Emergency Department Arrival Modes: Time for Mandatory Pediatric Readiness

Area of Science:

• Emergency Medicine
• Pediatric Care
• Health Services Research

Background:

• Many children requiring emergency care access it via private transport, bypassing Emergency Medical Services (EMS).
• These transports may lead children to emergency departments (EDs) without confirmed pediatric readiness.
• This study examines private transport prevalence and its implications for pediatric emergency care.

Purpose of the Study:

• To quantify the proportion of pediatric patients arriving at EDs via private transport.
• To assess if arrival mode differs based on patient age, ED type, or disposition.
• To inform policy regarding mandatory pediatric readiness in all EDs.

Main Methods:

• Retrospective analysis of 2022 electronic health records from 3 general and 2 pediatric EDs.
• Data included patient age, ED type, arrival mode (EMS/police vs. private), and disposition.
• Patients categorized as small children (<10 years), large children (10-18 years), and young adults (19-40 years).

Main Results:

• Over 37,000 small children, 19,000 large children, and 68,000 young adults were included.
• Private transport was used by 96.1% of small children, 90.0% of large children, and 85.4% of young adults.
• Private transport was common even for admitted/transferred patients, irrespective of ED type.

Conclusions:

• Pediatric patients predominantly use private transport to reach EDs, regardless of condition severity or ED specialization.
• This underscores the critical need for all EDs to ensure pediatric competence.
• Emergency Medical Services and regulatory agencies must address this reality to ensure optimal pediatric care.