Calling 911! What role does the pediatrician play?

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.