component in partnership with UCSF Benioff Children’s Hospital Oakland.
The prehospital assessments will align with the National and State EMSA EMSC
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recommendations:
• https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-
readiness/
• https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-
readiness/checklist-faq/
EMSC – Patient Flow
Upon activation of 911, injured or ill pediatric patients are identified by communication
center dispatchers. The majority of Alameda County is triaged through one of two ACE-
accredited communications centers who utilize the Medical Priority Dispatch System.
Dispatcher-assisted care is immediately rendered, when appropriate through pre-arrival
instructions, while field personnel are en route, with the overall goal being to improve patient
outcomes by reducing disability and death.
Prehospital personnel utilize Alameda County EMS Agency policies and protocols to assess
stability, initiate treatment, and determine the most appropriate destination. Due to the
geography of our county almost all patients, if transport is indicated, are transported by ground
ambulance. Seldom are local air ambulances (e.g., REACH, CHP) utilized.
To expedite transfer at arrival and for continuity of care, EMS personnel notify the emergency
department by radio as soon as possible of an incoming pediatric patient. Communication
includes their unit number and transport code, age and gender of the patient, chief complaint
of the illness or injury (including mechanism), treatments, vital signs, and estimated time of
arrival.
Additionally, all pediatric patients transported via ambulance are measured with a color-
coded length-based tape and the color is reported in the electronic health record as well as to
the receiving facility prior to the patient’s arrival. This allows enhanced preparation for the
emergency department team.
Currently, Alameda County has not integrated the PedRCs concept in the EMS Field Policy
Manual or implemented any destination changes for pediatric patients. For medical and
minor injury complaints, patients may be transported to any one of our thirteen 911
receiving facilities with emergency departments. Any injured pediatric patient with anatomic
or physiologic findings based on the Alameda County Trauma Triage Protocol are transported
to UCSF Benioff Children’s Hospital Oakland. Should a severely injured child arrive at any
other facility within Alameda County, the hospitals use the trauma re-triage procedure,
described in protocol, to expedite transfer of care to the UCSF Benioff Children’s Hospital
Oakland.
The table on page 2 lists those facilities with Neonatal and Pediatric Intensive Care as well as
specialized pediatric and adolescent behavioral health capabilities. Facilities lacking those
capabilities are encouraged to have transfer and transport agreements in place to facilitate
those needs. NICU and PICU availability is not currently factored into EMS transport
destination decision making, however would likely play a role in future designation. Pediatric
and adolescent behavioral health destination decisions are currently dictated by protocol.
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Alameda County EMS intends to recognize PedRC designations from contiguous counties.
While Alameda County EMS providers are encouraged to use receiving facilities within
Alameda County when making destination decisions, it is recognized that extenuating
circumstances may exist where transport to a facility outside of Alameda County is the
closest and most appropriate destination.
As with any specialty designation, Alameda County EMS shall review the designation made
by contiguous or other LEMSAs and ensure that there is an EMSC plan that is approved by
EMSA. Alameda County has the luxury of a children’s hospital and facilities with advanced
pediatric capabilities in our county, so the majority of our critically ill or injured pediatric
patients would be taken to those facilities. However, it is recognized that there are several
circumstances, to include but not limited to parental choice or the need for specialty care
not available in county such as burn care, that may lead to pediatric patients being
transported out of our county, particularly in the far east and south portions of our
county. We will work collaboratively with our neighboring LEMSAs to ensure that
appropriate pediatric destinations are identified to meet the needs of these patient
populations.
EMSC – Data Management and Quality Improvement
Both prehospital and hospital programs have several components to ensure a high level of
quality care. These include:
• Structure of Programs and Oversight
• Data collection and reporting (audits, benchmarking, etc.)
• Evaluation of EMS system indicators
• Quality Improvement and Assurance Cycles
• Training and education
• Re-evaluation and iterative feedback
The Alameda County EMS Agency EMSC and Pediatric QI Committee has been established
and meets biannually (and more frequently as we strengthen our program). The first meeting
this year was held in May 2024 to review performance data, identify areas in need of
improvement, and carry out and monitor improvement efforts. Attendees include the
prospective PedRC Medical Directors, Program Managers, hospital PECCs, EMS Agency
personnel including the Medical Director and EMSC Coordinator, and EMS stakeholders (fire
and private providers).
