McKenzie Alexandra Claire, Risom Mads Belger, Møller Jens-Jakob Kjer, Mikkelsen Johan, Skole-Sørensen Sarah Friis, Nielsen Vibe Maria Laden, Clausen Nicola Groes, Mikkelsen Søren
The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark.
Department Anaesthesiology Intensive Care Medicine, Odense University Hospital, Odense, Denmark.
Scand J Trauma Resusc Emerg Med. 2025 Feb 20;33(1):30. doi: 10.1186/s13049-025-01346-x.
The purpose of this study was to clarify the potentially life-saving critical interventions performed on children below the age of seven by the physician-manned mobile emergency care unit (MECU) in Odense, Denmark. We investigated critical interventions in relation to morbidity and mortality.
A retrospective cohort study of all MECU missions involving children below the age of seven. The study period was from October 1 2007 to December 31 2020. Data sources were the MECU Odense database, the Danish National Patient Registry, and the Danish Civil Registration System. Variables were critical interventions, the severity of injury/illness, MECU on-scene time, in-hospital diagnosis and 7-day, 30-day, and 90-day mortality.
The MECU carried out 4,032 missions to children below 7 years. 88 patients (2.2%) received at least one critical prehospital intervention. Upper airway suction was performed in 39 cases (1.0%), endotracheal intubation (all causes) in 36 cases (0.9%), and intraosseous access in 21 cases (0.5%). General anaesthesia was induced in 29 cases (0.7%). Seventeen patients (0.4%) received cardiopulmonary resuscitation and two patients received manual defibrillation (< 0.1%). 3,278 patients were admitted to the hospital and assigned a diagnosis when discharged. The most common diagnoses were assigned within the International Statistical Classification of Diseases and Related Health Problems 10th Revision Chapter XVIII (Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified), which includes febrile convulsions. 1,437 patients (43.8%) were assigned diagnoses within this diagnosis group. The overall 7-day mortality in the cohort was 0.74%, 30-day mortality was 0.82%, and 90-day mortality was 1.02%.
Prehospital critical interventions are rarely performed in children under the age of 7 years. The low frequency of these interventions may have implications for maintaining the clinical routine of the prehospital care providers.
本研究的目的是阐明丹麦欧登塞市由医生值守的移动急救护理单元（MECU）对7岁以下儿童实施的可能挽救生命的关键干预措施。我们调查了与发病率和死亡率相关的关键干预措施。
对所有涉及7岁以下儿童的MECU任务进行回顾性队列研究。研究期间为2007年10月1日至2020年12月31日。数据来源为欧登塞MECU数据库、丹麦国家患者登记处和丹麦民事登记系统。变量包括关键干预措施、损伤/疾病的严重程度、MECU现场时间、住院诊断以及7天、30天和90天死亡率。
MECU对7岁以下儿童执行了4032次任务。88名患者（2.2%）接受了至少一项关键的院前干预措施。39例（1.0%）进行了上呼吸道抽吸，36例（0.9%）进行了气管插管（各种原因），21例（0.5%）进行了骨内通路建立。29例（0.7%）实施了全身麻醉。17例患者（0.4%）接受了心肺复苏，2例患者接受了手动除颤（<0.1%）。3278例患者入院并在出院时得到诊断。最常见的诊断归类于《国际疾病分类及相关健康问题统计分类》第10版第十八章（症状、体征及临床和实验室异常发现，未在他处分类），其中包括热性惊厥。1437例患者（43.8%）归入该诊断组。该队列的总体7天死亡率为0.74%，30天死亡率为0.82%，90天死亡率为1.02%。
7岁以下儿童很少进行院前关键干预措施。这些干预措施的低频率可能对维持院前护理人员的临床常规产生影响。
