# Reducing Disparities for Children in Rural Emergency Resuscitation (RESCU-ER)

> **NIH NIH R01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2024 · $736,590

## Abstract

Summary
Mortality for infants is almost 2 times higher and for children 2.6 times higher in rural communities compared
with urban settings; little is known about what portion of these children interact with the Emergency Medical
Services (EMS) system. Data for rural health disparities currently come from vital statistics and suggest that
much of the excess rural mortality occurs in conditions that are common reasons for Emergency Medical
Services (EMS) dispatch. EMS providers provide scene response, resuscitation, stabilization, and transport for
a range of life-threatening conditions and the care they deliver is a critical link in the chain of survival. Our
research on EMS care in urban areas finds that more than half of out of hospital children's emergencies have
an adverse safety event (ASE) during the delivery of care, and the highest rates are seen in children with
cardiopulmonary arrest, trauma, respiratory distress, seizures, and births. Currently, it is not known if and to
what extent potentially modifiable factors occurring during EMS care contribute to disparities in mortality. This
project proposes to address this knowledge gap through the following aims: Aim 1: Conduct a comprehensive
comparative investigation into the epidemiology of disparities in rural child outcomes from life-threatening
emergencies to identify factors associated with improved outcomes & survival; Aim 2: Identify and characterize
ASEs that occur during EMS care and understand how modifiable and nonmodifiable factors magnify
or attenuate the effect of ASEs on outcomes; Aim 3: Test a new linear approach to cognitive aids to reduce
errors and promote high-quality EMS resuscitation for children. This research will be a substantive departure
from the status quo by leveraging big data approaches to move beyond high level outcome frequencies and
get to the source of what might be preventable through the health care delivery system. Errors are considered
an important source of preventable harm and potentially death. Completion of this project will result in: (i) a
novel population-based epistry on child mortality and morbidity and EMS response in rural and urban settings;
(ii) a conceptual framework of how errors contribute to preventable morbidity and mortality for rural and urban
children; and (iii) pilot data on the effectiveness of linear cognitive aids to improve the safety of EMS care and
potentially reduce disparities in rural and urban child morbidity and mortality.

## Key facts

- **NIH application ID:** 10885936
- **Project number:** 5R01HL141429-06
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** JEANNE-MARIE GUISE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $736,590
- **Award type:** 5
- **Project period:** 2018-04-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10885936

## Citation

> US National Institutes of Health, RePORTER application 10885936, Reducing Disparities for Children in Rural Emergency Resuscitation (RESCU-ER) (5R01HL141429-06). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10885936. Licensed CC0.

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