Related Experiment Videos
Prehospital interventions in children
E J Reisdorff1, K A Howell, J Saul
1Michigan State University Emergency Medicine Residency, Lansing, USA.
Insights
Pediatric emergency medical services (EMS) interventions were analyzed, finding advanced procedures were rare. Children receiving interventions were older and required longer on-scene times.
Area of Science:
- Emergency Medicine
- Pediatric Care
- Prehospital Services
Background:
- Skill maintenance in emergency medical services (EMS) relies on frequent procedure performance.
- Characterizing pediatric prehospital interventions is crucial for understanding care delivery.
Purpose of the Study:
- To determine the frequency and types of basic and advanced prehospital interventions performed on children.
- To analyze factors associated with intervention delivery in pediatric emergency care.
Main Methods:
- A retrospective review of 535 emergency medical services (EMS) runs involving children in central Michigan over three months.
- Data collected included patient demographics, procedure types (basic and advanced), at-scene time, and total run time.
Main Results:
- Of 424 pediatric cases, 287 received interventions. Advanced procedures were performed on only 19.3% of children.
- Basic procedures included spinal immobilization and oxygen administration; advanced procedures included venous access and medication administration.
- Children receiving interventions were older and had significantly longer at-scene and total run times compared to those who did not.
Conclusions:
- Advanced prehospital procedures for children are infrequently performed.
- Opportunities for critical interventions like intubation were rare in this pediatric EMS population.
- Interventions in pediatric emergencies are associated with older children and extended prehospital times.
Objectives:
Frequently performing procedures assists in skill maintenance. This study was conducted to characterize frequency and types of basic and advanced prehospital interventions performed on children.
Methods:
A retrospective study was conducted over a three-month period from emergency medical services (EMS) units working in central Michigan. Data were collected for age, sex, at-scene time, total run time, basic procedures (e.g., spinal immobilization), and advanced procedures (e.g., venous access).
Results:
A total of 535 EMS runs were reviewed. Runs were excluded for transport refusal (105) and site-to-site transfer (6). Of the remaining 424 children, 287 received an intervention (group 1) and 137 did not (group 2). Group 1 (9.5 +/- 5.6 years) was older (p < 0.001) than group 2 (6.0 +/- 5.8 years). There was no gender predominance between group 1 and group 2 (p = 0.06). In group 1 there were 104 patients who received multiple procedures. Basic procedures (n = 382) included spinal immobilization (149), oxygen administration (123), splinting (27), wound care (24), use of military anti-shock trousers (4), and cardiopulmonary resuscitation (1). Advanced procedures (n = 112) included venous access (65), medications of all routes (26), and cardiacoximetry monitoring (21). No child had an intraosseous line started and no child was successfully intubated. Only 82 of the 424 children (19.3%) had an advanced procedure. Group 1 at-scene times (16.1 +/- 8.1 min) were longer (p < 0.001) than those of group 2 (11.1 +/- 6.6 min). Total run times for group 1 (35.7 +/- 15.5 min) were longer (p < 0.001) than those for group 2 (26.7 +/- 11.3 min).
Conclusions:
Advanced EMS procedures were performed on only 19.3% of children. Opportunities to perform critical interventions (e.g., intubation) were rarely present. Children receiving procedures were older and had longer scene and run times.