Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study

Abstract

Background: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. Methods: We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Results: Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. Discussion: We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Conclusion: Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

Progression of vital signs during ambulance transport categorised by a paediatric triage model: a population-based historical cohort study

“…1 2 Especially infants and toddlers are frequent patient groups, and they can be difficult to assess due to a variety of factors: different normal ranges for vital signs, interaction with both patient and caregivers, and the fact that clinical deterioration can occur more abruptly in children than in adults due to prolonged physiological compensation for an acute illness or injury. [2][3][4] Caring for paediatric patients may be stressful for EMS professionals due to inadequate training related to clinical judgement and treatment of children with acute illness or injury. [5][6][7][8] A low frequency of life-threatening events among paediatric patients highlights the challenge of identifying patients at risk of clinical deterioration among the many other children with minor or non-urgent illnesses or injuries in acute care settings.…”

Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study

“…Children form a minority group of the emergency medical services (EMS) contacts. The reported proportion of EMS contacts in pediatric patients varies between 4% in Finland [ 1 ], 5% in Canada [ 2 ] and 7% in Denmark, Korea and United States [ 3 – 5 ]. However, children have unique needs in a healthcare setting and EMS has to address these needs [ 6 ].…”

“…As infants differ markedly from older children, protocols based on studies conducted on general pediatric populations or even derived from adults, may not be suitable for infants. Because dispatch protocols are often symptom-based [ 3 , 18 ] they may be difficult to apply to infants expressing themselves nonverbally. Thus, we sought to investigate EMS contacts with infants in detail.…”

Outcomes of Pediatric Patients in Secondary Transport to Tertiary Hospital

“…[3][4][5][6][7][8] Seizures, trauma, and respiratory distress account for most of the pediatric prehospital assessments. [3][4][5]8,9 Given the distinctive feature of pediatric patients, hospital destination must be addressed by EMS systems. 10 Recently, Fratta and Fishe, 11 in their pilot study of simulated destination decision making, developed a novel destination decision tool for transport choice.…”

“…They determine the hospital destination based on a patient's severity, expected time of travel and distance to hospital, regional resource availability, or patient/family preference 1,2 . Pediatric calls represent approximately 5% to 10% of all emergency transport 3–8 . Seizures, trauma, and respiratory distress account for most of the pediatric prehospital assessments 3–5,8,9 .…”