Emergency Department Resource Hub

Pediatric Triage Policies 
Essential Requirements: Your ED must have a triage policy that specifically addresses children of all ages and utilizes a standard, valid and reliable system to identify patients at high risk, which is based on severity of illness and injury, physiologic state and the risk or suspicion of critical illness and injury. This policy must include the use of a validated pediatric triage tool.

• Resources
  • Sample Pediatric Triage Guidelines
  • Illness and Injury Triage Policy Template
  • Sample Patient Care Policy and Procedures

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Pediatric Assessment and Reassessment 
Essential Requirements: Your ED must have established written policies, procedures and plans that specifically address pediatric patient assessment and reassessment. These may be inclusive of your policies that guide assessment of adults, but should specifically address pediatric VS ranges, presence of caregivers and rapid physical assessment of a child. The need for frequent reassessments of children in the ED should also be included in your department’s policies, procedures and plans and may have different reassessment frequencies, depending on the presenting complaint or concerning exam finding.

• Resources
  • Validity of Different Pediatric Early Warning Scores in the Emergency Department
  • Pediatric Vital Signs Ranges
  • Sample Pediatric Assessment-Reassessment Guidelines
  • Sample Vital Signs Policy

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Immunizations 
Essential Requirements: Your ED must have policy, procedures and plans to obtain and update the immunization status on all pediatric patients. This policy must include universal screening for vaccine deficiencies and clear documentation of vaccine status that are easily accessible by the medical provider. The Wisconsin Immunization Registry is an excellent and quick resource for obtaining baseline vaccine information for patients who are unsure of vaccination status.

• Resources
  • American Academy of Pediatrics – Recommended Child and Adolescent Immunization Schedule – January 2026
  • American Academy of Pediatrics – Shared Decision Making Guidelines
  • Immunizations and Responsibility of the Emergency Nurse
  • Vaccine Information Sheets
  • Flowchart to Assess Pediatric Vaccination Status – American College of Emergency Physicians
  • American Academy of Pediatrics Policy Statement – Increasing Immunization Coverage
  • Wisconsin Immunization Registry

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Children Maltreatment 
Essential Requirements: Your department must have a written policy that addresses how potential child maltreatment cases are identified and managed in your department.

• Resources
  • Sample Policy – Child Maltreatment
  • Evaluation of Suspected Child Physical Abuse
  • Murray LK, Nguyen A, Cohen JA. Child sexual abuse. Child Adolesc Psychiatr Clin N Am. 2014 Apr;23(2):321-37.
  • Screening for Physical Abuse in Children 
  • Abuse – Pathway to Promote Collaboration and Create a Safety Net for Children with Injuries (EDTC)

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Death of a Child 
Essential Requirements: Your ED must have a policy or guideline for the ED team following a death of a child.

• Resources
  • Guidelines for Supporting the Family After the Death of a Child
  • End of Life in the ED – Policy Template
  • Helping Children Cope with Death
  • Communicating News, Administrative Duties, Care Initiatives
  • End of Life Issues for Pediatric Patients in the ED
  • Care of a Dying Patient and Disposition of a Body
  • Sample Patient Death Policy

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Radiation Dosing 
Essential Requirements: Your ED must have a policy or guideline establishing age- or weight-appropriate dose reductions for children consistent with “as low as reasonably achievable” principles.

• Resources
  • Sample Policy – Imaging and Radiology
  • Radiation Risk to Children from Computed Tomography
  • Optimal Emergency Department Management of Children with Minor Blunt Head Trauma
  • State of Wisconsin Pediatric Imaging Guidelines for Blunt Trauma
  • Sample Radiation Protection Policy

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Behavioral and Social Health 
Essential Requirements: Your ED must have:

• • • A policy for universal suicide screening for children
    • A policy for management of acute agitation

• Resources
  • Pediatric Suicide Risk Screening & Assessment
  • Care of the Agitated Patient
  • Deescalation Tips for the Agitated Pediatric Patient
  • Pediatric Mental Health Care in the Emergency Department Toolkit
  • Elements of the National Alliance on Mental Illness’s Compassionate Care in the Emergency Room
  • Substance Abuse and Mental Health Services Administration (SAMHSA) Guidance for a Trauma-Informed Care Approach to Caring for Children with Mental Disorders
  • Substance Abuse and Mental Health Services Administration (SAMHSA) Practitioner Training and Virtual Learning Labs for Mental Health
  • Guidance for Emergency Department Preparedness for Children Seeking Mental Health Care
  • American Psychological Association Guidance on Setting up Telepsychology Services
  • American Academy of Pediatrics and American College of Emergency Physicians Policy Statement – Pediatric Mental Health Emergencies in the Emergency Medical Services System
  • Technical Report – Pediatric and Adolescent Mental Health Emergencies in the Emergency Medical Services System
  • Executive Summary: Evaluation and Management of Children with Acute Mental Health or Behavioral Problems – Recognition of Clinically Challenging Mental Health Related Conditions Presenting with Medical or Uncertain Symptoms
  • Relationship between Emergency Medical Services Use and Social Service Needs in a Pediatric Emergency Department Population
  • Example of Interpreter Contact Card

