The most common childhood injuries that require trauma care occur due to road accidents, fires, drowning and falls. Training doctors in pediatric emergency medicine literally can make the difference between life and death or long-term disability and health.
That is why Texas Children’s sends pediatric emergency experts to resource-limited countries and trains local physicians in the special care of children with traumatic injuries.
Pediatric emergency medicine (PEM) is a relatively new specialty in children’s care. In fact, it was not formally recognized as a pediatric specialty in the U.S. until 1980. While PEM is a young subspecialty, it is quickly gaining traction as a crucial tool to help countries reach the WHO Millennium Development Goal of reducing under-5 mortality rates.
Most pediatric healthcare centers in resource-limited settings lack essential infrastructure and supplies. What’s more, evidence suggests that inadequate initial patient assessment and delays in delivering life-saving treatment contributes to poor outcomes for young patients. 
Interventions, such as clinical training, education and research, help improve pediatric emergency care and lead directly to reductions in child mortality. Pediatric emergency medicine stands uniquely poised to bridge the significant gaps found in the child healthcare around the world.


  • Dr. Deborah Hsu
    Service Chief, Pediatric Emergency Medicine
    Associate Professor of Pediatrics, Emergency Medicine
  • Dr. Heather Crouse
    Director, Global Pediatric Emergency Medicine Program
    Assistant Professor of Pediatrics, Emergency Medicine
  • Dr. Marideth Rus
    Director, Global Pediatric Emergency Medicine Fellowship
    Assistant Professor of Pediatrics, Emergency Medicine

Global Pediatric Emergency Medicine Programs

PACHIMAKE - Emergency Department Process and Improvement in Malawi

The Texas Children’s Global PEM team has established a partnership in Lilongwe, Malawi to develop and implement triage systems in the emergency department at Kamuzu Central Referral Hospital. The partnership – PACHIMAKE – which means “at the heart of the matter” in the local Chichewa, includes Baylor College of Medicine, Utah, Cincinnati and University of North Carolina. The clinical uptake and impact of these triage systems is being measured. 

Curriculum Development and Training

The Pediatric Emergency Medicine team developed a training program and supplemental teaching curricula for the WHO Emergency Triage Assessment and Training (ETAT) course.

First piloted in Lesotho in 2008, we have worked in Guatemala in collaboration with the Texas Children’s Newborn Center designated as a World Health Organization Collaborating Center (WHO-CC) for Neonatal and Perinatal Health and the Pan American Health Organization (PAHO) to develop the program in Spanish for use in Latin America (Clasificación, Evaluación y Tratamiento de Emergencias Pediátricas (CETEP).

In 2011, in conjunction with PAHO and local ministries of health, Texas Children's began rolling out the training program through Latin America, including Nicaragua, El Salvador and Peru. We are studying both the quality and effectiveness of these training programs. This multi-phased project is funded by Texas Children’s Hospital.

Local EMS Systems Development and Improvement
PEM Global Health worked with a partner hospital in Antigua, Guatemala to scale-up ETAT trainings locally for pediatric healthcare providers from referral health posts, hospitals, ambulances and fire departments in the region of Sacatepequez, Guatemala. The program includes training in pediatric evaluation and management with ETAT, the development of local triage processes, and assistance in the formalization of referral and counter-referral systems in the region.

Developing and Implementing Technology in Low-Resource Settings
In collaboration with Rice University, the PEM Global Health team developed an inexpensive, durable, easy to use device to provide bubble continuous positive airway pressure (CPAP) to provide respiratory support to infants and young children in resource-limited settings. The device and accompanying educational program were piloted in Malawi in 2011. The project was funded by a USAID / Gates Foundation grant.

Baylor College of Medicine Pediatric Emergency Medicine - Global Health Fellowship

The Baylor Pediatric Emergency Medicine - Global Health (PEM-GH) Fellowship was established in 2005 in response to growing interest in global health and international emergency medicine among applicants applying to our pediatric emergency medicine (PEM) fellowship program. Our program is the first combined fellowship of its kind in the United States. Fellows will complete the standard PEM curriculum and supplementary training and experience in global health for a typical combined length of 3 ½ years. It is intended for those who are seeking an academic career in pediatric emergency medicine with a focus on global (domestic and international) health disparities. Individuals completing the fellowship will acquire skills in the development, integration, and evaluation of healthcare programs on a local, national, and global scale. We currently have 3 combined fellows in our program.
  • Dr. Heather Crouse
    Director, Global Pediatric Emergency Medicine Program
    Assistant Professor of Pediatrics, Emergency Medicine