EMS data is collected via our electronic medical record keeping program, ESO, and we are
actively working with ESO to construct Health Data Exchanges (HDE) with our receiving
facilities. Currently HDE is active with six of our receiving facilities. Tentative timelines for
HDE being established with the remaining facilities is noted in the table below:
Receiving Facilities HDE Status
Alameda Hospital (AHS) Active
Alta Bates Summit Hospital – Berkeley Tentative 2Q 2024
UCSF Benioff Children’s Hospital Active 2023
Eden Medical Center Tentative 2Q 2024
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Highland Hospital (AHS) Active
Kaiser – Fremont Tentative 2Q 2024
Kaiser – Oakland Tentative 2Q 2024
Kaiser – San Leandro Tentative 2Q 2024
San Leandro Hospital (AHS) Active
St. Rose Hospital Active
Stanford Health Care Tri-Valley Hospital Tentative 3Q 2024
Alta Bates Summit Hospital Oakland Tentative 2Q 2024
Washington Hospital Active
All such records that include Protected Health Information (PHI) as defined by the Health
Insurance Portability and Accountability Act (HIPAA) are handled confidentially per the
statute. If at any time a hospital or the EMS Agency identifies a need for improvement, an
EMS Unusual Occurrence Form may be generated, and a performance improvement action
plan will be developed by the EMS Medical Director and/or PedRC Committee
recommendations.
Data elements collected through ESO, HDE, and facility follow up will include, at minimum, the
following:
1. ESO Electronic Health Record: Baseline data from pediatric ambulance transports, including,
but not limited to:
a. Arrival time/date to the emergency department
b. Date of birth
c. Mode of arrival
d. Gender
e. Primary impression
f. Race/ethnicity
g. Housing status
2. HDE: Basic outcomes for EMS quality improvement activities, including but not limited to:
a. Admitting hospital name, if applicable
b. Discharge or transfer diagnosis
c. Time and date of discharge or transfer from the Emergency Department
d. Disposition from the Emergency Department
e. External cause of injury
f. Injury location
g. Residence zip code
3. HDE and Facility Follow Up: Specific patient outcome and disposition data from receiving
facilities related to:
a. Cardiopulmonary or respiratory arrests.
b. Child maltreatment cases.
c. Deaths.
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d. ICU Admissions.
e. OR Admissions.
f. Transfers.
g. Trauma Admissions.
Additionally, specific pediatric prehospital quality performance measures may be developed, and
outcome data may be requested regarding the following interventions and subsect of patients:
a. Airway Management – Assessment, Monitoring, Airway Maneuvers
b. Allergic Reactions Treatment and Outcome
c. Asthma (Respiratory distress with bronchospasm > = 2-year-old
d. Behavioral Health
e. Bronchiolitis (Respiratory distress < 2 years old)
f. Cardiopulmonary or respiratory arrests.
g. Croup Treatment and Outcome
h. Death
i. Pain – (including Pediatric Intranasal Fentanyl for Prehospital Pain Management)
j. Medication Safety
k. Seizures Treatment and Outcome
l. Shock Recognition and Treatment
m. Spinal Care Risk Assessment and Management
n. Trauma
Current Pediatric Data Metrics (Prehospital) – May-June 2024
Alameda County EMS Pre-Hospital Metrics _ Pediatric (≤14yrs)
Category Metric
Name Metric Description Type of
Metric
Cardiac
PCAR -1 Cardiac Arrest Survival - Non-Traumatic Arrest Outcome
PCAR-2 Cardiac Arrest Hospital Admissions - Non-Traumatic Arrest Outcome
Respiratory /
Airway
PRESP-1 Respiratory Assessment for Respiratory Distress Process
PRESP-2 Bronchodilator Administration for Bronchospasm (Transports Only) Process
PRESP-3 Supraglottic Airway Device - i-GEL Success Rates Process
Trauma
PTRA-1 90th Percentile Scene Times for Trauma Alerts Process
PTRA-2 Trauma Alerts Transported to a Pediatric Trauma Receiving Center Process
PTRA-3 Patients Meeting Critical Trauma Criteria documented as a Trauma
Alert Process
PTRA-4 Appropriate Use of Pediatric Trauma Re-Triage Process
Medication
Administration PMED-1 Accuracy for all Weight-Based Pediatric Medication Administrations Process
Seizures PSEIZ-1 Midazolam Administration for Active Seizures Process
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Pain
Management PPAIN-1 Fentanyl Administered for Pain ≥ 7 Process
Other
PEDS-1 Treatment Administered for Hypoglycemia with Altered Mental Status Process
PEDS-2 Blood Pressure Assessment for Patients < 3 years of age Process
