Harve H, Salmi H, Rahiala E, Pohjalainen P, Kuisma M
Emergency Medical Services, Department of Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Acta Anaesthesiol Scand. 2016 Mar;60(3):360-9. doi: 10.1111/aas.12648. Epub 2015 Oct 22.
We wanted to study the incidence, distribution and characteristics of paediatric out-of-hospital emergency care on a population level. This knowledge could ameliorate the design and education of emergency medical services and their personnel.
We studied all (n = 1863) emergency medical services responses and the patient records for paediatric patients (age 0-16 years) in Helsinki, Finland (population 603,968, paediatric population 92,742) during a 12-month period (2012). Patient characteristics, diagnoses, time intervals, medical treatments, procedures, vital measurements and outcome of out-of-hospital treatment were available for analysis.
The incidence of emergency medical services -treated paediatric out-of-hospital emergencies was 3.8/1000 inhabitants and 20/1000 1-16-year-old inhabitants. This formed 4.5% of all emergency calls, while children have a threefold share of the population (15%). Falls, dyspnoea, seizures and poisonings account for half of all emergencies. Few patients suffered from a life-threatening condition or trauma. Cardiac arrest or need for advanced life support measures (e.g. intubation) was rare. After evaluation by the emergency medical services, only half of the patients (56%) needed ambulance transportation to hospital. Only 30 (3.7%) of the non-transported patients made an unpremeditated visit to the emergency department after the original contact with the emergency medical services. All of them were well upon arrival to the emergency department.
Paediatric out-of-hospital emergencies are infrequent and have specific characteristics differing from the adult population. The design and training of emergency medical services and their personnel should focus on evaluation and management of the most frequent situations.
我们希望在人群层面研究儿科院外急救的发生率、分布情况及特征。这些信息有助于改进急救医疗服务及其人员的设计与培训。
我们研究了芬兰赫尔辛基（人口603,968，儿科人口92,742）在12个月期间（2012年）所有（n = 1863）急救医疗服务响应及儿科患者（0 - 16岁）的病历。患者特征、诊断、时间间隔、医疗治疗、操作、生命体征测量及院外治疗结果均可供分析。
急救医疗服务处理的儿科院外紧急情况发生率为每1000名居民中有3.8例，每1000名1 - 16岁居民中有20例。这占所有急救电话的4.5%，而儿童在人口中占比为三分之一（15%）。跌倒、呼吸困难、癫痫发作和中毒占所有紧急情况的一半。很少有患者患有危及生命的疾病或创伤。心脏骤停或需要高级生命支持措施（如插管）的情况很少见。经急救医疗服务评估后，只有一半的患者（56%）需要救护车送往医院。在最初与急救医疗服务接触后，只有30名（3.7%）未被转运的患者未经预约前往急诊科就诊。他们到达急诊科时情况均良好。
儿科院外紧急情况并不常见，且具有与成人不同的特定特征。急救医疗服务及其人员的设计与培训应侧重于对最常见情况的评估和管理。
