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Physician staffed emergency medical service for children: a retrospective population-based registry cohort study in Odense region, Southern Denmark.

Authors
  • Overgaard, Morten Føhrby1, 2
  • Heino, Anssi3
  • Andersen, Sofie Allerød4
  • Thomas, Owain5, 6
  • Holmén, Johan7
  • Mikkelsen, Søren4, 8, 9
  • 1 Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, Denmark [email protected] , (Denmark)
  • 2 Department of Anaesthesia and Intensive Care Medicine, The Hospital of South West Jutland, Esbjerg, Denmark. , (Denmark)
  • 3 Department of Perioperative Services, Intensive Care Medicine and Pain management, Turku University Hospital, Turku Finnish University Association, Turku, Finland. , (Finland)
  • 4 Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, Denmark. , (Denmark)
  • 5 Paediatric Anesthesia and Intensive Care, Skåne University Hospital Lund, Lund, Skåne, Sweden. , (Sweden)
  • 6 Institution of Clinical Sciences, Lund University, Lund, Sweden. , (Sweden)
  • 7 Pediatric Anesthesia and Intensive Care, Department of Prehospital and Emergency Care, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, Goteborg, Sweden. , (Sweden)
  • 8 Mobile Emergency Care Unit, Odense University Hospital, Odense, Denmark. , (Denmark)
  • 9 Department of Regional Health Research, University of Southern Denmark, Odense, Denmark. , (Denmark)
Type
Published Article
Journal
BMJ Open
Publisher
BMJ
Publication Date
Aug 13, 2020
Volume
10
Issue
8
Identifiers
DOI: 10.1136/bmjopen-2020-037567
PMID: 32792443
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of this study is to determine diagnostic patterns in the prehospital paediatric population, age distribution, the level of monitoring and the treatment initiated in the prehospital paediatric case. Hypothesis was that advanced prehospital interventions are rare in the paediatric patient population. We performed a retrospective population-based registry cohort study of children attended by a physician-staffed emergency medical service (EMS) unit (P-EMS), in the Odense area of Denmark during a 10-year study period. We screened 44 882 EMS contacts and included 5043 children. Patient characteristics, monitoring and interventions performed by the P-EMS crews were determined. We found that paediatric patients were a minority among patients attended by P-EMS units: 11.2% (10.9 to 11.5) (95% CI) of patients were children. The majority of the children were <5 years old; one-third being <2 years old. Respiratory problems, traffic accidents and febrile seizures were the three most common dispatch codes. Oxygen supplementation, intravenous access and application of a cervical collar were the three most common interventions. Oxygen saturation and heart rate were documented in more than half of the cases, but more than one-third of the children had no vital parameters documented. Only 22% of the children had respiratory rate, saturation, heart rate and blood pressure documented. Prehospital invasive procedures such as tracheal intubation (n=74), intraosseous access (n=22) and chest drainage (n=2) were infrequently performed. Prehospital paediatric contacts are uncommon, more frequently involving smaller children. Monitoring or at least documentation of basic vital parameters is infrequent and may be an area for improvement. Advanced and potentially life-saving prehospital interventions provide a dilemma since these likely occur too infrequently to allow service providers to maintain their technical skills working solely in the prehospital environment. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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