PEDS-3 Weight or Pediatape Color for all Patients Receiving a Weight-Based
Medication Process
PEDS-4 Blood Glucose Level Assessment for Altered Mental Status Process
PEDS-5 Appropriate Destination for Pediatrics on an Involuntary Psychiatric
Hold (5585) [≤17yrs] Process
Alameda County has already been working collaboratively with the Pediatric Emergency Care
Applied Research Network (PECARN). PECARN is a federally funded multi-institutional network for
research in pediatric emergency medicine. The goal of PECARN is to conduct meaningful and
rigorous multi-institutional research into the prevention and management of acute illnesses and
injuries in children and youth across the continuum of emergency medicine. UCSF is a participating
PECARN site with Alameda County EMS as is their prehospital affiliate. Alameda County EMS is
actively involved in enrolling patients in the Pediatric Dose Optimization for Seizures in EMS
(PediDOSE) study. This study is a prehospital study that is hoping to define the best method of
calculating midazolam dose treatment for status epilepticus in pediatric patients.
Data collection will strive to be as consistent as possible with current National and State EMSA
evidence-based metrics including:
• https://emscimprovement.center/domains/prehospital-care/prehospital-pediatric-
readiness/pprp-toolkit/quality-improvement-qi-process-improvement-pi/
• Pediatric Readiness in Emergency Medical Services Systems:
Prehospital QI
Education and Competencies for Providers
Equipment and Supplies
Interactions with Systems of Care
Coordination of Pediatric Emergency Care
Patient and Family-Centered Care in EMS
Patient and Medication Safety
Policies, Procedures, and Protocols
Quality Improvement/Performance Improvement
• https://emscimprovement.center/programs/partnerships/performance-measures/
• https://emsa.ca.gov/wp-content/uploads/sites/71/2022/11/SYS-100-11-2022-2023-Data-
11-8-2022-First.pdf
EMSC – Injury and Illness Prevention Planning
Although our EMS Agency has not previously formalized an EMSC System Plan, for several
years we have promoted and formally addressed pediatric injury and illness prevention, and
planning activities via prehospital, hospital, and public education.
1. We have provided free public education on Hands-Only CPR and Stop the Bleed,
working closely with Wilma Chan Highland Hospital and EMS Corps, to bring
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education and needed tools directly to public venues such as the Oakland Zoo.
2. In 2023, Alameda County EMS Injury Prevention Division (ALCO EMS IP) became
trainers for the Impact Teen Driving Program. The program has been implemented
in several schools so far, with an intent to expand to other schools in the future.
3. Community health activities are an important aspect of injury and illness
prevention. Each year ALCO EMS IP orchestrates the Safe Kids Day Health and
Wellness Fair which is an all-day free event typically hosted at the Oakland Arena.
The event consists of bike safety education, diaper distributions, bicycle helmet and
car seat distributions, and an opportunity for various local health and safety
organizations to get their messages out to the community.
4. ALCO EMS IP has had a helmet safety program for several years, assisting in
providing helmets to those who cannot afford them as well as those who present
without one. Helmets are free and range in size from toddler (2-4 years of age) to
a large teen/adult size. Helmet distribution halted due to COVID but resumed with
Safe Kids Day Health and Wellness Fair in June 2023.
5. ALCO EMS IP conducts regular monthly child safety seat inspections at the EMS
Agency office. In addition, they work with our law enforcement and community
organizations to provide education and free safety inspections for child safety seats
throughout our community.
6. ALCO EMS IP regularly distributes hundreds of child safety and booster seats each
year during inspection events and through community outreach groups, providing
them for a significantly reduced cost or free.
7. ALCO EMS IP is the lead agency for Safe Kids Alameda County, a member of Safe
Kids Worldwide which is a nonprofit organization working to help families and
communities keep kids safe from injuries. Safe Kids works with an extensive
network of more than 400 coalitions in the United States and with partners in
more than 30 countries to reduce traffic injuries, drownings, falls, burns,
poisonings and more.
