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Priorities for pediatric prehospital research
George L Foltin1, Peter Dayan, Michael Tunik
1Department of Pediatrics, Division of Pediatric Emergency Medicine, Bellevue Hospital Center, New York University School of Medicine, New York, NY, USA. gf16@nyu.edu
Insights
Emergency medical services (EMS) research for children is limited. The Pediatric Emergency Care Applied Research Network (PECARN) developed a prioritized research agenda for pediatric prehospital care, focusing on clinical and system topics.
Area of Science:
- Pediatric Emergency Medicine
- Prehospital Care Research
- Health Services Research
Background:
- Limited research exists on pediatric prehospital care, despite millions of US children annually receiving care from emergency medical services (EMS).
- The Pediatric Emergency Care Applied Research Network (PECARN) aims to advance high-quality research for children, including in the prehospital setting.
Framework:
- A 3-step consensus-driven process was employed to develop a pediatric-specific prehospital research agenda.
- Participants ranked and scored potential research priorities using a modified Hanlon method, assessing prevalence, seriousness, and practicality.
Implementation:
- Forty-two representatives from PECARN nodes, EMS agencies, and prehospital research fields participated.
- A revised priority list was presented at a PECARN EMS summit to achieve consensus.
Implications:
- Consensus was reached, yielding ranked lists of 15 clinical and 5 EMS system research topics.
- The identified priorities, including airway management, respiratory distress, and trauma, will guide future pediatric prehospital research within and beyond PECARN.
Unlabelled:
Up to 3 million US children are cared for by emergency medical services (EMSs) annually. Limited research exists on pediatric prehospital care. The Pediatric Emergency Care Applied Research Network (PECARN) mission is to perform high-quality research for children, including prehospital research. Our objective was to develop a pediatric-specific prehospital research agenda.
Methods:
Representatives from all 4 PECARN nodes and from EMS agency partners participated in a 3-step process. First, participants ranked potential research priorities and suggested others. Second, participants reranked the list in order of importance and scored each priority using a modified Hanlon method (prevalence, seriousness, and practicality of each research area were assessed). Finally, the revised priority list was presented at a PECARN EMS summit, and consensus was sought.
Results:
Forty-two representatives participated, including PECARN representatives, EMS agency leaders, and nationally recognized prehospital researchers. Consensus was reached on the priority ranking. The prioritization processes resulted in 2 ranked lists: 15 clinical topics and 5 EMS system topics. The top 10 clinical priorities included (1) airway management, (2) respiratory distress, (3) trauma, (4) asthma, (5) head trauma, (6) shock, (7) pain, (8) seizures, (9) respiratory arrest, and (10) C-spine immobilization. The 5 EMS system topics identify methods to improve prehospital care on the system level.
Conclusions:
PECARN has identified high-priority EMS research topics for children using a consensus-derived method. These research priorities include novel EMS system topics. The PECARN EMS pediatric research priority list will help focus future pediatric prehospital research both within and outside the network.
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