Ernest Eric V, Brazelton Tom B, Carhart Elliot D, Studnek Jonathan R, Tritt Patricia L, Philip Genghis A, Burnett Aaron M
1Regions Hospital,Emergency Medical Services,Saint Paul,MinnesotaUSA.
2University of Wisconsin School of Medicine and Public Health,Madison,WisconsinUSA.
Prehosp Disaster Med. 2016 Aug;31(4):386-91. doi: 10.1017/S1049023X1600056X. Epub 2016 May 24.
Introduction Traditionally, Emergency Medical Services (EMS) educators have divided the pediatric population into age groups to assist in targeting their clinical and didactic curriculum. Currently, the accrediting body for paramedic training programs requires student exposure to pediatric patients based entirely on age without specifying exposure to specific pathologies within each age stratification. Identifying which pathologies are most common within the different pediatric age groups would allow educators to design curriculum targeting the most prevalent pathologies in each age group and incorporating the physiologic and psychological developmental milestones commonly seen at that age. Hypothesis It was hypothesized that there are unique clusterings of pathologies, represented by paramedic student primary impressions, that are found in different age groups which can be used to target provider education.
This is a retrospective review of prospectively collected data documented by paramedic students in the Fisdap (Field Internship Student Data Acquisition Project; Saint Paul, Minnesota USA) database over a one-year period. For the purposes of this study, pediatric patients were defined arbitrarily as those between the ages of 0-16 years. All paramedic student primary impressions recorded in Fisdap for patients aged 0-16 years were abstracted. Primary impression by age was calculated and graphed. The frequency of primary impression was then assessed for significance of trend by age with an alpha ≤.05 considered significant.
The following primary impressions showed clinically and statistically significant variability in prevalence among different pediatric age groups: respiratory distress, medical-other, abdominal pain, seizure, overdose/poisoning, behavioral, and cardiac. In patients less than 13 years old, respiratory and other-medical were the most common two primary impressions and both decreased with age. In patients 5-16 years old, the prevalence of abdominal pain and behavioral/psych increased. Bimodal distributions for overdose were seen with one spike in the toddler and another in the adolescent population. Seizures were most common in the age group associated with febrile seizure. Sepsis was seen most often in the youngest patients and its prevalence decreased with age.
There are statistically significant variations in the frequency of paramedic student primary impressions as a function of age in the pediatric population. Emphasizing paramedic student exposure to the most common pathologies encountered in each age group, in the context of the psychological and physiological milestones of each age, may improve paramedic student pediatric practice. Ernest EV , Brazelton TB , Carhart ED , Studnek JR , Tritt PL , Philip GA , Burnett AM . Prevalence of unique pediatric pathologies encountered by paramedic students across age groups. Prehosp Disaster Med. 2016; 31(4):386-391.
引言 传统上，紧急医疗服务（EMS）教育工作者将儿科人群划分为不同年龄组，以协助确定其临床和教学课程的重点。目前，护理人员培训项目的认证机构要求学生接触儿科患者完全基于年龄，而未明确规定在每个年龄分层中接触特定的病症。确定不同儿科年龄组中最常见的病症，将使教育工作者能够设计针对每个年龄组中最普遍病症的课程，并纳入该年龄常见的生理和心理发育里程碑。假设 假设存在由护理专业学生的初步诊断所代表的独特病症聚类，这些聚类在不同年龄组中出现，并可用于指导提供者教育。
这是一项对护理专业学生在Fisdap（现场实习学生数据采集项目；美国明尼苏达州圣保罗）数据库中前瞻性收集的为期一年的数据进行的回顾性研究。在本研究中，儿科患者被任意定义为年龄在0至16岁之间的患者。提取Fisdap中记录的所有护理专业学生对0至16岁患者的初步诊断。计算并绘制按年龄划分的初步诊断情况。然后评估初步诊断频率随年龄变化趋势的显著性，α≤0.05被视为具有显著性。
以下初步诊断在不同儿科年龄组中的患病率在临床和统计学上显示出显著差异：呼吸窘迫、内科-其他、腹痛、癫痫发作、药物过量/中毒、行为问题和心脏问题。在13岁以下的患者中，呼吸问题和其他内科问题是最常见的两种初步诊断，且两者均随年龄增长而减少。在5至16岁的患者中，腹痛和行为/心理问题的患病率增加。药物过量呈现双峰分布，一个峰值出现在幼儿期，另一个出现在青少年期。癫痫发作在与热性惊厥相关的年龄组中最为常见。脓毒症在最年幼的患者中最常出现，且其患病率随年龄增长而降低。
护理专业学生的初步诊断频率在儿科人群中随年龄存在统计学上的显著差异。在每个年龄组心理和生理里程碑的背景下，强调护理专业学生接触每个年龄组中最常见病症，可能会改善护理专业学生的儿科实践。欧内斯特·E·V、布雷泽尔顿·T·B、卡哈特·E·D、斯塔德内克·J·R、特里特·P·L、菲利普·G·A、伯内特·A·M。护理专业学生在不同年龄组中遇到的独特儿科病症的患病率。院前灾难医学。2016；31(4):386 - 391。