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Clinical Care Protocols 
Essential Requirements: Your ED must have:

• Clinical pediatric protocols or clinical care algorithms for common conditions (e.g., asthma, seizure, anaphylaxis)

• Resources
  • Children’s Hospital of Philadelphia Clinical Pathways
  • Seattle Children’s Hospital – Community Provider Resources: Clinical Standard Work Pathways
  • Nationwide Children’s Clinical Pathways
  • Children’s Hospital Colorado Clinical Pathways
  • Children’s Minnesota Clinical Guidelines and Decision Support

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Family-Centered Care 
Essential Requirements: You must first have a written policy that addresses family-centered care (PFCC) in your ED and have essential elements of PFCC included in that policy. You will receive partial points (.4 for each) for each of the elements that are addressed in your policy. These include:

• • • Involving families and caregivers in care decisions
    • Involving families and caregivers in medication safety processes
    • Family presence during all aspects of emergency care
    • Education of the patient, family and caregivers on treatment plan and disposition
    • Bereavement counseling

• Resources
  • Sample Policy – Family Presence during Invasive Procedure and Resuscitation
  • Sample Family-Centered Care Guidelines 
  • Sample Family Presence Program in the ED

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Disaster Planning 
Essential Requirements: Your hospital’s disaster plan must address issues specific to the care of children. The following elements of the disaster plan are all scored independently to meet the disaster planning element:

• • • Availability of medications, vaccines, equipment, supplies and appropriately trained providers for children in disasters
    • Decontamination, isolation, quarantine of families and children of all ages along
    • Minimization of parent-child separation and methods for reuniting children with their families
    • Specify that all disaster drills should include pediatric patients
    • A plan for pediatric surge capacity for both injured and non-injured children
    • Access to behavioral health resources for children in the event of a disaster
    • Include the care of children with special health care needs, including children with developmental disabilities

•  Resources
  • Sample Checklist – Essential Pediatric Domains and Consideration
  • Checklist for Pediatric Considerations for a Disaster – EMSC
  • Pediatric Tabletop Disaster Exercises Resource Kit – AAP
  • Emergency Nurses Association Topic Brief – Disaster Planning: Preparing for Pediatric Surges
  • Homeland Security Exercise and Evaluation Program (HSEEP)
  • Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resource, Assistance       Center, and Information Exchange
  • CDC Public Health Emergency Exercise Toolkit
  • FEMA Independent Study Courses
    • An Introduction to Exercises (IS-0120.c)
    • Exercise Design and Development (IS-0129.a)
  •  Pediatric Disaster Simulation Resources
    • Simulated airway drills as a tool to measure and guide improvements in endotracheal intubation preparation in the pediatric emergency department
    • Pediatric Emergency Medicine Disaster Simulation Curriculum: The 5-Minute Trauma Assessment for Pediatric Residents (TRAP-5)– See Appendices at the end of the article
  • American Academy of Pediatrics and American College of Emergency Physicians Policy Statement – Emergency Information Forms and Emergency Preparedness for Children with Special Health Care Needs
  • English to Chinese Pediatric Translator
  • ED Disaster Checklist
  • Sample Pediatric Safe Area Registration Sheet for Unaccompanied Minors

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Interfacility Transfer Guidelines 
Essential Requirements: Your hospital must have an interfacility transfer guideline that outlines procedural and administrative policies with other hospitals for the transfer of patients of all ages, including children in need of care not available at your hospital. Compliance with the Emergency Medical Treatment and Labor Act (EMTALA) does not constitute having interfacility transfer guidelines. The guidelines may be a separate document or part of an interfacility transfer agreement document.

•  Resources
  • SAMPLE – Interfacility Transfer Agreement Template
  • Steps to Create a Transfer Agreement – EIIC
  • Pediatric Interfacility Transfer Guideline, EMSC Innovation and Improvement Center
  • Sample ED Transfer Checklist 
  • Interfacility Transfer Toolkit, EMSC Innovation and Improvement Center