Preparation is key to help staff confidently manage emergencies that may arise in the office.
ITASCA, IL—The American Academy of Pediatrics provides new guidance for pediatricians on how to prepare for emergencies in the office setting, where such scenarios are rare but can be serious when they do occur.
A revised policy statement, “Preparation for Pediatric Emergencies in the Office,” will be published in the May 2026 Pediatrics (published online April 20), along with a technical report that contains explanations and evidence for the recommendations. The AAP Committee on Practice and Ambulatory Medicine, Committee on Pediatric Emergency Medicine, and Section on Urgent Care Medicine wrote the policies, which contain the first update in recommendations since 2007.
“The AAP helps pediatric practices create an individualized plan to manage emergencies, such as if a child were to have a severe allergic reaction, a seizure or psychiatric emergency during an otherwise routine visit to their doctor,” said Patricia Cantrell, MD, FAAP, lead author of the statement.
“While it’s unusual to experience these types of emergencies in our clinics, it’s best to be prepared. Some first steps are to consider the office’s location, patient population, and distance from a hospital or emergency department.”
The guidance updates and expands upon the AAP’s 2007 recommendations, reflecting changes in evidence, medical practice, office workflows, and emergency care systems over the past two decades. In this revised statement, the authors standardize a baseline approach to pediatric emergencies across all common ambulatory settings including the primary care office, the urgent care center, and the pediatric specialty facility. This update features a more focused standard of care, highlighting the essential requirements and settings where expanded care may be needed. Additionally, the statement includes a focus on behavioral health emergencies which have become an increasingly common cause of acute emergencies in the pediatric office.
The policy statement includes a checklist that summarizes steps that medical offices can take to assess their readiness for pediatric emergencies. The self-assessment process encourages offices to consider not only their physical space and resources, but also their patient population, staff roles, available medications and equipment, and existing policies and procedures.
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.
“Ultimately, the goal is to ensure that when a pediatric emergency does occur in a medical office, the care team feels confident and sufficiently prepared to respond, improving outcomes for children and reducing stress for families and providers,” said David Mathison, MD, MBA, FAAP, co-author of the policy statement.
When considering what type of emergency plan best suits each office, the policy provides examples. For instance, an office in an urban setting with a rapid response time from emergency medical systems may decide to focus on stabilization of the patient. Rural offices with prolonged emergency response times instead might prepare for managing patients for an extended period until the child can receive a higher level of care.
Preparation includes creating protocols on how to manage emergencies, training staff, stocking the office with supplies and medications, and practicing emergency simulations to improve competency. 
Recommendations include training medical staff to recognize and manage common office emergencies, as well as maintaining skills for responding to emergency situations. These can be enhanced by performing emergency simulation drills at regular intervals.
“The policy offers a roadmap to tailor an office emergency preparedness plan to its specific setting and patient needs,” Dr. Cantrell said.  “It’s always best identify gaps before an emergency occurs.” 
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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.