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October 2025; Volume 14, Issue 10
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Utah Emergency Medical Services for Children
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Pedi Points
Tia Dickson RN, BSN
PCH Trauma RN, Utah EMSC Nurse Clinical Consultant
Ever wonder how we can help save more kids’ lives? The Utah Child Fatality Review Board is a special team that looks closely at cases where a child has died to understand what happened and how it might have been prevented. They study the data and create smart recommendations for healthcare providers, community leaders and even for families, to improve care, response, and prevention. By learning from real cases, we can be better prepared on scene and help stop future tragedies before they happen.
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Child Fatality Review: Lessons Learned
Tia Dickson RN, BSN
Utah EMS for Children (EMSC) Nurse Clinical Consultant
Bureau of EMS, Utah Department of Public Safety
PCH Pediatric Emergency Care Coordinator (PECC)
Summary from September 8th, 2025 PETOS
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Utah Child Fatality Review Board (CFRB) – How It Works
1. Purpose
The Child Fatality Review Board looks at deaths of children in Utah to figure out why they happened and how to prevent similar deaths in the future. Their goal is not to blame anyone but to make the state safer for kids.
2. Who Reviews the Cases
The board is made up of people from different professions: doctors, nurses, social workers, law enforcement, EMS, and other child safety experts like DCSF. They all bring their perspective to understand the full story.
3. How Cases Are Chosen
The board reviews cases of children who died from injury, illness, or unknown causes. They get information from the Medical Examiners office, hospitals, EMS reports, law enforcement, and social services.
4. What Happens in a Review
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The board looks at medical records, EMS reports, and investigation findings.
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They discuss what happened, including any delays, missed signs, or safety issues.
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They ask: “Could this death have been prevented?
5. Recommendations
After reviewing a case, the board makes suggestions to prevent future deaths. These might include:
6. Confidentiality
Everything discussed is private. The goal is learning, not punishing. This helps professionals be honest and thorough during reviews.
7. How EMS Fits In
We present information directly from your records on scene in the review. EMS providers can provide critical information about what happened. Their input helps the board understand the child’s care before arriving at the hospital.
8. Outcome
The board publishes general reports with lessons learned, data, trends, and recommendations so the community can work together to keep kids safe.
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Some Child Deaths Are Determined to Be Natural
1. What “Natural” Means
A natural death happens because of a medical condition, illness, or disease—not because of trauma, accidents, or outside forces. For example, a child with a severe heart defect or cancer who dies from that illness is considered a natural death.
2. How It’s Determined
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Medical history: Doctors look at the child’s health history and known conditions.
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Autopsy findings: A pathologist examines the body to see if disease caused the death.
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No evidence of trauma or injury: If there’s no sign of abuse, accidents, or external causes, the death may be natural.
3. Examples
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Sudden death from a severe infection, like pneumonia or sepsis.
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Complications from chronic illnesses, such as heart or lung disease.
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Even though natural deaths are caused by illness or medical conditions, some of them can be prevented. For example, certain childhood cancers have been linked to environmental toxin exposure, so reducing exposure can lower risk. Social programs that support pregnant people, like access to nutrition and prenatal care, can prevent premature births and related complications. Public health campaigns that promote safe sleep, immunizations, and proper infant care have also shown to reduce infant mortality.
The CFRB does not typically review natural deaths unless there are unusual circumstances to consider.
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When I presented PETOS early last month, the data showed motor vehicle crashes had overtaken suicide as the #1 cause of injury death among children in Utah. For this write-up, I looked at more current data, and the numbers have shifted again. This is common. The top 5–6 causes (suicide, motor vehicle crashes, firearms, infant sleep, homicide, suffocation) remain fairly consistent, even if exact rankings shift from year to year. According to Nathan Malan Utah CFRB Epidemiologist and Evaluator:
“In 2024, suicide was the main preventable cause of death. Suicide and transportation deaths have been back and forth for the last couple of years as the top killers. Right up there, though, are sleep-related infant deaths.”
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Key Takeaways from the Child Injury Death Rates in Utah, 2015–2024:
Suicide:
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Rates fluctuate over the years but reached a 10-year high of 6.29 per 100,000 children around 2019.
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It remains one of the top causes of injury death.
Firearm deaths:
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Reached a 10-year high of 4.22 per 100,000 children around 2020.
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Rates generally trend downward after the peak.
Infant sleep-related deaths:
Motor vehicle and other transportation:
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Rates peaked at 5.0 per 100,000 children (a 10-year high) around 2021.
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It has sometimes surpassed suicide as the leading cause.
Homicide:
Unintentional suffocation and drowning:
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Suffocation peaked at 1.48, drowning at 1.25 per 100,000 children over the 10-year period.
