CATCH continued from front page
by Michael H. Stroud, M.D., FAAP, and
Tamara Nelson Rush, M.S.N., R.N., C-NPT, EMT
Children with chronic, complex medical conditions require interprofessional collaboration among
providers. This collaboration is not limited to hospital providers but also is essential for providers and
agencies in the child’s community.
Needs may vary based on each child’s chronic medical condition. For example, a child born with chronic
complex needs requires different support than a child
incurring complex needs related to a traumatic event
or disease process. Advances in medicine and technology have increased the lifespan of children with special
health care needs and allow them to live at home and
be a part of their community.
The primary care physician (PCP) is the medical home for children with chronic complex health
care needs, and communication and details about
the child’s medical status begin here. Early interprofessional collaboration with the parents and/or
care providers can provide a framework for success
in the care of their child.
Topics for discussion include location of the clos-
est fire department and/or emergency medical ser-
vice (EMS) and communication with the electric
company if the child’s care warrants life-sustaining
equipment and uninterrupted electrical service.
EMS personnel must have the training, support
and appropriate resources to identify and respond
effectively to the unique aspects of children with special health care needs. The family and child should
participate in developing a written emergency care
plan (Ann Emerg Med. 1997;274-280). The PCP
may suggest a visit with an EMS liaison.
Everyone caring for the child should be knowledgeable of the child’s personal treatment plan inclusive of the Medical Orders for Scope of Treatment
form, which may include information regarding resuscitation. A suggestion for the PCP is to identify
a nurse in the practice to be the point person for
pediatric patients with chronic complex conditions.
The nurse’s role should include providing education
on medical equipment and medicines, and develop-
ing a portfolio with key information about the child,
durable medical equipment, subspecialists and home
health agency. The portfolio should contain an “all
about me” sheet, describing the child’s acceptable/
normal vital sign parameters, suctioning depth if
tracheostomy dependent, gastrostomy tube care,
and signs and symptoms of increased intracranial
pressure from ventriculoperitoneal shunt malfunc-
tion (Dietrich A, et al. Pediatric Trauma Life Support.
2009), if warranted.
Some states may offer community care managers
who are embedded in PCP practices to coordinate
care. This role offers the opportunity to ensure all
stakeholders in the care of the chronically ill child
are aware of and engaged in the process of specialized
Caring for children with chronic, complex medical
conditions requires collaboration among providers at
all levels. The child’s care team may include first responders, transport team members, community hospital and emergency department staff, primary care
physician and subspecialty physicians at a tertiary care
children’s hospital. Effective communication among
members of this team enhances the care and quality
of life for children with complex medical conditions.
Dr. Stroud is a member of
the AAP Section on Transport Medicine Executive
Committee. Ms. Rush is
a liaison from the National Association of Neonatal
Nurses to the section’s executive committee.
grant proposals and act as a local resource to grantees. Many consider their experience with CATCH
— as a grantee or a facilitator/liaison — an important leadership opportunity within the Academy. In
fact, in the past 25 years, five AAP presidents have
been involved with CATCH:
• Benard P. Dreyer, M.D., FAAP – CATCH grantee;
• O. Marion Burton, M. D., FAAP – district CATCH
• David T. Tayloe Jr., M.D., FAAP – CATCH grantee;
• Donald E. Cook, M.D., FAAP – district CATCH
• Colleen A. Kraft, president-elect, M.D., FAAP –
CATCH grantee, chapter facilitator, district facil-
Additionally, AAP CEO/Executive Vice President
Karen Remley, M.D., M.B.A., M.P.H., FAAP, served
as an adviser to a resident grantee.
CATCH has had more than 20 foundation and
corporate supporters as well as hundreds of individual donors over the years.
As the Academy celebrates the 25th anniversary of CATCH, look to future issues of AAP News
for additional articles and testimonials highlighting
CATCH and all who have made the program a lasting success.
For more information, visit www.aap.org/catch or
Care for children with complex conditions
requires collaboration among many providers
CATCH programs in the United States
Dr. Stroud Ms. Rush