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The Importance of Special Children’s Outreach and Pre-hospital Education (SCOPE)

By Frank Giampetro, PHCS EMS Education

Frank Giampetro

January 3, 2009

In September, 2007, Premier Health Care Services—in conjunction with Children’s Medical Center in Dayton and Nationwide Children’s in Columbus—presented a Special Children’s Outreach and Pre-hospital Education (SCOPE) program in Champaign County. The need for such a program arose when we realized that our local fire department did a tremendous job “filling the boot” for Muscular Dystrophy, but many children in our communities had other debilitating physical and/or medical challenges that were also in need of identification and support. We thought it important that we develop a county-wide identification and response system that would fit the needs of all children with special needs, regardless of their region or district of residence.

We offered the program to our county’s EMS departments, hospital emergency department, and health department, asking that each unit send two representatives to the eight-hour presentation. Class size was limited to twenty-four; by their choice, all departments were not represented, but all spots were filled.

We had an excellent course presented by the previously mentioned hospitals. The program included most of the lifelong challenges children sometimes face, including—but not limited to—cardiovascular, pulmonary, neurological, musculoskeletal, and traumatic disabilities. For the first time, we learned about “go bags.”

At the conclusion of the program, we placed an article in the local newspaper explaining our goal and asked that any family with a special needs child come to the county health department on a specific date and meet with us, discuss their child’s condition, and fill out a Patient Information Form (PIF).

The form is critical because it not only gives the condition of the child but also lists their special needs, the children’s hospital where they were most often treated, and the physicians in charge of their care. It also asks for information about special conditions that must be addressed pre-hospital and in the local Emergency Department. For example, in our first twelve registrants, we found a five-year-old who has no sternum and, thus, cannot have CPR performed, four children with MIC-key buttons, one with a Cerebral Spinal Fluid shunt, one trach tube with Bi-PAP, and several different medical ports. For the first time, we met a wonderful eight-year-old with Angelman Syndrome and found that we had much more learning to do at all levels.

Then, several important steps were taken. First, we made certain that all of our special children were registered with the health department and that we had written parental consent to give the information to the appropriate agencies. Second, each applicant was numbered, and the address of the child placed in the 911 dispatch system with a pop up screen that reads “Special Needs Patient Number __” when a call is received indicating that a child at that address may be in need of assistance.

For each of their squads, all departments in Champaign County were issued a notebook containing a copy of the PIF’s that pertain to the patients in their district and the district(s) for which they cover for mutual aid. When dispatched, they are given the Special Needs Patient number along with the address and can refer to the appropriate PIF page while enroute. When leaving the scene, the squad will notify the local hospital of the patient number they are transporting, and the Emergency Department has an identical notebook with all numbered PIF’s on their pedi crash cart.

Every squad’s notebook contains a laminated page giving a quick review of special device emergency procedures; every department is also given a Pre-hospital Protocols for Children with Special Health Care Needs training manual from the Children’s National Medical Center. The Champaign County Sheriff Department requested that the information also be placed in their vehicles.

Several departments have successfully developed a program of this type at the community level; this effort is our attempt to implement a program encompassing the entire county, including eight EMS departments. We would be happy to share the information we have with any department or region, as well as the experiences that we’ve gained. Please feel free to contact me with any questions at 937-508-8754 or fgiampetro@phcsday.com.

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Premier Health Care Services, Inc.
332 Congress Park Drive
Dayton, OH 45459
800-726-3627