Pediatric Patients Brought by Emergency Medical Services to the Emergency Department An Analysis From the National Hospital Ambulatory Medical Care Survey

被引:3
作者
Ramgopal, Sriram [1 ]
Varma, Selina [1 ]
Janofsky, Stephen [2 ]
Martin-Gill, Christian [3 ]
Marin, Jennifer R. [2 ,3 ]
机构
[1] Northwestern Univ, Ann & Robert H Lurie Childrens Hosp Chicago, Div Emergency Med, Feinberg Sch Med, Chicago, IL 60611 USA
[2] Univ Pittsburgh, Sch Med, Dept Pediat, Pittsburgh, PA 15261 USA
[3] Univ Pittsburgh, Sch Med, Dept Emergency Med, Pittsburgh, PA USA
关键词
emergency medical services; EMS; NHAMCS; prehospital; readiness; INTERHOSPITAL TRANSPORT; INTERFACILITY TRANSFERS; SECONDARY OVERTRIAGE; TRAUMA; EPIDEMIOLOGY; MANAGEMENT; CHILDREN;
D O I
10.1097/PEC.0000000000002355
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
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页码:E791 / E798
页数:8
相关论文
共 31 条
[1]  
Centers for Disease Control and Prevention, ICD ICD 10 CM INT CL
[2]  
Centers for Disease Control and Prevention, NAMCS NHAMCS REL EST
[3]  
Centers for Disease Control and Prevention National Center for Health Statistics, AMB HLTH CAR DAT
[4]   NHAMCS: Does It Hold Up to Scrutiny? [J].
Cooper, Richelle J. .
ANNALS OF EMERGENCY MEDICINE, 2012, 60 (06) :722-725
[5]   Emergency Medical Services Utilization by Children [J].
Dayal, Parul ;
Horeczko, Timothy ;
Wraa, Cheryl ;
Karsteadt, Larry ;
Chapman, Wendy ;
Bruhnke, Louis ;
Litman, Rebecca ;
Ruttan, Timothy ;
Kuppermann, Nathan ;
Marcin, James .
PEDIATRIC EMERGENCY CARE, 2019, 35 (12) :846-851
[6]   Epidemiology of Pediatric Prehospital Basic Life Support Care in the United States [J].
Diggs, Leigh Ann ;
Sheth-Chandra, Manasi ;
De Leo, Gianluca .
PREHOSPITAL EMERGENCY CARE, 2016, 20 (02) :230-238
[7]   Interfacility Transfer of Pediatric Trauma Patients by Helicopter Does Not Predict the Need for Urgent Intervention [J].
Engbrecht, Brett W. ;
Hollenbeak, Christopher S. ;
Lubin, Jeffrey S. ;
Cilley, Robert E. .
PEDIATRIC EMERGENCY CARE, 2013, 29 (06) :729-736
[8]   Interhospital Pediatric Patient Transfers-Factors Influencing Rapid Disposition After Transfer [J].
Gattu, Rajender K. ;
Teshome, Getachew ;
Cai, Ling ;
Wright, Christian ;
Lichenstein, Richard .
PEDIATRIC EMERGENCY CARE, 2014, 30 (01) :26-30
[9]   Secondary Overtriage in Pediatric Trauma: Can Unnecessary Patient Transfers Be Avoided? [J].
Goldstein, Seth D. ;
Van Arendonk, Kyle ;
Aboagye, Jonathan K. ;
Salazar, Jose H. ;
Michailidou, Maria ;
Ziegfeld, Susan ;
Lukish, Jeffrey ;
Stewart, F. Dylan ;
Haut, Elliott R. ;
Abdullah, Fizan .
JOURNAL OF PEDIATRIC SURGERY, 2015, 50 (06) :1028-1031
[10]  
Hazinski MF., 2016, AM ACAD PEDIAT AM HE