Prevalence of Low-Acuity Pediatric Emergency Medical Services Transports to a Pediatric Emergency Department in an Urban Area.
Pediatr Emerg Care
; 40(5): 347-352, 2024 May 01.
Article
en En
| MEDLINE
| ID: mdl-38355133
ABSTRACT
OBJECTIVES:
Many patients transported by Emergency Medical Services (EMS) do not have emergent resource needs. Estimates for the proportion of pediatric EMS calls for low-acuity complaints, and thus potential candidates for alternative dispositions, vary widely and are often based on physician judgment. A more accurate reference standard should include patient assessments, interventions, and dispositions. The objective of this study was to describe the prevalence and characteristics of low-acuity pediatric EMS calls in an urban area.METHODS:
This is a prospective observational study of children transported by EMS to a tertiary care pediatric emergency department. Patient acuity was defined using a novel composite measure that included physiologic assessments, resources used, and disposition. Bivariable and multivariable logistic regression were conducted to assess for factors associated with low-acuity status.RESULTS:
A total of 996 patients were enrolled, of whom 32.9% (95% confidence interval, 30.0-36.0) were low acuity. Most of the sample was Black, non-Hispanic with a mean age of 7 years. When compared with adolescents, children younger than 1 year were more likely to be low acuity (adjusted odds ratio, 3.1 [1.9-5.1]). Patients in a motor vehicle crash were also more likely to be low acuity (adjusted odds ratio, 2.4 [1.2-4.6]). All other variables, including race, insurance status, chief complaint, and dispatch time, were not associated with low-acuity status.CONCLUSIONS:
One third of pediatric patients transported to the pediatric emergency department by EMS in this urban area are for low-acuity complaints. Further research is needed to determine low-acuity rates in other jurisdictions and whether EMS providers can accurately identify low-acuity patients to develop alternative EMS disposition programs for children.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Población Urbana
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Servicios Médicos de Urgencia
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Servicio de Urgencia en Hospital
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Gravedad del Paciente
Tipo de estudio:
Observational_studies
/
Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Pediatr Emerg Care
/
Pediatr. emerg. care
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Pediatric emergency care
Asunto de la revista:
MEDICINA DE EMERGENCIA
/
PEDIATRIA
Año:
2024
Tipo del documento:
Article