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Level of Comfort With Pediatric Trauma Transports: Survey of Prehospital Providers
Lilly Bayouth1, Lauren Edgar2, Brent Richardson2
1Department of Surgery, Brody School of Medicine, 3627East Carolina University, Greenville, NC, USA.
Insights
Pediatric trauma transport is challenging for prehospital providers, who report lower comfort levels and higher anxiety. Enhanced training and reference tools are recommended to improve care for critically injured children.
Area of Science:
- Emergency Medicine
- Pediatric Trauma Care
- Prehospital Services
Background:
- Unintentional injury is the leading cause of death in pediatric patients.
- Prehospital transport and triage of pediatric trauma patients lack standardization.
- Prehospital providers experience anxiety and low confidence in pediatric trauma care.
Purpose of the Study:
- To evaluate prehospital providers' comfort levels with pediatric versus adult trauma patient transport.
- To identify specific challenges and areas for improvement in pediatric trauma care.
- To assess the impact of experience and training on provider confidence.
Main Methods:
- Two web-based surveys were administered to prehospital transport providers (n=146).
- Comfort levels were assessed for tasks related to pediatric and adult trauma transport.
- Bivariate statistics and qualitative thematic analyses were used.
Main Results:
- Providers reported significantly lower comfort with pediatric trauma patients in key areas like airway management and interpreting pediatric physiology.
- Key themes included a need for more clinical knowledge, uncertainty in pediatric medication administration, and a desire for additional training.
- Infrequent transport of pediatric trauma patients and associated anxiety were significant factors affecting provider comfort.
Conclusions:
- Prehospital pediatric trauma transport is infrequent and a significant source of provider anxiety.
- There is a clear need for enhanced training and readily accessible reference tools for prehospital providers.
- Equipping transport vehicles with crucial reference tools can address deficiencies and improve care.
Background:
Unintentional injury is the leading cause of death in pediatric patients. Despite a heavy burden of pediatric trauma, prehospital transport and triage of pediatric trauma patients are not standardized. Prehospital providers report anxiety and a lack of confidence in transport, triage, and care of pediatric trauma patients.
Materials And Methods:
Prehospital transport providers with 3 organizations across southeast Georgia and northeast Florida were contacted via email (n = 146) and asked to complete 2 Web-based surveys to evaluate their comfort level with performing tasks in the transport of pediatric and adult trauma patients. Bivariate statistics and qualitative thematic analyses were performed to assess comfort with pediatric trauma transports.
Results:
Survey 1 (N = 35) showed that mean comfort levels of prehospital providers were significantly lower for pediatric patients than adult trauma patients in 7 out of 9 tasks queried, including airway management and interpreting children's physiology. The following themes emerged from survey 2 (N = 14) responses: additional clinical knowledge resources would be beneficial when caring for pediatric trauma patients, pediatric medication administration is a source of uncertainty, prehospital transport teams would benefit from additional pediatric trauma training, infrequent transport of pediatric trauma patients affects provider comfort level, and pediatric trauma generates higher levels of anxiety among providers.
Discussion:
Prehospital transport of pediatric trauma patients is infrequent and a source of anxiety for prehospital providers. Rigs should be equipped with a reference tool addressing crucial tasks and deficiencies in training.
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