Preferences for EMS transport and pediatric emergency department care

To characterize the reasons pediatric emergency department (PED), patients access emergency medical services (EMS) for transport to the pediatric ED. To describe the acceptability of other modes of transport and alternative sites of care.

We included a convenience sample of the responsible adults accompanying pediatric patients who arrived via EMS to the PED of an academic medical center. We administered a survey to evaluate why they chose EMS and their feelings about alternative modes of transport (e.g., medical van, taxi) or alternative sites of care (e.g., urgent care center, primary care physician's office, or getting an appointment within 24 hours).

One hundred thirty-eight surveys were completed. Pediatric patients averaged eight years of age. Trauma (44%) and seizures (17%) were the chief complaints. The primary reasons for EMS use were perceived medical necessity (54%) and security of transport by EMS (17%). Only transport by EMS was found to be acceptable. The responsible adults expressed acceptance of the PED (median=7, 1=not acceptable, 7=very acceptable) as a destination, more than their child's primary care doctor's (median=4), urgent care centers (median=3), or no transport and a physician appointment within 24 hours (median=1).

Adults access the EMS system for children because of concerns regarding the acuity of illness and for the security of EMS transport. They were generally uninterested in transport by any mode other than EMS. However, they would accept transport to alternative sites for immediate care.