TY - JOUR
T1 - Pediatric patients brought by emergency medical services to the emergency department
AU - Ramgopal, Sriram
AU - Varma, Selina
AU - Janofsky, Stephen
AU - Martin-Gill, Christian
AU - Marin, Jennifer R.
N1 - Publisher Copyright:
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Background/Objective: To describe the epidemiology of emergency department (ED) visits by pediatric patients transported from the out-of-hospital setting (ie, scene) by emergency medical services (EMS), and identify factors associated with EMS transport. Methods: We performed a cross-sectional study of ED visits from 2014 to 2017 utilizing a nationally representative probability sample survey of visits to US EDs. We included pediatric patients (<18 years old) and compared encounters transported from the scene by EMS to those who arrived to the ED by all other means. We performed multivariable logistic regression to identify factors associated with scene EMS transport. Results: Of 130.2 million pediatric ED encounters, 4.7 million (3.8%) arrived by EMS. Most patients were White (61.1%), non-Hispanic (77.5%), and publicly insured (52.2%). Multivariable analysis demonstrated associations with EMS transport: Black (vs White) race (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.16–1.89), ages 1 to younger than 5 years (aOR, 0.52; 95% CI, 0.37–0.72) and 5 to younger than 12 years (aOR, 0.56; 95% CI, 0.40–0.80) (vs adolescents), pediatric (aOR, 0.60; 95% CI, 0.42–0.85) and nonmetropolitan hospital status (aOR, 0.52; 95% CI, 0.35–0.78), blood testing (aOR, 2.34; 95% CI, 1.71–3.19), time to evaluation (31–60 minutes [aOR, 0.56; 95% CI, 0.39–0.80] and >60 minutes [aOR, 0.51; 95% CI, 0.33–0.77] compared with 0–30 minutes), admission (aOR, 3.20; 95% CI, 2.33–4.38), and trauma (1.80; 95% CI, 1.43–2.28). Conclusions: Four percent of pediatric ED patients are transported to the ED by EMS from the scene. These patients receive a rapid and resource intense diagnostic evaluation, suggesting that higher acuity. Black patients, adolescents, and those with trauma were more likely to be transported by EMS.
AB - Background/Objective: To describe the epidemiology of emergency department (ED) visits by pediatric patients transported from the out-of-hospital setting (ie, scene) by emergency medical services (EMS), and identify factors associated with EMS transport. Methods: We performed a cross-sectional study of ED visits from 2014 to 2017 utilizing a nationally representative probability sample survey of visits to US EDs. We included pediatric patients (<18 years old) and compared encounters transported from the scene by EMS to those who arrived to the ED by all other means. We performed multivariable logistic regression to identify factors associated with scene EMS transport. Results: Of 130.2 million pediatric ED encounters, 4.7 million (3.8%) arrived by EMS. Most patients were White (61.1%), non-Hispanic (77.5%), and publicly insured (52.2%). Multivariable analysis demonstrated associations with EMS transport: Black (vs White) race (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.16–1.89), ages 1 to younger than 5 years (aOR, 0.52; 95% CI, 0.37–0.72) and 5 to younger than 12 years (aOR, 0.56; 95% CI, 0.40–0.80) (vs adolescents), pediatric (aOR, 0.60; 95% CI, 0.42–0.85) and nonmetropolitan hospital status (aOR, 0.52; 95% CI, 0.35–0.78), blood testing (aOR, 2.34; 95% CI, 1.71–3.19), time to evaluation (31–60 minutes [aOR, 0.56; 95% CI, 0.39–0.80] and >60 minutes [aOR, 0.51; 95% CI, 0.33–0.77] compared with 0–30 minutes), admission (aOR, 3.20; 95% CI, 2.33–4.38), and trauma (1.80; 95% CI, 1.43–2.28). Conclusions: Four percent of pediatric ED patients are transported to the ED by EMS from the scene. These patients receive a rapid and resource intense diagnostic evaluation, suggesting that higher acuity. Black patients, adolescents, and those with trauma were more likely to be transported by EMS.
KW - EMS
KW - Emergency medical services
KW - NHAMCS
KW - Prehospital
KW - Readiness
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U2 - 10.1097/PEC.0000000000002355
DO - 10.1097/PEC.0000000000002355
M3 - Article
C2 - 35100778
AN - SCOPUS:85123973121
SN - 0749-5161
VL - 38
SP - E791-E798
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 2
ER -