AGAC-NPs Caring for Pediatric Trauma Patients

Situation: The trauma team at Nebraska Medicine provides care for patients with traumatic injuries throughout the lifespan (neonate to the elderly). Our team consists of faculty physicians, advance practice providers (APPs), fellows, residents, and support staff working in collaboration.


Background: APPs on the trauma team include physician assistants (PAs) and nurse practitioners (NPs) with various professional certifications. Specifically, NPs may have Adult Gerontology Acute Care (AGAC-NP), Acute Care Nurse Practitioner (ACNP) or Family Nurse Practitioner (FNP) certification. AGACNP and ACNP scope of practice is generally recognized to be from adolescence into adulthood. FNP scope of practice includes pediatric patients.


Assessment: Based on discussion with experts, the DHHS Nursing Practice Consultant and the DHHS Nursing Program Manager, NMC nursing leadership and ACS/trauma APP leadership, experts from DHHS provided the following feedback: The Nebraska Nurse Practice Act is intentionally vague to allow for flexibility in emergent situations. In an emergent situation, the AGAC-NP should do whatever is necessary to stabilize the patient until a pediatric-trained provider is available. Additionally, the DHHS experts emphasized that the person who is (1) available and (2) most qualified to care for the pediatric trauma patient should do so.


Recommendation: It is acceptable for NPs with AGAC-NP or ACNP certification (without FNP or pediatric NP certification) to stabilize a pediatric patient until a pediatric-trained provider is available. If a pediatric trained provider and an adult-only trained NP are working together, the pediatric-trained provider should assume care of a pediatric patient as soon as possible.

Approved on 1/15/2026 by Kelly Vaughn.