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Both remain lower on the list but are notable causes, especially in younger children.
Unintentional/undetermined poisoning:
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A Look at the Top 5 (in 2024)
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Suicide
History & Data
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In past decades, motor vehicle crashes were the leading cause of injury death in children and teens.
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Over the last decade, suicide rates in Utah youth have risen sharply.
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This trend is higher than the national average, and it has raised major concerns for health and safety leaders.
Why This Matters
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Crisis resources:
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988 Suicide & Crisis Lifeline
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SafeUT app (24/7 chat with counselors, anonymous tip line).
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The Warm Line 1-801-587-1055 (7days, 8am-11pm) is triage line providers or parents can call to be directed to the best care.
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Training: More first responders, teachers, and community members are being trained in suicide prevention and intervention (e.g., CALM).
We are on a downward trend, interventions are working, but this is no time to let up.
What Still Needs Work
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Breaking the Stigma: Kids and families must feel safe to talk about mental health.
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Access to Care: Many rural areas lack mental health providers.
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Safer Environments: Encouraging safe firearm storage and reducing access to lethal means.
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Support for Responders: EMS providers need mental health resources after pediatric suicide calls.
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Ongoing Education: Communities, schools, and healthcare teams must keep building awareness.
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Firearms
History and Data
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After suicide, firearms are the next leading cause of injury-related death in Utah youth.
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These deaths include both homicides and unintentional shootings.
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Children and teens in Utah are at higher risk compared to many other states due to high rates of firearm ownership.
Why This Matters for EMS
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Firearm injuries are often devastating and leave little chance for survival.
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EMS providers are first on scene for accidental shootings, assaults, and suicide attempts with firearms.
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Responders may also witness the emotional impact on families and communities.
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What Utah is Doing Now
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Education Campaigns: State and community groups promote safe firearm storage and handling.
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Free Gun Locks: Many law enforcement agencies, health departments, and community partners provide free or low-cost locks.
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Partnerships: Collaboration with firearm owners and gun shops to spread suicide prevention and safety messaging.
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Hospital & Trauma Centers: Focus on prevention programs and family counseling after firearm-related incidents.
What Still Needs Work
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Safe Storage: More families need to lock up firearms and store ammunition separately.
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Access in Crisis: Reducing firearm access when someone is suicidal can save lives. Firearm injury is three times more likely in homes with unlocked guns. There are 3 times when it is especially important to “gun proof” your home
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Public Awareness: Not all families know about free safety resources.
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EMS Support: Firearm calls are emotionally taxing; responders need mental health support after pediatric firearm cases.
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Infant Sleep Related Deaths (SUID)
The Issue
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Sudden Unexpected Infant Death (SUID) includes deaths during sleep that may be due to suffocation, strangulation, or unexplained causes.
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In Utah, unsafe sleep is one of the leading causes of death for infants under 1 year.
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Most of these tragedies are preventable with safe sleep practices.
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Why This Matters for EMS
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EMS providers are often first on scene when an infant is found unresponsive.
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Responders may face emotional stress from these cases and grief from families.
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EMS can also play a prevention role by sharing safe sleep messages with parents and caregivers.
What Utah is Doing Now
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Public Health Campaigns: “ABCs of Safe Sleep” → Alone, on the Back, in a Crib.
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Hospital Programs: Many birthing hospitals teach parents about safe sleep before discharge.
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Data Tracking: The Utah Child Fatality Review is currently studying SUID cases to improve prevention.
What Still Needs Work
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Awareness Gaps: Not all families know or follow safe sleep guidelines.
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Cultural & Family Practices: Bed-sharing remains common, despite risks.
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Consistent Messaging: Families sometimes hear mixed advice from relatives or social media influencers.
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EMS Role: Reinforcing safe sleep messages during calls, home visits, or community education. Safe Sleep: safeinfantsleep.utah.gov
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Motor Vehicle Crashes
The Issue
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Motor vehicle crashes remain a leading cause of injury and death for children and teens in Utah, especially for ages 5–19.
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Pedestrian incident: In the first four months of 2025, the Utah Department of Public Safety reported that 11 people under the age of 20 were seriously injured or killed by vehicles, with the age group under 20 making up the largest number of people hit by cars.
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Seat belts, car seats, and booster seats dramatically reduce risk—but misuse and non-use remain a problem.
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The most dangerous time in or around cars for children are going to and from school.
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What Utah is Doing Now
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Child Passenger Safety Programs: Free car seat inspections, education, and distribution.
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Seat Belt Campaigns: Public awareness efforts targeting teens and families.
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Graduated Driver Licensing (GDL): State laws limit nighttime driving and passengers for teen drivers.
