Pediatric patients brought by emergency medical services to the emergency department

Sriram Ramgopal*, Selina Varma, Stephen Janofsky, Christian Martin-Gill, Jennifer R. Marin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)E791-E798
JournalPediatric emergency care
Volume38
Issue number2
DOIs
StatePublished - Feb 1 2022

Keywords

  • EMS
  • Emergency medical services
  • NHAMCS
  • Prehospital
  • Readiness

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

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