Supporting Pediatric Emergency Readiness Through Weight-Based Dosing, Clinical Decision Support, and Preparation

Children account for a significant share of emergency care, yet many healthcare professionals have fewer opportunities to treat pediatric patients than adults. Emergency departments, hospitals, and prehospital providers must be prepared to manage pediatric emergencies despite these differences in clinical exposure. Doing so requires knowledge of age-dependent physiology, accurate weight-based medication dosing, appropriately sized equipment, and access to reliable clinical guidance when time is limited.

The American Academy of Pediatrics' Pediatric Readiness in the Emergency Department: Technical Report highlights the scale of this challenge. More than 80% of children receiving emergency care are treated in general, nonspecialized hospital emergency departments, and approximately 70% of emergency departments see fewer than 10 children per day. The report also cites research associating high pediatric readiness with a 60% to 76% reduction in mortality risk among critically ill and injured children. Together, these findings underscore the importance of equipping healthcare teams to respond effectively, even when pediatric emergencies are relatively uncommon in their daily practice.

James Kempema, MD, and Marlynn Kempema, RN, co-founders of Pedi STAT & STAT EM, emphasize that medication safety is a central part of that preparation. "Unlike many adult medication regimens, pediatric doses frequently depend on weight, often measured in kilograms, and must be adjusted to account for the medication, its concentration, and the clinical situation," Dr. Kempema explains. "Clinicians may need to determine or estimate a child's weight, calculate the appropriate dose, convert that dose into an administration volume, and select equipment suited to the patient's size."

These decisions can become particularly demanding during resuscitation, when several tasks must be performed quickly and accurately. Errors in calculation, unit conversion, or equipment selection can contribute to treatment delays and patient harm.

Clinical decision-support resources can help clinicians navigate these demands. The 2026 joint policy statement from the American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), American College of Surgeons (ACS), and Emergency Nurses Association (ENA) recommends accessible pediatric dosing guidance, standardized medication practices, and decision-support resources. These recommendations reflect a broader principle of patient safety. Preparedness depends not only on individual knowledge and experience, but also on having reliable processes and information available at the point of care.

This challenge is familiar to Dr. Kempema, whose career spans more than 30 years of medicine, including emergency medicine, pre-hospital care, and professional education. His experience illustrates how even knowledgeable clinicians may need accessible references when faced with an unfamiliar pediatric emergency. "Even when a clinician immediately identifies the correct treatment for a pediatric seizure, executing it requires several fast-following steps," he explains. "These steps include verifying weight-based dosing, calculating medication volume, and selecting the proper equipment. Integrated clinical tools help streamline these critical decisions, allowing providers to apply their expertise seamlessly under pressure."

That need helped inform the development of Pedi STAT, a pediatric emergency reference app created by Dr. Kempema, with Marlynn contributing her clinical and educational experience. Developed to make key pediatric dosing and equipment information readily accessible, the app reflects the founders' focus on the practical decisions clinicians face during time-sensitive emergencies.

Pedi STAT allows clinicians to establish a child's size in four ways: by entering a known weight or estimating weight using age, height, or length. Based on the information entered, users can access medication doses and administration volumes across relevant treatment categories, along with pediatric equipment-sizing information and resuscitation guidance. Additional references cover age-related vital signs, asthma severity, burns, and pediatric triage. By bringing these resources together, the app is designed to help clinicians navigate several connected aspects of pediatric emergency care without having to consult multiple references separately.

Another feature is the ability to review the calculation behind a recommended dose. This visibility allows clinicians to examine how a result was derived and verify the relationship between patient size, the prescribed dose, medication concentration, and administration volume. Rather than presenting a number without context, the tool makes the underlying calculation available for review. Such transparency may support verification and reinforce clinicians' understanding of the dosing process, although the app remains a reference and calculation aid rather than a substitute for professional judgment, independent checks, or institutional protocols.

The motivation behind the product is rooted in patient care. Dr. Kempema states, "We started it to truly care for children." That emphasis reflects a practical approach to clinical innovation: identifying recurring challenges in frontline care and developing resources around the decisions healthcare professionals must make. "During pediatric emergencies, where medication dosing and equipment specifications vary significantly based on a child's size, readily available guidance helps bridge the critical gap between clinical knowledge and safe, precise execution," Dr. Kempema notes.

The development of STAT EM extends this approach beyond pediatric care. Building on Pedi STAT's pediatric content, the broader platform is planned to support adult, neonatal, and obstetrical care, with additional medication-dosing resources, equipment guidance, and resuscitation workflows. The expansion reflects an effort to make clinical reference tools available across a wider range of patient populations and emergency care settings, including hospitals and emergency medical services. These resources may also complement staff onboarding, simulation-based training, and continuing clinical education.

Technology, however, is only one component of pediatric readiness. Dr. Kempema identifies a broader set of priorities, including pediatric-specific equipment and supplies, staff competency development, medication-safety procedures, and readily available clinical decision support. Effective preparation requires these elements to work together, supported by clear protocols, regular training, and organizational processes that help clinicians access the right information when they need it.

This is already being implemented and has had great success in Saudi Arabia. A study published in PubMed shows that across cardiac arrest, asthma exacerbation, seizures, and hypoglycemia, the PediSTAT application increased accuracy and reduced the risk of medical errors for common pediatric emergencies.

For healthcare leaders, this means evaluating not only whether appropriate pediatric resources are available, but also whether staff know how to use them in practice. Reviewing dosing protocols, organizing equipment by size, conducting pediatric simulation exercises, and integrating accessible clinical references into established workflows can all contribute to a more coordinated approach to emergency preparedness.