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EMS & Trauma Training: Providers receive pediatric trauma and extrication training.
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Zero Fatalities
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What Still Needs Work
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Proper Car Seat Use: Many caregivers still install or use seats incorrectly.
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Teen Driving Safety: Ongoing education on distraction, seat belts, and safe driving.
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Rural Road Safety: Many crashes occur in remote areas with longer EMS response times.
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EMS Support: Trauma calls involving children are emotionally taxing; peer support is vital.
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Community Education: Continuous reminders about car seat checks, seat belts, and helmet use for bikes/ATVs.
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Homicide
The Issue
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Homicide is one of the leading causes of injury death in Utah children and teens.
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These deaths include shootings, stabbings, physical abuse, and other intentional violence (Nonaccidental trauma – NAT).
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Young children are more often victims of abuse at home, while teens are more likely to experience assaults outside the home.
Why This Matters for EMS
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Calls often involve not just trauma care, but assessment of the child’s environment and potential ongoing danger.
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Responders should be involved in recognizing and reporting abuse.
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What Utah is Doing Now
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Child Abuse Reporting & Investigation: Mandatory reporting laws and coordinated response with DCFS and law enforcement. EMS providers are mandated reporters.
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Prevention Programs: Community and school programs focus on violence prevention, conflict resolution, and safe environments.
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EMS & Healthcare Training: Providers trained to recognize signs of abuse and neglect. www.identifychildabuse.org is excellent training on what to look for and will grant 2 CME for providers.
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Trauma Support: Victim services, counseling, and peer support for families and responders.
What Still Needs Work
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Early Recognition: More training on identifying abuse and at-risk children.
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Family Support: Strengthening social services to prevent violence before it occurs.
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Community Awareness: Continued efforts to reduce teen violence, bullying, and domestic conflict.
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EMS Support: Pediatric homicide calls are emotionally intense; responders need peer and mental health resources.
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Coordination: Better integration between EMS, law enforcement, schools, and child protective services.
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What we are doing does work. Trends over times show that our efforts are not in vain. From Nathan Malan:
It’s important to keep perspective: over the past 25 years, Utah has seen a significant decline in child deaths, largely due to reductions in unintentional injury deaths. The vast majority of these were motor vehicle and transportation-related deaths, which have decreased thanks to safer roads, vehicles, and improved public awareness. Other unintentional injury causes are more difficult to track, as the numbers fluctuate from year to year, but continued attention and prevention efforts remain critical.
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The Utah Child Fatality Review Board (CFRB) investigates every child death in the state to understand what happened and why. By examining medical records, EMS reports, law enforcement findings, and social services data, the Board identifies patterns and contributing factors. Based on these reviews, the CFRB issues evidence-based recommendations to improve child safety, prevent future deaths, and guide statewide policies and programs. Our leading causes of pediatric injury death; suicide, firearms, SUID, MVC, and homicide are largely preventable.
EMS providers play a critical role not only in lifesaving care but also in supporting families, educating communities, and connecting children to resources—Thank you!
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For additional guideline direction check out the UPTN website or the new app, “Utah PTN” on android and apple devices.
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Fatality Review Teams and State Title V Programs
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CME credit for this issue
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Training officers may review the topic above as a team training AND perform a simulation/skills check as directed. Once complete, send a roster of participants to Utah.PETOS@gmail.com and those listed will be issued 1-hour of CME credit from the Bureau of EMS, DPS.
Individuals can get CME credit on their own by viewing a PETOS presentation in our archives and completing the instructions on the webpage.
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Skills checking
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Review the newsletter content with your team.
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Discuss the Deep Dive
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Review your agency policy and process for calling a case in the field.
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Discuss evidence collection/ preservation
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Safety Alert: Broselow Pediatric Emergency Rainbow Tape recall
The FDA has issued its most serious type of recall for certain Broselow Pediatric Emergency Rainbow Tapes due to labeling errors that could cause dosing mistakes. The recall involves removing affected devices from where they are used or sold. Continued use of these tapes may cause serious injury or death. Organizations should review the recall notice, check all inventory, and replace any impacted products immediately. Read the recall notice.
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EMSC Pulse
National EMSC has a newsletter filled with fantastic pediatric information, resources, and links. Check it out!
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Spread the Word
The Intermountain Primary Children’s Hospital – Taylorsville campus is open. It provides an alternative to the Emergency Department for a child or teen experiencing a behavioral health crisis. Check the flyer to know which children should be transported there.
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Hospital NPRP is right around the corner
We are excited to announce that the next National Pediatric Readiness Project (NPRP) assessment of Emergency Departments (EDs) across the U.S. is set to launch in March 2026, reflecting updated national guidelines and growing momentum in pediatric emergency care.
www.pediatricreadiness.org to start preparing today.
