Woods Rashida H, Shah Manish, Doughty Cara, Gilchrest Anthony
Pediatr Emerg Care. 2018 Mar;34(3):149-153. doi: 10.1097/PEC.0000000000001280.
The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers.
We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed.
Of 62 eligible EMS agencies that took the survey, 35.7% were aware of the NHTSA guidelines, 62.5% agreed they would improve safety, and 41.1% planned to implement them. Seventy-five percent of EMS agencies used the ideal or acceptable alternative to transport children requiring continuous monitoring, and 69.5% chose ideal or acceptable alternatives for children requiring spinal immobilization. The ideal or acceptable alternative was not chosen for children who were not injured or ill (93.2%), ill or injured but not requiring continuous monitoring (53.3%), and situations when multiple patients required transport (57.6%). The main requirements for implementation were provider education, ambulance interior modifications, new guidelines in the EMS agency, and purchase of new equipment.
Few EMS agencies are aware of the NHTSA guidelines on safe transport of children in ground ambulances. Although most agencies appropriately transport children who require monitoring, interventions, or spinal immobilization, they use inappropriate means to transport children in situations with multiple patients, lack of injury or illness, or lack of need for monitoring.
美国国家公路交通安全管理局（NHTSA）于2010年发布了关于地面救护车安全运送儿童的建议草案。本研究的目的是评估紧急医疗服务（EMS）机构对这些指南的知晓情况，并确定实施障碍。
我们对德克萨斯州的911响应地面运输EMS机构进行了一项横断面匿名在线调查。评估了人口统计学、基于病例场景的运输方式以及实施障碍。
在参与调查的62家合格EMS机构中，35.7%知晓NHTSA指南，62.5%同意他们会改善安全性，41.1%计划实施这些指南。75%的EMS机构在运送需要持续监测的儿童时采用了理想或可接受的替代方式，69.5%在运送需要脊柱固定的儿童时选择了理想或可接受的替代方式。对于未受伤或患病的儿童（93.2%）、患病或受伤但不需要持续监测的儿童（53.3%）以及多名患者需要运送的情况（57.6%），未选择理想或可接受的替代方式。实施的主要要求是提供者教育、救护车内部改装、EMS机构的新指南以及购买新设备。
很少有EMS机构知晓NHTSA关于地面救护车安全运送儿童的指南。尽管大多数机构在运送需要监测、干预或脊柱固定的儿童时方式恰当，但在多名患者、无受伤或患病情况或无需监测的情况下，他们采用了不恰当的方式运送儿童。
