The joint statement outlines what every emergency department (ED) needs to be ready to care for children and adolescents—an effort that could save more than 2,100 lives nationwide each year.
ITASCA, IL -- A joint policy statement, “Pediatric Readiness in the Emergency Department” details the critical steps emergency departments can take to be fully prepared for children in emergencies.
The American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), the Emergency Nurses Association (ENA), and the American College of Surgeons (ACS) collaborated on the policy statement and an accompanying technical report that outlines the scientific evidence supporting each recommendation.
Both documents serve as an update to recommendations previously revised in 2018 and 2009.
“More than 80% of children who come to an emergency department go to a local community hospital, not a children’s hospital,” said Kate Remick, MD, FAAP, FACEP, FAEMS, lead author of the statement. “Every emergency department should be fully prepared for kids, no matter how often they see them. These recommendations save lives.”
The policy statement and technical report will be published online Jan. 20, 2026, in Pediatrics (published in the February 2026 print issue); the Annals of Emergency Medicine (ACEP); Journal of Emergency Nursing (ENA); and Journal of the American College of Surgeons (ACS).
Policy statements and technical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.  
More than 35 million children and families go to emergency departments for medical care each year, most often in local hospitals that may see fewer than 10 children a day. A child’s chance of recovery in an emergency depends on whether the hospital has the right tools, staff and training.
Emergency departments that are equipped to treat children have much better outcomes, reducing the risk of death by 76% for those who are extremely sick and 60% for those with serious injuries.
The cost needed to reach the top 25% of high pediatric readiness is relatively low, between $4 to $48 per pediatric patient, depending on patient volume.
Yet more must be done to make sure every U.S. emergency department can fully meet national standards. Widespread strain on the health care system makes it challenging for departments to resource and fully focus on kids’ unique health needs.
The statement informs the work of the National Pediatric Readiness Project, an initiative of the Emergency Medical Services for Children (EMSC) Program—part of the Department of Health and Human Services’ Health Resources and Services Administration—in collaboration with multidisciplinary organizations. The NPRP aims to support the more than 5,000 EDs nationwide in improving pediatric capabilities through self-assessments, benchmarking, checklists, quality dashboards, and other resources.
These recommendations are intended for all emergency departments that provide care for children, including freestanding emergency departments, rural emergency hospitals, critical access hospitals and low-volume emergency departments.
The recommendations continue to emphasize the importance of appointing both nurse and physician pediatric emergency care coordinators to lead readiness efforts within emergency departments. Updates include:
To help emergency departments implement these recommendations, the statement includes a Pediatric Readiness Checklist.
The new statement sets the stage for the upcoming nationwide NPRP Assessment period, slated to open on March 3, 2026. Emergency departments will be assessed on a 100-point scale and receive a score for benchmarking and a gap report identifying areas for improvement.
The previous assessment published in 2023 noted improvements in five of six categories measured since 2013, including an increase in the number of emergency departments with pediatric equipment and supplies (90% to 97%) and the number of emergency departments with a pediatric mental health care policy (44.1% to 73.1%).
“The 2026 assessment is our chance to see where we stand—and where we can do better,” said Marianne Gausche-Hill, MD, co-author of the statement. “By participating in the National Pediatric Readiness Project Assessment, emergency care teams are leading efforts to quantify the progress made and improvements needed to optimize emergency care for the nation’s children. Furthermore, participation in pediatric readiness efforts are among criteria for ACEP’s ED Accreditation (Edict) program, which demonstrates a commitment to quality and safety.”
Emergency Nurses Association President Dustin Bass, DNP, MHA, RN, CEN, NEA-BC, said, “Every minute counts for parents and caregivers seeking emergency care when their child suffers a sudden illness or injury. Improving pediatric readiness in all emergency departments offers reassurance to families, while instilling confidence in emergency care providers, that these young patients will receive the appropriate, necessary treatment as quickly as possible. The updated recommendations, which include a pediatric readiness checklist, are vital to ensuring EDs are ready for those crucial moments when kids need us most.”
Hospitals can learn more by registering for a free webinar on Feb. 12 and can start preparing now using NPRP resources, including a toolkit, checklist, and an open assessment based on the 2018 guidelines (for EDs’ internal use), at pediatricreadiness.org.
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About the American Academy of Pediatrics (AAP)
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.
About the American College of Emergency Physicians (ACEP)
The American College of Emergency Physicians (ACEP) is the national medical society representing emergency medicine. Through continuing education, research, public education, and advocacy, ACEP advances emergency care on behalf of its 40,000 emergency physician members, and the more than 150 million people they treat on an annual basis. For more information, visit www.acep.org and www.emergencyphysicians.org.
About the Emergency Nurses Association (ENA)
The Emergency Nurses Association is the premier professional nursing association dedicated to defining the future of emergency nursing through advocacy, education, research, innovation, and leadership. Founded in 1970, ENA has proven to be an indispensable resource to the global emergency nursing community. With 40,000 members worldwide, ENA advocates for patient safety, develops industry-leading practice standards and guidelines, and guides emergency health care public policy. ENA members have expertise in triage, patient care, disaster preparedness, and all aspects of emergency care. Additional information is available at www.ena.org.
About the American College of Surgeons (ACS)
The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The ACS is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The ACS has approximately 90,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the ACS.