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Autism awareness training (agency and hospital)
If your agency is interested in the John Wilson Autism training or in receiving the free autism kits, contact Jeff Wilson, PM @jeffwilson122615@gmail.com.
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PECC development
For Utah hospital and EMS Agency PECCs
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Join us tomorrow: Webinar supporting PECCs starting pediatric disaster preparedness
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ENA passes resolution in support of PECCs
The Emergency Nurses Association (ENA) delegation voted overwhelmingly, 95% in favor, to adopt GA25-02A: Designation of a Nurse Pediatric Emergency Care Coordinator (PECC) in Every ED. The vote, held at ENA’s General Assembly in New Orleans last weekend, underscores ENA’s strong commitment to Pediatric Readiness and the essential role of PECCs. Pictured at right are the authors of the resolution (several of whom are members of the EMSC community), just after the vote.
PECCs ensure EDs are prepared to care for children by supporting policies, equipment, training, and quality improvement. Studies show that EDs with designated PECCs consistently achieve higher Pediatric Readiness scores. Learn more about PECCs.
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Understanding the PECC role
For hospital PECCs
For EMS PECCs
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PECC quarterly meeting
You will receive an invitation with the link through email. If you are a PECC and don’t receive this invitation, contact our program manager, Jared Wright jaredwright@utah.gov.
When?
Tuesday, November 18th, 2024, 10:00 AM
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Pediatric education from Utah EMSC
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Pediatric Emergency and Trauma Outreach Series (PETOS)
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PETOS (pediatric emergency and trauma outreach series)
This lecture provides 1 free CME credit from the Office of Emergency Medical Services, DPS for EMTs and Paramedics. The lectures are presented by physicians and pediatric experts from Primary Children’s Hospital. The format is informal; inviting questions and discussion.
Upcoming topics
Oct 13th, 2025 – Miguel Pineda – Eye Injuries
Nov 10th, 2025 – Courtney Lawrence – Pediatric Burn Injury
Dec 8th, 2025 – Matthew Steimle – Cardiac Emergencies
02:00 PM Mountain Time (US and Canada)
Join Zoom Meeting
https://zoom.us/j/98193757707?pwd=UzdNeXppQUdtZ01KZUp2UFlzRk9vdz09
Meeting ID: 981 9375 7707
Password: EmscPCH
Archived presentations can be viewed and also qualify for CME credits. You can access them at https://intermountainhealthcare.org/for-professionals/PETOS.
To obtain a completion certificate—follow the instructions on the website
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Emergency Pediatric Course – NAEMT
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Other pediatric education for all
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Teen to Adult Healthcare Transition Summit
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Intermountain Pediatric Emergency Care Conference (I-PECC)
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University of Utah Pediatrics ECHO 2025
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The Pediatrics ECHO is back! For those new to Pediatrics ECHO, you can earn CME for participating in a case-based learning session with experts in a variety of pediatric topics.
You can view previous session recordings and other programs on the Project ECHO page. CME is available for participation in these classes.
More Information
The University has an EMS education website.
When? Wednesdays 12 – 1 pm (MT)
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University of Utah Injury Prevention Learning Series
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Pediatric Injury Prevention Resources
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University of Utah’s EMS Trauma Grand Rounds
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Hospital-focused pediatric education
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Primary Children’s Pediatric Grand Rounds
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Offered every Thursday, September-May (currently on hiatus, archives available)
Offering both RN and MD CME
The pediatric grand rounds weekly lecture series covers cutting-edge research and practical clinical applications, for hospital and community-based pediatricians, registered nurses, and other physicians and practitioners who care for children of any age.
Every Thursday, 8 a.m. to 9 a.m. from September through May in the 3rd Floor Auditorium at Primary Children’s Hospital and at Lehi a broadcast will be held in the education center (1st floor in rooms 1 & 2).The lectures are also broadcast live to locations throughout Utah and nationwide. Click on this link to view the broadcast: https://www.youtube.com/channel/UCNQP-M_3-PdPDvnICr2Fjpg
Connect live
Click here for the PGR PCH YouTube channel to find the live broadcast. Archives (without continuing education credit) will be posted here within 1 week of the broadcast.
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Emergency Medical Services for Children Utah, Bureau of EMS, Department of Public Safety
The Emergency Medical Services for Children (EMSC) Program aims to ensure emergency medical care for the ill and injured child or adolescent is well integrated into an emergency medical service system.
Email: tdickson@utah.gov
Website: https://ems.utah.gov/
Phone: (801) 707-3763
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