Pediatric Trauma Center Utilization for Children Transported by Emergency Medical Services

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Pediatric Critical Care

Background:

• Pediatric trauma is a major cause of death and disability in the US.
• Care at pediatric trauma centers (PTCs) improves outcomes for injured children.
• National transport patterns to PTCs for eligible children are not well understood.

Purpose of the Study:

• To evaluate emergency medical services (EMS) transport patterns for injured children meeting American College of Surgeons (ACS) trauma center criteria.
• To identify factors influencing transport to a PTC for these children.

Main Methods:

• Retrospective cohort study using the 2019-2022 National EMS Information System (NEMSIS) database.
• Included children (<16 years) meeting ACS field triage criteria.
• Assessed geographic access (60-minute ground transport) using GIS data and linked to transport outcomes via multivariable logistic regression.

Main Results:

• Of 97,985 children meeting trauma criteria, 56% had access to a PTC, but only 40.6% were transported there.
• Males and firearm injury patients were more likely to reach a PTC.
• Adolescents and rural/suburban patients were less likely to be transported to a PTC.

Conclusions:

• Less than half of eligible children with PTC access were transported to one, indicating suboptimal care.
• Interventions are crucial to increase appropriate PTC transport for pediatric trauma patients.
• Enhancing pediatric readiness at non-PTCs is also necessary to optimize care for injured children.