Related Experiment Video
Updated: May 27, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Critical interventions, diagnosis, and mortality in children treated by a physician-manned mobile emergency care unit
Alexandra Claire McKenzie1,2, Mads Belger Risom1,2, Jens-Jakob Kjer Møller3
1The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark.
Insights
Physician-manned mobile emergency care units (MECU) rarely perform critical interventions in children under seven. This low frequency of pediatric emergency interventions may impact prehospital care providers' clinical skills.
Area of Science:
- Pediatric Emergency Medicine
- Prehospital Care
- Mobile Emergency Care Units
Background:
- Physician-manned mobile emergency care units (MECU) provide critical care.
- Understanding interventions in pediatric emergencies is vital for patient outcomes.
Purpose of the Study:
- To analyze critical interventions performed by MECU on children under seven.
- To investigate the relationship between interventions, morbidity, and mortality in pediatric emergencies.
Main Methods:
- Retrospective cohort study of MECU missions involving children under seven (October 2007 - December 2020).
- Data from MECU Odense, Danish National Patient Registry, and Danish Civil Registration System.
- Analysis of critical interventions, injury/illness severity, on-scene time, diagnoses, and mortality (7, 30, 90 days).
Main Results:
- MECU performed 4,032 missions for children under seven; 2.2% received critical interventions.
- Most common interventions included airway suction (1.0%), endotracheal intubation (0.9%), and intraosseous access (0.5%).
- Overall 7, 30, and 90-day mortality rates were 0.74%, 0.82%, and 1.02%, respectively.
Conclusions:
- Critical prehospital interventions are infrequently required for children under seven.
- The low incidence of these procedures may affect prehospital care providers' proficiency.
Background:
The purpose of this study was to clarify the potentially life-saving critical interventions performed on children below the age of seven by the physician-manned mobile emergency care unit (MECU) in Odense, Denmark. We investigated critical interventions in relation to morbidity and mortality.
Methods:
A retrospective cohort study of all MECU missions involving children below the age of seven. The study period was from October 1 2007 to December 31 2020. Data sources were the MECU Odense database, the Danish National Patient Registry, and the Danish Civil Registration System. Variables were critical interventions, the severity of injury/illness, MECU on-scene time, in-hospital diagnosis and 7-day, 30-day, and 90-day mortality.
Results:
The MECU carried out 4,032 missions to children below 7 years. 88 patients (2.2%) received at least one critical prehospital intervention. Upper airway suction was performed in 39 cases (1.0%), endotracheal intubation (all causes) in 36 cases (0.9%), and intraosseous access in 21 cases (0.5%). General anaesthesia was induced in 29 cases (0.7%). Seventeen patients (0.4%) received cardiopulmonary resuscitation and two patients received manual defibrillation (< 0.1%). 3,278 patients were admitted to the hospital and assigned a diagnosis when discharged. The most common diagnoses were assigned within the International Statistical Classification of Diseases and Related Health Problems 10th Revision Chapter XVIII (Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified), which includes febrile convulsions. 1,437 patients (43.8%) were assigned diagnoses within this diagnosis group. The overall 7-day mortality in the cohort was 0.74%, 30-day mortality was 0.82%, and 90-day mortality was 1.02%.
Conclusion:
Prehospital critical interventions are rarely performed in children under the age of 7 years. The low frequency of these interventions may have implications for maintaining the clinical routine of the prehospital care providers.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:30Preventive Healthcare Services
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...