As the LEMSA, our agency provides oversight and system integration for Pediatric Receiving
Center Quality Improvement activities including:
• Creating a Pediatric Receiving Center designation plan, to include specialized
pediatric care, for approval by the LEMSA
• Developing or revising specific pediatric policies, procedures, and protocols
• Developing and revising Pediatric Surge Plans consistent with HPP/ASPR requirements,
Western Regional Alliance for Pediatric Emergency Management (WRAP-EM), Pediatric
Pandemic Network, and National Pediatric Disaster Coalition subject matter expertise.
• Developing and distributing “Pediatric Surge PLAYBOOK” educational tools and resources;
participating in National and State Conferences to promote pediatric surge readiness
education and partnerships
• Receiving and investigating EMS Unusual Occurrence pertaining to pediatric care
• Reviewing performance improvement plans for issues identified by CQIP
• Producing and distributing pediatric data reports
• Reviewing annual CQIP updates from designated PedRCs and EMS service
providers
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• Scheduling and staffing EMS stakeholder EMSC and Pediatric QI meetings
• Establishing future goals and objectives using evidence-based practice and with
our stakeholders’ input, we will:
1. Support and promote our existing illness and injury prevention programs, and
2. Focus on CQI for ensuring appropriateness and accuracy of prehospital
pediatric medications.
Effectiveness of the EMSC Program can be directly related to the effectiveness of training
received by all constituents. Administrative and medical oversight is heavily involved at all
training levels. All paramedics accredited in Alameda County are required to maintain PALS
certification to ensure readiness to respond to pediatric emergencies.
Prehospital education on pediatric care, guided by data and our process improvement
activities, is provided on an on-going and as needed basis throughout the year.
EMSC – Pediatric Surge Planning
The 2022 RSV and Respiratory Illness Pediatric Surge event highlighted the significant national
limitations and gaps in pediatric inpatient critical care capability, and pediatric patient transfer
capacity. In order to ensure effective pediatric operational all-hazard response, the priority
Pediatric Surge Planning remains an area we continue to discuss and revise with our Healthcare
Preparedness Program (HPP). The Pediatric Surge plan is an Annex to our Healthcare
Preparedness Program (HPP) Response Plan Summary Document. This Pediatric Surge Annex
references and aligns with the Alameda County Response Plans including a summary of the
Alameda County Medical Health Operational Area Coordinator (MHOAC) Program plans and
procedures that would be activated to support the healthcare facility response in an emergency.
The EMSC Coordinator supports the MHOAC to conduct pediatric customized polls as needed in
actual events. The pediatric surge staffed bed capability is updated daily via ReddiNet.
The EMSC Coordinator leverages pediatric subject matter experts across multiple pediatric
networks as needed. The EMSC Coordinator contributed to the published WRAP-EM Pediatric
Surge PLAYBOOK which is an attachment to the ALCO Pediatric Surge Plan mentioned above:
https://wrap-em.org/index.php/jit-resources/pediatric-surge-playbook. The EMSC Coordinator is
also the EMS Liaison to the National Pediatric Disaster Coalition (NPDC).
Pediatric scenarios and component capabilities are routinely integrated into disaster exercises
and trainings to emphasize the nuance of pediatric patient triage, movement, and surge
expansion. Alameda County EMS has recommended pediatric surge expansion and
decompression strategies for a catastrophic event which are included in the Pediatric Surge
Annex to the HPP Response plan and tested with WRAP-EM and in annual HPP required
exercises. Additional information and guidance are available in the EMS Field Guide and on
the ALCO EMS Website – EMS for Children.
