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Paediatric prehospital emergencies and restrictions during the COVID-19 pandemic: a population-based study
Jelena Oulasvirta1,2, Jussi Pirneskoski2, Heini Harve-Rytsälä2
1Division of Anaesthesiology, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
The COVID-19 pandemic saw fewer children needing emergency medical services (EMS), but those who did were more severely ill. This indicates a concerning impact on pediatric emergency care during the pandemic.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Epidemiology
Background:
- Children are generally less vulnerable to severe COVID-19.
- Concerns exist regarding children as secondary victims of the pandemic and control measures.
- The study investigates the impact of the pandemic on pediatric prehospital emergency medical services (EMS).
Purpose of the Study:
- To analyze the effects of the COVID-19 pandemic and associated control measures on pediatric prehospital emergency medical services (EMS) contacts.
- To compare EMS utilization and characteristics in children during the pandemic versus pre-pandemic periods.
Main Methods:
- Population-based cohort study of children aged 0-15 years in the Helsinki University Hospital area.
- Comparison of data from March 1-May 31, 2020 (study period) with equivalent periods in 2017-2019 (control periods).
- Analysis included demographics, contact reasons, dispatch/transport priorities, interventions, and COVID-19 precautions.
Main Results:
- Paediatric EMS contacts decreased by 30.4%.
- Contacts were more frequently trauma-related and dispatched with higher urgency.
- Despite fewer transports, there was an increase in deaths during the study period compared to controls.
Conclusions:
- The number of paediatric EMS contacts significantly decreased during the pandemic.
- Children requiring EMS during the pandemic were more critically ill, suggesting delayed or missed care.
- The findings highlight a concerning trend in pediatric emergency care during the COVID-19 pandemic.
Background:
Children are less vulnerable to serious forms of the COVID-19 disease. However, concerns have been raised about children being the second victims of the pandemic and its control measures. Therefore, we wanted to study if the pandemic, the infection control measures and their consequences to the society projected to paediatric prehospital emergency medical services (EMS) contacts.
Methods:
We conducted a population-based cohort study concerning all children aged 0-15 years with EMS contacts in the Helsinki University Hospital area during 1 March 2020-31 May 2020 (study period) and equivalent periods in 2017-2019 (control periods). We analysed the demographic characteristics, time of EMS contact, reason for EMS contact, priority of the dispatch, reason for transportation, priority of transportation, if any consultations were made or additional units required, any medication or oxygen or fluids given, if intubation was performed, and whether paramedics took precautions when COVID-19 infection was suspected.
Results:
The number of paediatric EMS contacts decreased by 30.4% from mean of 1794 contacts to 1369 (p=0.003). The EMS contacts were more often due to trauma (+23.7%, p<0.05), dispatched in the most urgent category (+139.9%, p=0.001), additional help and the mobile intensive care unit were more frequently requested (+43.3%, p=0.040 and+46.3%, p=0.049, respectively). However, EMS contacts resulted less often in ambulance transport (-21.1%, p<0.001). Alarmingly, there were four deaths during the study period compared with 0-2 during the control periods.
Conclusions:
The number of EMS contacts decreased during the pandemic. Nevertheless, the children encountered by the EMS were more seriously ill than during the control periods.
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