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Comprehensive children emergency receiving center (CCERC)
New Updated 10/2021


Child or Children: Defined to be under the age of 15 y/o


Comprehensive Children's Emergency Receiving Center (CCERC):  Emergency and referral center for children in Orange County

Pediatric Base Hospital:  CCERC designated by OCEMS for on-line medical control


Pediatric Resource Center:   Available for advisory children's issues over the phone to EMS personnel or Emergency Departments in Orange County

Transport Criteria:

1. A CCERC is the most appropriate, nearest emergency receiving center (ERC)

2. Child's parent or caretaker requests transport to a CCERC, and transport is reasonable

3. Child appears to be having an acute stroke or neurologic emergency

4. Child is an interfacilty transport from a health care facility or provider to a CCERC

CCERC Radio Contact Criteria:

CCERC contact is encouraged and appropriate at any time a paramedic determines there is a benefit to do so.

Respiratory Distress or labored breathing with:

  • Intercostal retractions

  • Nasal flaring with inspiration

  • Respiratory less than approximately 12/min or more than approximately 50/min

  • Cyanosis (lips and central face area)

  • Complaint of difficulty breathing by child who can communicate

  • Paramedic judgement


Circulatory compromise with:

  • Poor skin color (pallor, cyanosis)

  • Decreased capillary refill

  • Altered mental status or confusion

  • Mottling of skin

  • Pale lips or finger beds

  • Weak / thready pulse

  • Paramedic judgement

Pediatric patients identified in Standing Orders as requiring field treatment by EMS



Apparent Life-Threatening Event (ALTE

Brief Resolved Unexplained Event (BRUE


ALTE or BRUE are defined as an episode that occurs in a child 3 years old and younger that is frightening to the observer and is characterized by some combination of:

Children with any of the acute symptoms below:

  • Apnea episode

  • Color change (cyanosis, pallor, erythema) episode

  • Choking or gagging spontaneous, unrelated to food or fluid intake

Radio Contact Process:

  • When contacting OCC, the EMS personnel should request a CCERC for contact

  • If there is a need to contacting the Base Hospital in an MCI with children involved, contact should be make to the normal Base Hospital per agency

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