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EMSC Alameda County EMS Agency Staff
Name Title
Lauri McFadden EMS Director
William McClurg EMS Deputy Director
Zita Konik, MD EMS Medical Director
Nicole D’Arcy, MD Deputy EMS Medical Director
Cynthia Frankel, RN EMS Coordinator; EMSC Program Coordinator
Naila Francies, EMT-P EMS Coordinator
Kat Woolbright Injury Prevention Program Manager
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Exhibit A – Pediatric Transport Volume – 2023 and 2022
2023
Destination Location Name 2023 Count of
Transports
Children's Hospital & Research Center Oakland 1,375
Washington Hospital, Fremont 342
Stanford Health Care Tri-Valley Hospital 245
Kaiser Permanente, San Leandro Medical Center 242
Kaiser Permanente, Oakland Medical Center 211
Kaiser Permanente, Fremont 191
Eden Medical Center 157
Kaiser Permanente, Walnut Creek 104
Saint Rose Hospital 81
San Leandro Hospital 63
Alameda County Medical Center, Highland 54
Willow Rock Center 35
Stanford Health Care 28
Alta Bates Summit Medical Center, Alta Bates Campus 24
Alta Bates Summit Medical Center, Summit Campus 24
Alameda Hospital 19
Santa Clara Valley Medical Center 11
San Ramon Regional Medical Center 6
Lucille Packard Children's Hospital at Stanford 5
John Muir Medical Center, Walnut Creek 4
Kaiser Permanente, Richmond 3
UCSF Benioff Children's Hospital 2
Saint Francis Memorial Hospital 2
Alta Bates Summit Medical Center, Herrick Campus 2
Regional Medical Center of San Jose 1
Kaiser Permanente, Antioch 1
John George Psychiatric Pavilion 1
TOTAL 3,233
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2023
TRANSPORTED PEDI PTS BY AGE - 2023
Age Number Percent
<1 367 11%
1 408 13%
2 234 7%
3 212 6%
4 157 5%
5 122 4%
6 115 4%
7 126 4%
8 105 3%
9 101 3%
10 133 4%
11 187 6%
12 245 8%
13 360 11%
14 392 12%
TOTAL 3264
TRANSPORTED TYPE PEDI PT. 2023
MEDICAL 76%
TRAUMA 22%
TRAUMA & MEDICAL 2%
UNK 0%
TOTAL 3264
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2022
Destination - 2022 TOTAL
Alameda Hospital 61
Alta Bates Berkeley 117
California Pacific Medical Center 2
Eden Medical Center 325
Highland Hospital 269
John George Psychiatric Pavilion 2
John Muir Medical Center, Walnut Creek 6
Kaiser Antioch 3
Kaiser Fremont 314
Kaiser Manteca 1
kaiser Modesto 1
Kaiser Oakland 333
Kaiser Richmond 8
Kaiser San Leandro 426
Kaiser Santa Clara 1
Kaiser Walnut Creek 130
Lucille Packard Children's Hospital at Stanford 5
Regional Medical Center 8
San Joaquin General Hospital 3
San Leandro Hospital 140
San Ramon Regional Medical Center 9
Santa Clara Valley Medical Center 11
SF General Hospital 1
St Francis Hospital 1
St Rose Hospital 155
Stanford Health Care Tri-Valley Hospital 309
Stanford Palo Alto Campus 21
Alta Bates Summit Hospital Oakland 65
Sutter Tracy Community Hospital 1
UCSF Benioff Children’s Oakland 1416
Washington Hospital 523
Willow Rock Center 54
Other Specified Location 15
TOTAL 4736
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2022
TRANSPORTED PEDI PTS BY AGE, 2022
Age Numbe r Percen t
1 472 9.97%
2 309 6.52%
3 209 4.41%
4 168 3.55%
5 154 3.25%
6 142 3.00%
7 137 2.89%
8 140 2.96%
9 141 2.98%
10 164 3.46%
11 164 3.46%
12 272 5.74%
13 340 7.18%
14 399 8.42%
15 455 9.61%
16 486 10.26 %
17 584 12.33 %
TOTAL 4,73 6 100%
TRANSPORTED TYPE PEDI PT. 2022
MEDICAL 3,823 (80.73%)
TRAUMA 769 (16.24%)
UNK 144 (0.03%)
TOTAL 4,736
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Exhibit B – Pediatric-Specific Equipment List
Minimum Supply Specifications
BLS
ALS
Non-
Transport
ALS
Transport
AIRWAY EQUIPMENT
Oropharyngeal Airways (Sizes 0-3) 1 each 1 each 1 each
Nasopharyngeal Airways (14, 18, 22, 26 Fr.) 1 each 1 each 1 each
McIntosh Laryngoscope Blades (#2, #1) 1 each 1 each
Miller Laryngoscope Blades (#2, #1) 1 each 1 each
