Joyce S M, Brown D E, Nelson E A
Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City 84132, USA.
Prehosp Disaster Med. 1996 Jul-Sep;11(3):180-7. doi: 10.1017/s1049023x00042928.
To describe the epidemiology of pediatric emergency medical services (EMS) practice in a large patient population from several geographic areas.
Retrospective computer analysis of EMS databases from four states using a common data set and analysis system.
Pennsylvania, Tennessee, Mississippi, and Nevada (except Clark County), 1990 through 1992.
All patient-care reports of patients 14 years old and younger were extracted from the EMS databases and analyzed for the following factors: age, gender, date, elapsed prehospital times, incident type, mechanism of injury, call disposition, illness or injuries encountered, severity of illness/injury (by abnormal vital signs), and basic life support (BLS) and advanced life support (ALS) treatment delivered.
A total of 1,512,907 patient care reports were reviewed. Those of 61,132 children were extracted for analysis. These children comprised about 4% of prehospital responses. Male subjects predominated (56%), and children aged 7 through 14 years represented 46% of cases. Most calls occurred in the evening and daylight hours. Children were transported by ambulance in 89% of cases, and care was refused in 7.7%. Mean response time was 9 +/- 16 minutes, mean scene time 12 +/- 14 minutes, and mean transport time 14 +/- 20 minutes. Traumatic incidents predominated at 42%, with motor vehicle accidents and falls the most common mechanisms. Blunt injuries accounted for 94% of trauma, whereas respiratory problems, seizures, and poisoning/overdose were the most common medical problems. Vital signs were obtained in 56% of cases. Abnormal vital signs were noted in 21% of these, and the presumptive causes were similar in distribution to those of the general population, with the addition of cardiac arrest. The most commonly used treatments were spinal immobilization, oxygen administration, intravenous access and several ALS medications. An ALS capability was available in more than half the runs, but ALS treatment was delivered in only 14% of those cases. Outcome data were not available.
This multistate analysis of pediatric EMS epidemiology confirms findings reported in smaller regional studies, with several exceptions. Excessive scene times were not noted. Few children had serious disorders as evidenced by abnormal vital signs. An ALS treatment, when available, was used infrequently. These findings have implications for EMS planners and educators.
描述来自多个地理区域的大量患者群体中儿科急诊医疗服务（EMS）的流行病学情况。
使用通用数据集和分析系统对四个州的EMS数据库进行回顾性计算机分析。
宾夕法尼亚州、田纳西州、密西西比州和内华达州（克拉克县除外），1990年至1992年。
从EMS数据库中提取所有14岁及以下患者的医疗护理报告，并分析以下因素：年龄、性别、日期、院前时间、事件类型、受伤机制、呼叫处置情况、所遇到的疾病或损伤、疾病/损伤严重程度（通过异常生命体征判断）以及所提供的基础生命支持（BLS）和高级生命支持（ALS）治疗。
共审查了1,512,907份患者医疗护理报告。提取了61,132名儿童的报告进行分析。这些儿童约占院前急救响应的4%。男性占主导（56%），7至14岁的儿童占病例的46%。大多数呼叫发生在傍晚和白天时段。89%的病例中儿童由救护车运送，7.7%的病例护理被拒绝。平均响应时间为9±16分钟，平均现场时间为12±14分钟，平均运送时间为14±20分钟。创伤事件占主导，为42%，其中机动车事故和跌倒最为常见。钝性损伤占创伤的94%，而呼吸问题、癫痫发作和中毒/过量是最常见的医疗问题。56%的病例获取了生命体征。其中21%的病例生命体征异常，推测原因在分布上与普通人群相似，还包括心脏骤停。最常用的治疗方法是脊柱固定、输氧、建立静脉通路以及使用几种ALS药物。超过一半的出诊有ALS能力，但其中只有14%的病例进行了ALS治疗。未获得结局数据。
这项对儿科EMS流行病学的多州分析证实了在较小区域研究中报告的结果，但有几个例外。未发现现场时间过长的情况。很少有儿童因生命体征异常而患有严重疾病。有ALS治疗时，使用频率很低。这些发现对EMS规划者和教育者有启示意义。
