Child health

EMTs are able to deliver comprehensive neonatal and paediatric care as a means to reduce child morbidity and mortality by addressing major causes of disease impacting child health in emergencies.

EMTs should be adequately equipped with sufficient resources and technical clinical expertise to deliver basic essential neonatal and paediatric emergency and trauma stabilization care, alongside the ability to respond to common childhood communicable and noncommunicable illnesses. EMTs should be able to respond to the leading causes of death in children such as preterm birth and intrapartum-related (meaning birth asphyxia) complications, pneumonia, diarrhoea and malaria.27

1. Paediatric care

• • Deliver basic emergency and trauma stabilization, essential newborn care, outpatient paediatric care, screening and isolation of communicable diseases and basic management of noncommunicable diseases.
  • Supply tetanus vaccination, however, routine vaccination programmes are not an EMT function.
  • Screen children aged 6–59 months for malnutrition using mid-upper arm circumference (MUAC) and initiate ambulatory treatment in uncomplicated cases.
  • Use an appropriate clinical documentation system, with separate provision for paediatric observations, fluid balance and pain management. Immunization, nutritional status and weight should be specifically considered.
  • Stock adequate equipment, consumables and enough essential newborn and paediatric pharmaceuticals for a minimum period of 14 days.

Type 2

• • Staffed with at least one with paediatric experience and paediatric nurses, as well as a surgeon and anaesthesiologist with paediatric experience to provide paediatric anaesthesia, surgical, perioperative and medical care.

Type 3

• • Integrate a neonatal nurse, manage neonatal and paediatric patients with intensive care requirements.

2. Child protection

• • Ensure that staff receive suitable training to be able to identify and respond to child protection issues according to internal child protection policy.
  • Appoint a child protection focal point in the team with additional training and experience in child protection.
  • Ensure that throughout the process of clinical care the newborn or child is not separated from their parent or agreed caretaker.
  • Establish a registration system and recognized procedure to account for all unaccompanied minors in the health facility.

1. Clinical staff have experience in neonatal care, clinical paediatrics, paediatric emergencies, trauma and wound care, nutrition, fluid and electrolyte management, conscious sedation, pain management and specific paediatric drug dosages.
2. Provide adaptive training for child health care.
3. Set up an identified and supervised area for unaccompanied minors.
4. Consider child friendly handwashing stations and latrines.
5. All staff sign the child protection policy.
6. Establish a documentation and reporting system for unexplained injuries in children, including body mapping, stored in a safe, locked place and respect national reporting mechanisms.

Type 3

• • Include a paediatric emergency medical doctor, a paediatric surgeon, a paediatric anaesthesiologist and a nurse with neonatal intensive care experience.
  • Ensure familiarity with procedures such as oxygen therapy in children, indwelling venous catheters, fluid and electrolyte management in children, intraosseous lines, chest drain procedures, placement of urinary catheters, bladder taps, lumbar punctures, ascetic taps, nebulization therapy and non-invasive ventilation.