Pediatric Magill Forceps 1 each 1 each
i-gel Supraglottic Airway (1.0, 1.5, 2.0, 2.5) 2 each
(optional)
1 each
(1.0 optional)
1 each
(1.0 optional)
Pediatric/Infant Non-Rebreather Masks 1 each 1 each 1 each
Pediatric End-Tidal CO₂ Sampling Nasal Cannula 1 each 1 each
Pediatric BVM with O₂ reservoir and facemask 1 each 1 each 1 each
Infant BVM with O₂ reservoir and facemask 1 each 1 each 1 each
Pediatric Suction Catheters (6, 10, 18 Fr.) 1 each 1 each 1 each
EQUIPMENT AND SUPPLIES
AED “Hands-Off” Defib Pads 1 set
Pediatric Blood Pressure Cuff 1 each 1 each 1 each
Infant Blood Pressure Cuff 1 each 1 each 1 each
Bulb Syringe (Optional if in Delivery Kit) 1 each 1 each 1 each
Delivery Kit Sterile, prepackaged to include:
• Minimum of two (2) umbilical cord clamps
• Scissors (may be separate)
• Aspirating Bulb Syringe
• Gloves
• Drapes
• Antiseptic Solution
1 each
1 each
1 each
EMS Approved Length Based Resuscitation Tape (LBRT) 1 each 1 each
Monitor/Defibrillator “Hands Off” Pediatric Defib Pads 1 each 1 each
IMMOBILIZATION EQUIPMENT
Pediatric Spine Board with Velcro Straps and Head
Harness
1 each
(IFT Optional) 1 each 1 each
IV EQUIPMENT/SYRINGES/NEEDLES
Pediatric Arm Boards 1 each 1 each
IV Catheters (22G, 24G) 2 each 2 each
EZ-IO 15mm Needle Set (Pink) 1 each
(optional)
2 each
(optional)
EZ-IO 25mm Needle Set (Blue) 1 each 2 each
T-connector 1 each 2 each
19 | P a g e
Attachment 1: Hospital NPRP Assessment
– Link: https://www.pedsready.org/
Attachment 2: Prehospital Pediatric NPPRP Assessment – Link https://emspedsready.org/
Attachment 3: EMSC and Pediatric Clinical Committees - Description
• Pediatric integration and QI occur in Alameda County EMS regularly held meetings with Alameda
County EMS partners (monthly or quarterly)
o Alameda County EMS Pediatric Clinical Monthly Meetings
o Alameda County EMSC and Pediatric QI Meetings (Bi-Annual) *
o BLS Providers
o Medical Dispatch Review Committee
o Receiving Hospital Meeting
o EMS Quality Council
o Disaster Preparedness Healthcare Coalition (DPHC) Quarterly Meetings
o Cardiac Arrest System of Care Meeting
* Includes EMS Pediatric Receiving Hospital and Prehospital PECCs
EMSC and Pediatric QI Committee
OBJECTIVES
• A standing committee that advises on pediatric hospital and prehospital care.
• The subcommittee’s goals are the evaluation of pediatric policies and protocols for the EMS
system with the responsibility for addressing system vulnerabilities and needs.
• The subcommittee supports the EMS Medical Directors by evaluating topics and data related to
identified issues such as clinical research on prehospital pediatric care, clinical outcomes,
community education, interfacility transfers, repatriation, and long-term outcomes.
TIMEFRAME
• Scheduled: Two times per year.
LEAD AND FACILITATORS
• EMSC Coordinator supported by EMS Medical Directors, EMS Administrators, and QI Coordinator
TARGET GROUP
• Representatives from Pediatric Specialty Hospitals (including: PECCs and ED Medical/Nursing
Directors from Pediatric Receiving Centers); Alameda County Pediatric Specialty Centers for
Critical Care include UCSF Benioff Children’s Hospital and Kaiser Oakland Medical Center.
• Representatives from each non-specialty pediatric receiving hospital ((hospital administration,
PECCS, and one clinical expert) who are knowledgeable about the pediatric cases reviewed at
each institution’s pediatric committee
• Representatives from Prehospital EMS Provider Agencies (EMS Liaisons, QI, PECCs, and Medical
Directors)
Attachment 4: Pediatric Resources, Research and Pediatric Policies – Links:
• https://emscimprovement.center/news/pecarn-cooperative-agreements-awarded-2023/
• https://pecarn.org/research-nodes/
• Alameda County EMS Website - EMSC Resources https://wrap-em.org/