If your child suddenly needs urgent medical attention — at the scene of a car crash or because of a choking incident, for example — it will be at least in part because of the work of Dena Brownstein that the paramedics who respond to the 9-1-1 call know what to do.

For more than 15 years, Brownstein, an emergency services physician at Children’s Hospital and Regional Medical Center and an associate professor of pediatrics at the UW, has been working with paramedics and emergency medical technicians (EMTs) to improve their training and confidence in caring for children.

“Most paramedics have very limited experience dealing with children,” she noted, “since only about 10 percent of calls involve kids and only 1 percent are for life-threatening emergencies involving kids.”

Yet the quality of pre-hospital care a child receives is important and can sometimes mean the difference between life and death. For all these reasons, paramedics find critical situations involving children among their most anxiety-provoking calls.

Brownstein will receive the UW’s Outstanding Public Service Award in June, honoring the work she has done training paramedics for pediatric emergencies.

She was already working with prehospital care when she applied for a demonstration grant from the Maternal and Child Health Bureau of the U.S. Department of Health and Human Services in the mid-1980s to improve pediatric prehospital care in Washington state. With this funding, she drew on the knowledge of local experts, including UW faculty members Linda Quan at Children’s and Michael Copass at Harborview, and began work on a course in pediatric emergency care designed specifically for paramedics and EMTs. Through a “train-the-trainer” program, the course was offered throughout the state, and was subsequently picked up and adapted for use in a number of other states around the country.

She also saw the potential and value of multimedia tools early on and developed videos that teach procedures and help students recognize signs of respiratory distress.

By the late 1990s, the American Academy of Pediatrics (AAP) put its considerable weight behind better training for paramedics and EMTs in child emergency care. The Washington course originally developed by Brownstein and her colleagues was one of those that influenced the national curriculum that she edited, along with Ronald Dieckmann of the University of California, San Francisco, and San Francisco General Hospital, and Marianne Gausche-Hill of Harbor-UCLA Medical Center in Los Angeles, under the AAP’s sponsorship.

Now called Pediatric Education for Prehospital Professionals, or PEPP, the course is being taught around the nation, and in other countries as well. More than 37,000 paramedics and EMTs have been trained so far.

With professional editorial assistance, color illustrations and multimedia support, the original “homegrown” materials were transformed into a package with CDs, a teaching guide and a resource manual.

Acknowledging the extraordinary quality of the Medic One program here in Seattle and King County, Brownstein said, “I have great admiration for paramedics and the work they do. They often function in very difficult circumstances, especially when you compare that with our work in a hospital setting. I really enjoy working with them and I’ve found that they are eager and motivated to learn.”

“It was really my good fortune to fall in with like-minded people at the Academy and have them take this on,” she said. “I would never have been able to promote the program in the same way myself.”

Brownstein noted that she hasn’t followed the most traditional path in academic medicine, but that she was able to be successful by pursuing her own passions. Along with the paramedic training, she has all along worked in the emergency department at Children’s, trained medical students and residents, and also focused on patient safety and quality of care.

“I would really like to encourage younger faculty members starting out to realize that you can stick to what’s most important to you, seek support for your interests, and come out all right,” she said.

“I certainly didn’t do this work because I wanted an award,” Brownstein said. “But it’s still great to be recognized in this way for doing work that has meaning and importance for me.”

– Vince Stricherz

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