Research in emergency medical services for children.

Research is the key to future improvements in emergency medical services for children (EMS-C). Ultimately these improvements should result in better prevention of childhood emergencies and better outcomes for children who experience emergency illness or injury. Research in EMS-C can be descriptive of the system and its users or focused on specific clinical or basic scientific questions. Descriptive research is needed to describe the EMS-C system, its users, the types of problems for which it is used, and the associated outcomes and costs. To facilitate the descriptive research, a uniform data set, a taxonomy of chief complaints, and a method of linkage among databases collected by different components of the system are needed. Focused research efforts in clinical and basic sciences are also needed. The Institute of Medicine report identified seven research areas for highest priority: clinical aspects of emergencies and emergency care; indices of severity of injury and, especially, severity of illness; patient outcomes and outcome measures; costs; system organization, configuration, and operation; and effective approaches to education and training, and prevention. Maturity of the subspecialty of emergency medicine will be indicated by the development of basic science research and epidemiology by physicians with clinical interests in emergency medicine. The most exciting discoveries are likely to come in areas that we have not yet imagined. Rapid development of meaningful research will require massively increased funding to support both the research itself and the training of future scientists to work in pediatric emergency medicine.