Pre-hospital care for children: a descriptive study from Central Norway

Pre-hospital incidents involving pediatric and neonatal patients are infrequent, and clinical characteristics and care for these patients differ from the adult population. Lack of knowledge, guidelines, and experience can make pre-hospital pediatric care challenging, and there is limited research on the epidemiology and best practice of care for this population. We examined the pre-hospital pediatric population in the county of Sør-Trøndelag, Norway, to improve our understanding of this population in our region.

We conducted a retrospective observational cohort study of emergency incidents involving children under twelve years of age with dispatch of Emergency Medical Services (EMS) in Sør-Trøndelag between 2018 and 2022. Incidents and patient characteristics were extracted from the Emergency Medical Communication Center (EMCC) database. In addition, data on patient characteristics and interventions for more serious incidents seen by the Helicopter Emergency Medical Service (HEMS) were included from the database LABAS. We provided descriptive statistics and estimated population incidences using Poisson regression.

The catchment area of EMCC Sør-Trøndelag has a population of approximately 43,000 children under the age of twelve years. During the five-year study period, there were 7005 emergency calls concerning this patient population, representing 6% of all emergency calls (total no. 108,717). Of these, 3500 (50%) resulted in the dispatch of an ambulance and/or HEMS, yielding an annual incidence of EMS dispatches of 17 per 1000 children. The three most common primary medical problems were respiratory distress, altered consciousness, and trauma. Among the 309 HEMS patients, 131 (42%) received advanced interventions from the HEMS physician. Assisted ventilation was the most frequent intervention.

Pediatric and neonatal patients make up a small proportion of pre-hospital patient dispatches in Sør-Trøndelag. Consequently, each EMS provider infrequently encounters children in the pre-hospital environment, resulting in less experience with pediatric advanced medical interventions. This study identifies some clinical characteristics and interventions regarding pediatric and neonatal patients that have been pointed out as focus areas for pediatric pre-hospital research.