Emergency medical services for children in rural and frontier America: diverse and changing environments.

Rural emergency medical services for children is challenged by timely access to professional care at all levels. Particular issues of communication, providers, equipment, transport, education, legislation, financing, prevention, public awareness, data collection, and research are addressed as they confront the rural physician, with some established and suggested methods of solution. The most sophisticated health care provider, pediatrician, family practitioner, or emergency department physician must accept responsibility for implementing and facilitating the many diverse elements of rural emergency medical service for children, for structuring a functional and progressive whole that is germane to the community, and for improving rural child morbidity and mortality.