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Emergency medical services and the pediatric patient: are the needs being met?
Insights
Emergency medical services often overlook critically ill children, who represent 10% of paramedic calls. These children experience higher prehospital death rates, especially without access to pediatric centers, indicating unmet needs.
Area of Science:
- Pediatric Emergency Medicine
- Prehospital Care Systems
- Public Health
Background:
- Emergency medical systems (EMS) in the US primarily focus on adult conditions like myocardial infarction and trauma.
- Current EMS protocols frequently neglect the unique requirements of critically ill children.
- Pediatric patients constitute a significant portion of emergency medical calls, necessitating specialized care.
Purpose of the Study:
- To evaluate the adequacy of prehospital emergency medical care for critically ill children.
- To identify disparities in pediatric emergency care outcomes within Los Angeles County.
- To determine if existing EMS infrastructure meets the specific needs of pediatric patients.
Main Methods:
- Analysis of data from Los Angeles County Trauma Surveys.
- Review of Mobile Intensive Care Unit (MICU) Rescue Reports.
- Examination of Base Station Hospital records for pediatric emergency calls.
Main Results:
- Children account for approximately 10% of all paramedic calls in Los Angeles County.
- Pediatric patients exhibit a higher mortality rate in the prehospital setting compared to adults.
- Higher pediatric death rates correlate with areas lacking dedicated pediatric critical care centers.
- Secondary transfers of children from emergency departments to specialized centers are common.
Conclusions:
- The current prehospital emergency medical system inadequately addresses the needs of critically ill children.
- Geographic disparities in access to pediatric critical care centers impact prehospital outcomes.
- There is a critical need to enhance EMS protocols and resources for pediatric emergencies.
Abstract:
Emergency medical systems are being developed throughout the United States primarily to deal with myocardial infarction and trauma. These programs often fail to recognize the special needs of the critically ill child. Data collected in Los Angeles County from the LA County Trauma Surveys, Mobile Intensive Care Unit Rescue Reports, and Base Station Hospitals demonstrate that children represent approximately 10% of the paramedic calls. The calls are for medical problems as well as trauma. These data suggest that children have a higher death rate in the field than adults, and deaths occur more commonly in areas where there are no pediatric centers. Children are often secondarily transferred from emergency departments to other centers for definitive care. This study suggests that the needs of children in the prehospital setting are not being met.