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Pediatric Emergency Medicine: from small beginnings, a subspecialty emerges and evolves in RI, nationwide.

Pediatric Emergency Medicine (PEM) was introduced in Rhode Island in 1985, the year after the establishment of the federal EMS-C program designed to assist states in improving emergency medical care for children. Based at Rhode Island Hospital, PEM began as a fledgling subspe cialty when DR. WILLIAM LEWANDER was recruited as Rhode Island’s first PEM sub specialist by the divisions of Emergency Medicine and Pediatrics. Dual-trained in PEM and toxicology and a member of the first class of PEM fellows at Boston Children’s Hospital, Dr. Lewander was charged with building a system of regional emergency care dedicated to the medical needs of children and their families. Early in his career, he worked tirelessly caring for patients and educating physicians, nurses and EMS providers about the evolving body of medical evidence which recognized that children were not “little adults” and were best served when receiving specialized emergency care befitting their unique phys iologies and responses to injury and illness. Within a few years of arrival, additional PEM medical and nursing colleagues joined Dr. Lewander. Together, they collaborated with emergency medicine physicians and pediatric surgeons to develop a multifaceted emergency medical system focused on the unique medical, developmental and social needs of children and adolescents.