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Prehospital paediatric emergencies in Belgium: an epidemiologic study
Laurent Houtekie1, Philippe Meert, Frédéric Thys
1Departments of aAcute Medicine bPediatrics, St-Luc University Hospital, Brussels, Belgium.
Insights
Belgian emergency medical services (EMS) rarely encounter life-threatening pediatric emergencies. While most children treated by EMS have medical conditions, advanced interventions are uncommon, and outcomes for critical cases remain poor.
Area of Science:
- Pediatric Emergency Medicine
- Emergency Medical Services (EMS)
- Public Health
Background:
- Emergency medical services in Belgium are regulated, with medical teams mandated in specific procedures.
- Data on pediatric involvement in emergency medical services within Belgium is limited.
- Understanding pediatric emergency cases is crucial for improving prehospital care.
Purpose of the Study:
- To analyze the characteristics of children treated by emergency medical services in Belgium.
- To identify common pathologies and specific needs of pediatric patients in prehospital settings.
- To inform the development of targeted emergency medical interventions for children.
Main Methods:
- Retrospective review of pediatric patients (<16 years) managed by an EMS team.
- Data collected over a two-year period (2010-2011).
- Analysis of patient demographics, medical conditions, diagnoses, and outcomes.
Main Results:
- 229 pediatric missions were conducted between 2010-2011.
- 76% of pediatric cases presented with medical conditions, with seizures (34.1%) being the most frequent diagnosis.
- Cardiac arrest occurred in 2.2% of cases, all resulting in fatalities; 26.6% required medication, and 43.2% were discharged from the emergency room.
Conclusions:
- Prehospital pediatric emergencies are infrequently life-threatening and rarely require advanced medical interventions.
- The outcomes for pediatric patients experiencing severe, life-threatening emergencies remain poor.
- There is a clear need for enhanced training for EMS teams to manage critical pediatric cases effectively.
Objectives:
In Belgium, emergency medical services (EMS) are staffed with a medical team if mandatory according to the regulation authority procedures. Children are involved in interventions, but no extensive data are available in the country. We analysed the characteristics of the children involved in EMS to gain better knowledge of the pathologies and the needs of these patients.
Materials And Methods:
A retrospective review of all patients under 16 years of age dealt with by our EMS team during a 2-year period.
Results:
During the 2010-2011 period, our EMS performed 229 paediatric missions. Most of the patients (76.0%) presented medical conditions. Seizure was the most common diagnosis (34.1%), including febrile convulsions in 55.1% of the cases. Five patients (2.2%) suffered a cardiac arrest. All of them died despite advanced life support. Two more patients died before or just after admission to the emergency room. In the subgroup of patients admitted to our hospital, 26.6% needed drug administration and 43.2% were discharged home after emergency room management.
Conclusion:
Prehospital paediatric emergencies are rarely life-threatening conditions and seldom need advanced medical interventions. However, the outcome of real life-threatening conditions is poor, therefore emphasizing the need for better trained teams.
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