Use of emergency medical services by children with special health care needs

Area of Science:

• Pediatric Emergency Medicine
• Public Health Surveillance
• Healthcare Services Research

Background:

• Children with special health care needs (CSHCN) represent a vulnerable population requiring specific medical attention.
• Understanding the patterns of emergency medical services (EMS) utilization by CSHCN is crucial for optimizing prehospital care.
• Existing data on EMS responses for CSHCN are limited, particularly in urban settings.

Purpose of the Study:

• To characterize EMS responses for CSHCN in an urban area over a 12-month period.
• To compare EMS responses related to CSHCN with those unrelated to their specific health conditions.
• To inform the development of targeted EMS protocols for CSHCN.

Main Methods:

• A prospective surveillance system was implemented to identify and track EMS responses for individuals aged 21 years or younger with chronic health conditions.
• Data were collected on the nature of the EMS response, its relation to the child's special health care needs, and the outcome.
• Responses were categorized as related or unrelated to the child's known special health care needs.

Main Results:

• A total of 924 EMS responses involving CSHCN were recorded within one year.
• Less than half of the EMS responses were directly related to the child's special health care needs.
• Younger CSHCN were more likely to have EMS responses linked to their conditions; seizure disorders were common in related responses, while asthma predominated in unrelated ones. Approximately 58% of all responses led to hospital transport.

Conclusions:

• EMS responses for CSHCN exhibit distinct characteristics compared to non-related calls.
• The majority of CSHCN-related EMS incidents did not necessitate interventions beyond standard prehospital care.
• Findings provide valuable insights for communities aiming to enhance EMS delivery for CSHCN.