Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-23T11:32:11.750Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of Pediatric EMS Practice: A Multistate Analysis

Published online by Cambridge University Press:  28 June 2012

Steven M. Joyce ,
Douglas E. Brown  and
Elizabeth A. Nelson
Steven M. Joyce*
Affiliation:
Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah
Douglas E. Brown
Affiliation:
EMS Data Systems Inc., Phoenix, Arizona
Elizabeth A. Nelson
Affiliation:
EMS Data Systems Inc., Phoenix, Arizona
*
Division of Emergency Medicine, University of Utah School of Medicine, 75 North Medical Drive, 1150 Moran Eye Building, Salt Lake City, UT 84132, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To describe the epidemiology of pediatric emergency medical services (EMS) practice in a large patient population from several geographic areas.

Design:

Retrospective computer analysis of EMS databases from four states using a common data set and analysis system.

Setting:

Pennsylvania, Tennessee, Mississippi, and Nevada (except Clark County), 1990 through 1992.

Methods:

All patient-care reports of patients 14 years old and younger were extracted from the EMS databases and analyzed for the following factors: age, gender, date, elapsed pre-hospital times, incident type, mechanism of injury, call disposition, illness or injuries encountered, severity of illness/injury (by abnormal vital signs), and basic life support (BLS) and advanced life support (ALS) treatment delivered.

Results:

A total of 1,512,907 patient care reports were reviewed. Those of 61,132 children were extracted for analysis. These children comprised about 4% of prehospital responses. Male subjects predominated (56%), and children aged 7 through 14 years represented 46% of cases. Most calls occurred in the evening and daylight hours. Children were transported by ambulance in 89% of cases, and care was refused in 7.7%. Mean response time was 9±16 minutes, mean scene time 12±14 minutes, and mean transport time 14±20 minutes. Traumatic incidents predominated at 42%, with motor vehicle accidents and falls the most common mechanisms. Blunt injuries accounted for 94% of trauma, whereas respiratory problems, seizures, and poisoning/overdose were the most common medical problems. Vital signs were obtained in 56% of cases. Abnormal vital signs were noted in 21% of these, and the presumptive causes were similar in distribution to those of the general population, with the addition of cardiac arrest. The most commonly used treatments were spinal immobilization, oxygen administration, intravenous access and several ALS medications. An ALS capability was available in more than half the runs, but ALS treatment was delivered in only 14% of those cases. Outcome data were not available.

Conclusion:

This multistate analysis of pediatric EMS epidemiology confirms findings reported in smaller regional studies, with several exceptions. Excessive scene times were not noted. Few children had serious disorders as evidenced by abnormal vital signs. An ALS treatment, when available, was used infrequently. These findings have implications for EMS planners and educators.

Keywords

advanced life supportbasic life supportchildrendatabaseemergency medical servicesepidemiologypediatric
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 3 , September 1996 , pp. 180 - 187
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Seidel, JS, Hornbein, M, Yoshiyamak, , et al. : Emergency medical services and the pediatric patient: Are the needs being met? Pediatrics 1984;73:769–772.CrossRefGoogle ScholarPubMed
2. Seidel, JS, Henderson, DP, Ward, P, et al. : Pediatric prehospital care in urban and rural areas. Pediatrics 1991;88:681–690.CrossRefGoogle ScholarPubMed
3. Tsai, A, Kallsen, G: Epidemiology of pediatric prehospital care. Ann Emerg Med 1987;16:284–292.CrossRefGoogle ScholarPubMed
4. Johnston, C, King, WD: Pediatric prehospital care in a southern regional emergency medical service system. Southern Medical Journal 1988;81:1473–1476.CrossRefGoogle Scholar
5. Joyce, SM, Brown, D: An optically scanned EMS reporting and analysis system for statewide use: Development and five years’ experience. Ann Emerg Med 1991:20:1325–1330.CrossRefGoogle ScholarPubMed
6. American College of Surgeons: Advanced Trauma Life Support Course. Appendix B, American College of Surgeons, Chicago, 1989.Google Scholar
7. Ramenofsky, ML, Luterman, A, Curreri, PW, Talley, MA: EMS for pediatrics: Optimum treatment or unnecessary delay? J Pediatr Surg 1983:18:498–503.CrossRefGoogle ScholarPubMed
8. Gausche, M, Henderson, DP, Seidel, JS: Vital signs as part of the prehospital assessment of the pediatric patient: A survey of paramedics. Ann Emerg Med 1990;19:173–178.CrossRefGoogle Scholar
9. Luten, R, Foltin, G (eds.): Pediatric Resources for Prehospital Care. National Center for Education in Maternal and Child Health, Arlington, Va.: 1993.Google Scholar
10. Durch, JS, Lohr, KN (eds.): Institute of Medicine Committee on Pediatric Emergency Medical Services Recommendations. In: Emergency Medical Services for Children. Washington, DC: National Academy Press, 1993.Google Scholar
11. Dean, JM: Uniform Pre-Hospital Emergency Medical Services (EMS) Data Conference Summary Report. Springfield, VA: National Technical Information Service, 1994.Google Scholar
12. Rowe, PC (Ed): The Harriet Ijme Handbook, 11th Ed., Chicago: Year Book Medical Publishers, 1987Google Scholar
13. Jorden, RC: Multiple trauma. In: Rosen, F, Baker, FJ, Braen, GR, et al. (eds): Emergency Medicine, Concepts and Clinical Practice. 1st Ed, St. Louis: CV Mosby, 1983: pp 111–128.Google Scholar
14. Mayer, TA: Approach to the pediatric multiple trauma patient. In: Hawood-Nuss, A, Lindon, C, Luten, RC, et al. (eds): The Clinical Practice of Emergency Medicine. 1st Ed., Philadelphia: JB Lippincott, 1991;pp 800–814.Google Scholar