From the Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Departments of Pediatrics.
Pediatr Emerg Care. 2022 Feb 1;38(2):e791-e798. doi: 10.1097/PEC.0000000000002355.
BACKGROUND/OBJECTIVE: To describe the epidemiology of emergency department (ED) visits by pediatric patients transported from the out-of-hospital setting (ie, scene) by emergency medical services (EMS), and identify factors associated with EMS transport.
We performed a cross-sectional study of ED visits from 2014 to 2017 utilizing a nationally representative probability sample survey of visits to US EDs. We included pediatric patients (<18 years old) and compared encounters transported from the scene by EMS to those who arrived to the ED by all other means. We performed multivariable logistic regression to identify factors associated with scene EMS transport.
Of 130.2 million pediatric ED encounters, 4.7 million (3.8%) arrived by EMS. Most patients were White (61.1%), non-Hispanic (77.5%), and publicly insured (52.2%). Multivariable analysis demonstrated associations with EMS transport: Black (vs White) race (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.16-1.89), ages 1 to younger than 5 years (aOR, 0.52; 95% CI, 0.37-0.72) and 5 to younger than 12 years (aOR, 0.56; 95% CI, 0.40-0.80) (vs adolescents), pediatric (aOR, 0.60; 95% CI, 0.42-0.85) and nonmetropolitan hospital status (aOR, 0.52; 95% CI, 0.35-0.78), blood testing (aOR, 2.34; 95% CI, 1.71-3.19), time to evaluation (31-60 minutes [aOR, 0.56; 95% CI, 0.39-0.80] and >60 minutes [aOR, 0.51; 95% CI, 0.33-0.77] compared with 0-30 minutes), admission (aOR, 3.20; 95% CI, 2.33-4.38), and trauma (1.80; 95% CI, 1.43-2.28).
Four percent of pediatric ED patients are transported to the ED by EMS from the scene. These patients receive a rapid and resource intense diagnostic evaluation, suggesting that higher acuity. Black patients, adolescents, and those with trauma were more likely to be transported by EMS.
背景/目的：描述由急救医疗服务（EMS）从院外（即现场）转运的儿科患者到急诊科就诊的流行病学情况，并确定与 EMS 转运相关的因素。
我们利用对美国急诊科就诊的全国代表性概率抽样调查，对 2014 年至 2017 年的急诊科就诊进行了横断面研究。我们纳入了儿科患者（<18 岁），并将从现场由 EMS 转运的就诊与通过其他所有方式到达急诊科的就诊进行了比较。我们进行了多变量逻辑回归分析，以确定与现场 EMS 转运相关的因素。
在 1.302 亿例儿科急诊科就诊中，有 470 万（3.8%）通过 EMS 到达。大多数患者为白人（61.1%）、非西班牙裔（77.5%）和公保患者（52.2%）。多变量分析显示与 EMS 转运相关的因素包括：黑人（与白人相比）种族（校正优势比[aOR]，1.48；95%置信区间[CI]，1.16-1.89）、1 岁以下（aOR，0.52；95%CI，0.37-0.72）和 5-11 岁（aOR，0.56；95%CI，0.40-0.80）（与青少年相比）、儿科（aOR，0.60；95%CI，0.42-0.85）和非大都市医院状态（aOR，0.52；95%CI，0.35-0.78）、血液检测（aOR，2.34；95%CI，1.71-3.19）、评估时间（31-60 分钟[aOR，0.56；95%CI，0.39-0.80]和>60 分钟[aOR，0.51；95%CI，0.33-0.77]与 0-30 分钟相比）、住院（aOR，3.20；95%CI，2.33-4.38）和创伤（1.80；95%CI，1.43-2.28）。
4%的儿科急诊科患者由 EMS 从现场转运到急诊科。这些患者接受了快速和资源密集型的诊断评估，表明病情更为严重。黑人患者、青少年和创伤患者更有可能通过 EMS 转运。
