INTRODUCTION: In a time of emergency department overcrowding and increased utilization of emergency medical services, a highly functional prehospital system will balance the needs of the individual patient with the global needs of the community. Our community addressed these issues through the development of a multitiered prehospital care system that incorporated EMS initiated non-transport of pediatric patients. OBJECTIVE: To describe the outcome of pediatric patients accessing a progressive prehospital system that employed EMS initiated non-transport. METHODS: A prospective observational case series was performed on pediatric patients (< 21 years old) designated EMS initiated non-transport. Patients were designated non-transport after an initial EMS protocol driven, complaint-specific clinical assessment in conjunction with medical oversight affirmation. Telephone follow-up was completed on all consecutively enrolled non-transport patients to collect information about outcome (safety) as well as overall satisfaction with the system. A five-point Likert scale was utilized to rate satisfaction. RESULTS: There were 5,336 EMS requests during the study period. Seven hundred and four were designated non-transport, of which 74.8% completed phone follow-up. Categories of EMS request included minor; medical illness 43.4%, trauma 55.9%, and other 1.1%. There were 13 admissions (2.4%) to the hospital after EMS initiated non-transport designation. Admissions after non-transport had trends toward younger age (p = 0.002) and medical etiology (p = 0.006). There were no PICU admissions or deaths. CONCLUSION: Our EMS system provides an alternative to traditional protocols, allowing EMS initiated non-transport of pediatric patients, resulting in effective resource utilization with a high level of patient safety and family satisfaction.
INTRODUCTION: In a time of emergency department overcrowding and increased utilization of emergency medical services, a highly functional prehospital system will balance the needs of the individual patient with the global needs of the community. Our community addressed these issues through the development of a multitiered prehospital care system that incorporated EMS initiated non-transport of pediatric patients. OBJECTIVE: To describe the outcome of pediatric patients accessing a progressive prehospital system that employed EMS initiated non-transport. METHODS: A prospective observational case series was performed on pediatric patients (< 21 years old) designated EMS initiated non-transport. Patients were designated non-transport after an initial EMS protocol driven, complaint-specific clinical assessment in conjunction with medical oversight affirmation. Telephone follow-up was completed on all consecutively enrolled non-transport patients to collect information about outcome (safety) as well as overall satisfaction with the system. A five-point Likert scale was utilized to rate satisfaction. RESULTS: There were 5,336 EMS requests during the study period. Seven hundred and four were designated non-transport, of which 74.8% completed phone follow-up. Categories of EMS request included minor; medical illness 43.4%, trauma 55.9%, and other 1.1%. There were 13 admissions (2.4%) to the hospital after EMS initiated non-transport designation. Admissions after non-transport had trends toward younger age (p = 0.002) and medical etiology (p = 0.006). There were no PICU admissions or deaths. CONCLUSION: Our EMS system provides an alternative to traditional protocols, allowing EMS initiated non-transport of pediatric patients, resulting in effective resource utilization with a high level of patient safety and family satisfaction.
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: Wim Breeman; Nathan A Poublon; Michael H J Verhofstad; Esther M M Van Lieshout Journal: Scand J Trauma Resusc Emerg Med Date: 2018-09-14 Impact factor: 2.953
Authors: Martin Poryo; Martin Burger; Stefan Wagenpfeil; Bennet Ziegler; Harald Sauer; Marina Flotats-Bastardas; Ulrich Grundmann; Michael Zemlin; Sascha Meyer Journal: Front Pediatr Date: 2019-10-25 Impact factor: 3.418