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Characteristics of the pediatric patients treated by the Pediatric Emergency Care Applied Research Network's
E Brooke Lerner1, Peter S Dayan, Kathleen Brown
1from the Department of Emergency Medicine, Medical College of Wisconsin , Milwaukee, Wisconsin (EBL) , Department of Pediatrics, Columbia University College of Physicians and Surgeons, The New York Presbyterian -Morgan Stanley Children's Hospital , New York, New York (PSD, MK) , Departments of Pediatrics and Emergency Medicine, George Washington School of Medicine, Children's National Medical Center , Washington, DC (KB) , Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago, Illinois (SF) , Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital , St. Louis, Missouri (JL) , Departments of Emergency Medicine, University of Michigan and Hurley Medical Center , Flint, Michigan (DB) , Department of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati , Ohio (LB) , Division of Emergency Medicine, Michigan State University College of Human Medicine, Helen DeVos Children's Hospital , Grand Rapids, Michigan (JDH) , Department of Pediatrics, Division of Emergency Medicine, State University of New York at Buffalo, Women and Children's Hospital of Buffalo , Buffalo, New York (KL) , Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School , Boston, Massachusetts (LEN) , Departments of Pediatrics and Emergency Medicine, Children's Hospital of Michigan , Detroit, Michigan (PM) , Departments of Emergency Medicine and Pediatrics, University of Michigan Health System , Ann Arbor, Michigan (AR) , Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine , Cincinnati, Ohio (HS) , Department of Pediatrics, University of Utah School of Medicine , Salt Lake City, Utah (JS) , Section of Transport Medicine, The Children's Hospital of Philadelphia, Department of Pediatrics, University
Insights
Aggregating pediatric emergency medical service (EMS) data across diverse agencies proved challenging due to variable methods and missing information. Few pediatric EMS patients received prehospital medications or interventions.
Area of Science:
- Pediatric Emergency Medicine
- Emergency Medical Services (EMS)
- Health Informatics
Background:
- Pediatric emergency care relies on data from various emergency medical service (EMS) agencies.
- Standardizing data collection and aggregation across these diverse agencies presents significant challenges.
Purpose of the Study:
- To characterize pediatric patients transported by the Pediatric Emergency Care Applied Research Network's (PECARN) affiliated EMS agencies.
- To describe the process of submitting and aggregating patient care data from multiple, diverse EMS agencies.
Main Methods:
- Retrospective analysis of electronic patient care data from PECARN partner EMS agencies (2004-2006).
- Data aggregated by recoding variables into categories and summarized using descriptive statistics.
- Analysis focused on variables with usable data submitted by a majority of participating agencies.
Main Results:
- Fourteen of sixteen participating EMS agencies submitted data, representing 514,880 pediatric transports.
- Common chief complaints included traumatic injury (28%), general illness (10%), and respiratory distress (9%).
- A small proportion of pediatric patients received prehospital medications or interventions (e.g., vascular access 14%, asthma medication 3%).
Conclusions:
- Data aggregation across diverse EMS agencies is challenging due to variable data collection methods and missing data.
- Despite electronic database advancements, consistent data submission remains an obstacle.
- The study highlights that a limited number of pediatric EMS patients require advanced prehospital interventions.
Objective:
To describe pediatric patients transported by the Pediatric Emergency Care Applied Research Network's (PECARN's) affiliated emergency medical service (EMS) agencies and the process of submitting and aggregating data from diverse agencies.
Methods:
We conducted a retrospective analysis of electronic patient care data from PECARN's partner EMS agencies. Data were collected on all EMS runs for patients less than 19 years old treated between 2004 and 2006. We conducted analyses only for variables with usable data submitted by a majority of participating agencies. The investigators aggregated data between study sites by recoding it into categories and then summarized it using descriptive statistics.
Results:
Sixteen EMS agencies agreed to participate. Fourteen agencies (88%) across 11 states were able to submit patient data. Two of these agencies were helicopter agencies (HEMS). Mean time to data submission was 378 days (SD 175). For the 12 ground EMS agencies that submitted data, there were 514,880 transports, with a mean patient age of 9.6 years (SD 6.4); 53% were male, and 48% were treated by advanced life support (ALS) providers. Twenty-two variables were aggregated and analyzed, but not all agencies were able to submit all analyzed variables and for most variables there were missing data. Based on the available data, median response time was 6 minutes (IQR: 4-9), scene time 15 minutes (IQR: 11-21), and transport time 9 minutes (IQR: 6-13). The most common chief complaints were traumatic injury (28%), general illness (10%), and respiratory distress (9%). Vascular access was obtained for 14% of patients, 3% received asthma medication, <1% pain medication, <1% assisted ventilation, <1% seizure medication, <1% an advanced airway, and <1% CPR. Respiratory rate, pulse, systolic blood pressure, and GCS were categorized by age and the majority of children were in the normal range except for systolic blood pressure in those under one year old.
Conclusions:
Despite advances in data definitions and increased use of electronic databases nationally, data aggregation across EMS agencies was challenging, in part due to variable data collection methods and missing data. In our sample, only a small proportion of pediatric EMS patients required prehospital medications or interventions.
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