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Comparison of Outcomes for Emergency Medical Services-Transported Infants With Suspected Brief Resolved Unexplained
Jake Toy1,2,3,4, Rishi Bhargava5, Calvin G Lowe6
1Harbor-UCLA Medical Center Department of Emergency Medicine.
Insights
Care for infants with brief resolved unexplained events (BRUEs) remained consistent during the COVID-19 pandemic. Emergency medical services transports increased before the pandemic and then stabilized.
Area of Science:
- Pediatrics
- Emergency Medicine
- Public Health
Background:
- The coronavirus disease 2019 (COVID-19) pandemic and subsequent stay-at-home mandates significantly altered healthcare delivery.
- Understanding the impact on pediatric emergency care, particularly for conditions like brief resolved unexplained events (BRUEs), is crucial.
- This study examines changes in care-seeking behavior, delivery, and outcomes for infants with suspected BRUEs pre- and post-pandemic onset.
Purpose of the Study:
- To compare care-seeking behavior, care delivery, and outcomes for infants with suspected BRUEs before and after the COVID-19 pandemic.
- To analyze trends in emergency medical services (EMS) transports and hospital admissions for BRUE infants.
- To assess the impact of the pandemic on clinical management and patient outcomes for this pediatric population.
Main Methods:
- Multicenter, retrospective observational study of EMS-treated infants (≤12 months) with a primary paramedic impression of BRUE.
- Data collected on interventions, management, transports, and admissions for two periods: pre-pandemic (April 2019-February 2020) and post-pandemic (April 2020-February 2021).
- Longitudinal trends (July 2017-February 2021) analyzed using descriptive statistics and interrupted time series modeling.
Main Results:
- No significant differences observed in infant demographics or presentations before and after the pandemic onset.
- A notable increase in EMS transports for suspected BRUE infants occurred pre-pandemic, followed by a plateau post-pandemic.
- Hospital admission rates for infants with suspected BRUE remained consistent between the pre- and post-pandemic periods.
Conclusions:
- Care-seeking behavior and hospital admission rates for infants with suspected BRUE, treated by EMS, were similar before and after the COVID-19 pandemic.
- A pre-pandemic rise in EMS transports for BRUE infants was followed by stabilization after the pandemic's onset and stay-at-home mandates.
- The findings suggest resilience in the emergency care system for managing BRUE infants during the pandemic.
Objectives:
This study compares care-seeking behavior, care delivery, and outcomes for infants with suspected brief resolved unexplained events (BRUEs) who were treated by emergency medical services (EMS) and emergency department clinicians before and after the onset of the coronavirus disease 2019 (COVID-19) pandemic and stay-at-home mandates.
Methods:
This multicenter, retrospective observational study uses prehospital and hospital data on EMS-treated infants (age ≤12 months) with a primary paramedic impression of BRUE. We evaluated interventions, management, and outcomes, including transports and admissions, before (April 2019 to February 2020) and after (April 2020 to February 2021) the start of the pandemic and stay-at-home mandates in March 2020. We also characterized longitudinal trends in transports and hospital admissions for BRUE infants between July 2017 and February 2021. Data were analyzed using descriptive statistics and interrupted time series modeling.
Results:
There were no significant differences in demographic characteristics or infant presentations before and after the beginning of the pandemic and stay-at-home mandates. We noted an increase in transports during the before period, but transports plateaued in the after period. There was no significant difference in admissions between the before and after periods.
Conclusions:
For EMS-treated infants with paramedic-suspected BRUE, presentations and hospital admissions were similar before and after the beginning of the COVID-19 pandemic and stay-at-home mandates. There was a longitudinal increase in EMS transports for infants with suspected BRUE before the COVID-19 pandemic and stay-at-home mandates, which then leveled off in the after period.
