BACKGROUND: The authors have demonstrated that 28% of children cared for by paramedics are not transported to hospital by ambulance. OBJECTIVE: To determine the characteristics, reasons, and outcomes for this nontransported population. METHODS: This was a prospective cohort study in a single city with a two-tiered emergency medical services system. Enrolled were all children aged < 16 years assessed by paramedics but not transported to hospital over a five-month period. Data were collected from ambulance call reports, phone interviews, and hospital charts. Descriptive statistics were used. RESULTS: Over five months, there were 345 nontransported pediatric patients with a mean age of 6 years, and 58.3% were male. The dispatch priority was urgent in 68.1% of cases and prompt in 30.4% of cases. The primary problems were almost evenly split between trauma (50.7%) and medical (45.2%) causes. Paramedics listed the following reasons for nontransport: parent will take the child to a physician (27.8%), parent will monitor the child's condition (25.8%), and no reason documented (46.4%). Phone interview was conducted with 106 parents (30.7%): 76.4% believed there was a true emergency at the time of the 9-1-1 call, 75.5% stated that the paramedics did not recommend that the child be transported to hospital by ambulance, and 29.2% stated that the paramedics said ambulance transport was not necessary. Fifty-one children were seen in an emergency department (ED) within 48 hours of the 9-1-1 call. The majority (91.3%) were discharged home from the ED, while a small minority (8.7%) were admitted to hospital. No deaths were reported. CONCLUSIONS: Most nontransported children did not require immediate or urgent medical care. Both parents and paramedics gave input into the nontransport decision, and the short-term outcome of this population appeared to be good. Paramedic documentation for the reasons for nontransport should be improved.
BACKGROUND: The authors have demonstrated that 28% of children cared for by paramedics are not transported to hospital by ambulance. OBJECTIVE: To determine the characteristics, reasons, and outcomes for this nontransported population. METHODS: This was a prospective cohort study in a single city with a two-tiered emergency medical services system. Enrolled were all children aged < 16 years assessed by paramedics but not transported to hospital over a five-month period. Data were collected from ambulance call reports, phone interviews, and hospital charts. Descriptive statistics were used. RESULTS: Over five months, there were 345 nontransported pediatric patients with a mean age of 6 years, and 58.3% were male. The dispatch priority was urgent in 68.1% of cases and prompt in 30.4% of cases. The primary problems were almost evenly split between trauma (50.7%) and medical (45.2%) causes. Paramedics listed the following reasons for nontransport: parent will take the child to a physician (27.8%), parent will monitor the child's condition (25.8%), and no reason documented (46.4%). Phone interview was conducted with 106 parents (30.7%): 76.4% believed there was a true emergency at the time of the 9-1-1 call, 75.5% stated that the paramedics did not recommend that the child be transported to hospital by ambulance, and 29.2% stated that the paramedics said ambulance transport was not necessary. Fifty-one children were seen in an emergency department (ED) within 48 hours of the 9-1-1 call. The majority (91.3%) were discharged home from the ED, while a small minority (8.7%) were admitted to hospital. No deaths were reported. CONCLUSIONS: Most nontransported children did not require immediate or urgent medical care. Both parents and paramedics gave input into the nontransport decision, and the short-term outcome of this population appeared to be good. Paramedic documentation for the reasons for nontransport should be improved.
Authors: Manish N Shah; Jeremy T Cushman; Colleen O Davis; Jeffrey J Bazarian; Peggy Auinger; Bruce Friedman Journal: Prehosp Emerg Care Date: 2008 Jul-Sep Impact factor: 3.077
Authors: Remco H A Ebben; Lilian C M Vloet; Renate F Speijers; Nico W Tönjes; Jorik Loef; Thomas Pelgrim; Margreet Hoogeveen; Sivera A A Berben Journal: Scand J Trauma Resusc Emerg Med Date: 2017-07-17 Impact factor: 2.953
Authors: Sherwin E Phillips; Pamela S Gaskin; David Byer; W L Cadogan; Andrew Brathwaite; Anders L Nielsen Journal: Emerg Med Int Date: 2012-11-07 Impact factor: 1.112