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Pediatric pre-hospital emergencies in Belgium: a 2-year national descriptive study
Pierre Demaret1,2, Frédéric Lebrun3,4, Philippe Devos5
1Division of pediatric critical care medicine, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium. pierre.demaret@chc.be.
Insights
Pediatric physician-staffed emergency medical services (EMS) missions are infrequent and distinct from adult cases. Understanding these pediatric emergency differences helps EMS teams better prepare for critically ill children.
Area of Science:
- Emergency Medicine
- Pediatrics
- Public Health
Background:
- Pediatric and adult emergencies exhibit distinct characteristics.
- Pediatric life-threatening emergencies are infrequent.
- This study presents the first European national cohort analysis of pediatric physician-staffed EMS missions, comparing them to adult missions.
Purpose of the Study:
- To describe pediatric physician-staffed EMS missions nationally.
- To compare pediatric EMS interventions with adult missions.
- To inform EMS teams about pediatric emergency specifics for improved pre-hospital care.
Main Methods:
- Analysis of a national database of 254,812 EMS interventions.
- Inclusion of 15,294 pediatric emergencies (6%).
- Comparison of treatment modalities and diagnoses between pediatric and adult patients.
Main Results:
- Pediatric patients received intravenous infusions less often (52.7% vs 77.1%) but had higher intra-osseous access rates (1.3% vs 0.8%).
- Therapeutic immobilization was more common in children (16.3% vs 13.2%).
- Neurological problems (32.4%) and trauma (27.1%) were more prevalent in children, with age-dependent diagnosis patterns.
Conclusions:
- Pre-hospital pediatric EMS missions are infrequent and differ significantly from adult interventions.
- Key pediatric characteristics, including higher rates of neurological issues and trauma, require specific EMS approaches.
- This data aids EMS teams in enhancing preparedness for pediatric emergencies.
Unlabelled:
This study aims to describe the pediatric physician-staffed EMS missions at a national level and to compare the pediatric and the adult EMS missions. Using a national database, we analyzed 254,812 interventions including 15,294 (6 %) pediatric emergencies. Less children than adults received an intravenous infusion (52.7 versus 77.1 %, p < 0.001), but the intra-osseous access was used more frequently in children (1.3 versus 0.8 %, p < 0.001). More children than adults benefited from a therapeutic immobilization (16.3 versus 13.2 %, p < 0.001). Endotracheal intubation was rare in children (2.1 %) as well as cardiopulmonary resuscitation (1.2 %). Children were more likely than adults to suffer from a neurological problem (32.4 versus 21.3 %, p < 0.001) or from a trauma (27.1 versus 16.8 %, p < 0.001). The prevalence of the pediatric diagnoses showed an age dependency: the respiratory problems were more prevalent in infants (40.3 % of the 0-12-months old), 52.1 % of the 1-4-year-old children suffered from a neurological problem, and the prevalence of trauma raised from 14.8 % of the infants to 47.1 % of the 11-15 year olds.
Conclusion:
Pre-hospital pediatric EMS missions are not frequent and differ from the adult interventions. The pediatric characteristics highlighted in this study should help EMS teams to be better prepared to deal with sick children in the pre-hospital setting.
What Is Known:
• Pediatric and adult emergencies differ. • Pediatric life-threatening emergencies are not frequent. What is New: • This study is the first to describe a European national cohort of pediatric physician-staffed EMS missions and to compare the pediatric and the adult missions at a national level. • This large cohort study confirms scarce regional data indicating that pediatric pre-hospital emergencies are not frequent and mostly non-life-threatening.
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