There are six children's hospitals in Chicago, Illinois and the surrounding region. These hospitals often have bed limitations due to high censuses in daily operations. The Pediatric Committee of the Chicago Healthcare System Coalition for Preparedness and Response had provided two conferences in pediatric emergency preparedness in Spring 2010 that identified a need to examine scarce critical care resources in the region. A “Pediatric Critical Care and Transport Stakeholder's Summit” was convened in April 2010. This meeting brought together the Pediatric Critical Care Medical and Nursing Directors along with Transport Team representatives from major hospitals to identify the key issues related to pediatric emergency preparedness and scarce resources. The four-hour Summit, was held in a Conference Center, away from any hospital or clinical setting, was organized into seven sections: (1) Welcome & Introductions; (2) Issues Identification; (3) Scenario Introduction; (4) Specific Issues Indentification; (5) Prioritization of Specific Issues; (6) Development of Action Steps; and (7) Moving Forward. A Facilitator with specific knowledge of hospital-based preparedness led the Summit process. He utilized a pediatric scenario to engage the participants in discussion, interaction, and planning. Action steps, with statements of need and specific action items were developed, based on the following prioritized issues: (1) lack of pediatric training and experience for front line personnel; (2) alternate care sites/bed capacity/surge planning; (3) ethical issues; (4) transport; (5) credentialing/pediatric specialist availability; (6) incident command/community integration; (7) pediatric supplies and equipment; (8) patient indentification; (9) financial tracking/reimbursement; and (10) Crisis Standards of Care/Crisis Operation Standards Moving forward, the participants of the Summit will reconvene into small workgroups to develop plans and training for the areas specified above. In May, 2011 a statewide exercise utilizing the special population of children will occur to test these plans.