reports and their recommendations to recognize and acknowledge the human side of pediatric emergency care. He described how the federal Emergency Medical Services for Children (EMS-C) program, like many other federal health care programs, had its origins in policy makers’ personal medical experiences. Over 25 years ago, Dr. Sundwall’s daughter was very seriously injured by an automobile. She received good emergency care and survived. Years later, when Dr. Sundwall was working in Washington, DC, for Senator Orrin Hatch, he met another congressional staff member who had a poor experience with the pediatric emergency care system. Together, they partnered to write the legislation that created the EMS-C program. Dr. Sundwall emphasized how pleased he was that his daughter’s terrible injury translated into assistance for many other children. He noted that one of the IOM committee’s recommendations was for Congress to increase the modest federal funding for the EMS-C program to $37.5 million. There continues to be enormous strains on the emergency care system nationwide, and the EMS-C program is well positioned to help address those challenges for children.

Another challenge facing the emergency care system is its ability to respond to disasters. According to John Agwunobi, assistant secretary for health in the U.S. Department of Health and Human Services (DHHS), one of the essential components of a prepared nation is the presence of a robust, well-funded, well-staffed, connected emergency care system. A community will be better prepared for disasters if it has resources (e.g., defibrillators, ventilators) in place, citizens who are trained in cardiopulmonary resuscitation and understand how to access the system, academics conducting research and developing training programs for health professionals, and communications systems that connect the various responders.

Adm. Agwunobi emphasized that it is not appropriate to rely entirely on the federal government to improve emergency preparedness. A truly robust emergency care system must be supported by communities. The average citizen needs to understand the capabilities of the emergency care system and the resources needed for the system to maintain operations. People also need to understand that we are all responsible for supporting the emergency medical system.

In the event of a large-scale disaster, such as pandemic influenza, Adm. Agwunobi explained, the system currently does not have all the personnel or the resources that would be needed to respond. That means that communities are going to have to rely on outside health professionals and laypersons to assist. The Medical Reserve Corps (MRC) is one available resource. The MRC consists of groups of volunteer physicians, nurses, dentists, emergency personnel, and others who come together on a volunteer basis to assist in the event of an emergency. They will be available to augment the local health care workforce in the event of a disaster, expanding



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