Related Experiment Video
Updated: May 11, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Calling 911! What role does the pediatrician play?
Devin Grossman1, Sergey Kunkov, Carl Kaplan
1Lewis M. Fraad Department of Pediatrics (Emergency Medicine), Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. devin.grossman@stonybrookmedicine.edu
Insights
Caregivers calling a child's primary care provider (PCP) before emergency medical services (EMS) transport to a pediatric emergency department (PED) increased admission and intervention rates. This highlights the importance of PCP availability for telephone triage.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Primary Care
Background:
- Emergency Medical System (EMS) use for pediatric emergencies is common.
- The role of primary care provider (PCP) consultation before EMS utilization is not well-defined.
- Optimizing emergency care pathways is crucial for patient outcomes.
Purpose of the Study:
- To compare admission rates and medical interventions in children transported by EMS to a pediatric emergency department (PED).
- To evaluate the impact of caregiver consultation with the child's PCP prior to EMS activation.
- To assess the association between pre-EMS PCP contact and healthcare utilization.
Main Methods:
- Prospective cohort study of pediatric patients transported via EMS to an urban public hospital PED.
- Data collected on whether caregivers contacted the child's PCP before calling 911.
- Statistical analysis using chi-square tests and logistic regression to determine associations with medical interventions and hospital admission.
Main Results:
- Of 614 enrolled patients, 12.1% of caregivers called the PCP before EMS.
- Patients whose caregivers contacted the PCP were significantly more likely to receive medical interventions (15.2% vs. control) and be admitted (33.3% vs. control).
- Contacting the PCP was associated with a 3.2-fold increased likelihood of admission and 1.7-fold increased likelihood of medical intervention, adjusting for triage level.
Conclusions:
- Contacting a primary care provider before emergency medical services transport is linked to higher rates of pediatric hospital admission and medical intervention.
- The findings suggest that primary care providers play a role in influencing emergency care pathways.
- Enhanced primary care accessibility for telephone triage could potentially optimize the use of emergency medical services.
Objective:
The objective of this study was to compare admission rates and medical interventions among children whose caregivers called their child's primary care provider (PCP) before taking an ambulance to the pediatric emergency department (PED) versus those who did not.
Methods:
This was a prospective cohort study of patients brought to an urban, public hospital PED via emergency medical system (EMS). Children were included if the caregiver called 911 to have them transported via EMS and was present in the PED. The main variable was whether the child's PCP was called before EMS utilization. Study outcomes were medical interventions, such as intravenous line insertion or laboratory tests, and hospital admission. χ Test and logistic regression were used to evaluate the relationship of the main variable to the study outcomes.
Results:
Six hundred fourteen patients met inclusion criteria and were enrolled. Five hundred eighty-five patients (95.3%) were reported to have a PCP. Seventy-four caregivers (12.1%) called their child's PCP before calling EMS. Two hundred seventy-seven patients (45.1%) had medical interventions performed; of these, 42 (15.2%) called their PCP (P = 0.03). Forty-two patients (6.8%) were admitted; among these, 14 (33.3%) called their PCP (P < 0.01). Adjusting for triage level, patients whose caregiver called the PCP before calling EMS were 3.2 times (95% confidence interval, 1.9-5.2 times) more likely to be admitted and 1.7 times (95% confidence interval, 1.1-2.9 times) more likely to have a medical intervention compared with patients whose caregivers did not call their child's PCP.
Conclusions:
Children were more likely to be admitted or require a medical intervention if their caregiver called their PCP before calling EMS. The availability of a PCP for telephone triage may help to optimize EMS utilization.
Related Concept Videos
01:21Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution itself.
01:21Cardiopulmonary Resuscitation I: Adult
01:17Ethical Dilemmas I
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...
01:30Ethical Dilemmas II
01:23Cardiopulmonary Resuscitation III: AED Use
01:18Interdisciplinary Care: The Health Care Team-II
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...