Pediatrician's Role in Emergency Medical Services for Children

PEDIATRICS ◽  
1988 ◽  
Vol 81 (5) ◽  
pp. 735-735
Author(s):  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Care ◽  
Life Support ◽  
Care Delivery ◽  
Prehospital Care ◽  
Pediatric Emergency ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical ◽  
Pediatric Emergency Care

To reduce the morbidity and mortality of critically ill and injured children, comprehensive care must be provided. This includes effective services and treatment from the onset of the illness or injury through definitive care. Pediatricians should counsel families not only about prevention of disease and injury but also about access to pediatric emergency care resources in their region. If the interval between recognition of illness and delivery of care is to be reduced to a minimum, a prehospital protocol must be established. Parents as well as prehospital care providers must be knowledgeable about their community's prehospital protocol for life-threatening illness or injury. Primary care pediatricians need to establish networks with hospital-based pediatricians, emergency physicians, pediatric surgeons, and other pediatric medical and pediatric surgical specialists so that there is clearly assigned responsibility for provision of pediatric emergency care.1 When available, a pediatric surgeon should take charge of the child with multiple traumatic injuries. Optimally, the pediatric emergency care delivery system will be comprehensive and designed to meet the unique needs of children. The specific objectives of an emergency medical services for children (EMS-C) system should remain constant even though available resources may vary from region to region. For an EMS-C system to be most effective, practitioners need to develop the knowledge, skills, attitudes, and experience necessary to provide essential life support for ill and injured children. Many regions currently have well-developed emergency medical services (EMS) systems with outstanding capability and sophistication but most have been designed to meet the needs of adults.2

Emergency Care of the Child

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 572-576
Author(s):  
MARTHA BUSHORE
Keyword(s):  
Health Care Providers ◽  
Emergency Care ◽  
Life Support ◽  
Prehospital Care ◽  
Pediatric Emergency ◽  
Care Providers ◽  
Transport Services ◽  
Emergency Medical ◽  
Field Triage ◽  
Pediatric Emergency Care

Optimal emergency care of the child requires a well-developed EMS-C system. The components are easy to identify. We need macroregions with institutions acknowledging their institutional capabilities for pediatric emergency care and supporting field triage and transfer agreements. We need highly educated and skilled prehospital care providers, from emergency medical technicians in the field to air and ground transport services with specialized pediatric transport teams. In addition to having an appropriate hospital emergency department attending physician staff, hospitals must develop networks of cooperation between emergency departments appropriate for pediatrics and childern's emergency care centers. These centers strive for quality care through systematic record keeping, chart reviews, and audits identifying care deficiencies and appropriate remedies. Subsequent reviews document improved care. There are meetings of prehospital and hospital-based providers to discuss the management of challenging cases. Comprehensive pediatric emergency care involves integration of emergency stabilization patient care with community and hospital social services, patient education programs (such as Child Life), and comprehensive rehabilitation programs, as well as community accident prevention and basic life support programs. As we strive to develop optimal emergency medical services for our country to best serve our people, comprehensive emergency care of children must have separate consideration from comprehensive emergency care of adults. If we are to assure optimal outcome for the life-threatened child, we need to continuously assess regional needs and capabilities and encourage optimal involvement of health care providers and institutions.

Guidelines for Pediatric Emergency Care Facilities

PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 526-537
Author(s):  
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Pediatric Emergency ◽  
Medical Services ◽  
Emergency Medical ◽  
Care Facilities ◽  
Trained Personnel ◽  
Pediatric Emergency Care

Emergency care for life-threatening pediatric illness and injury requires specialized resources including equipment, drugs, trained personnel, and facilities. The American Medical Association Commission on Emergency Medical Services has provided guidelines for the categorization of hospital pediatric emergency facilities that have been endorsed by the American Academy of Pediatrics (AAP).1 This document was used as the basis for these revised guidelines, which define: 1. The desirable characteristics of a system of Emergency Medical Services for Children (EMSC) that may help achieve a reduction in mortality and morbidity, including long-term disability. 2. The role of health care facilities in identifying and organizing the resources necessary to provide the best possible pediatric emergency care within a region. 3. An integrated system of facilities that provides timely access and appropriate levels of care for all critically ill or injured children. 4. The responsibility of the health cane facility for support of medical control of pre-hospital activities and the pediatric emergency care and education of pre-hospital providers, nurses, and physicians. 5. The role of pediatric centers in providing outreach education and consultation to community facilities. 6. The role of health cane facilities for maintaining communication with the medical home of the patient. Children have their emergency care needs met in a variety of settings, from small community hospitals to large medical centers. Resources available to these health care sites vary, and they may not always have the necessary equipment, supplies, and trained personnel required to meet the special needs of pediatric patients during emergency situations.

Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 681-690 ◽  
Author(s):  
James S. Seidel ◽  
Deborah Parkman Henderson ◽  
Patrick Ward ◽  
Barbara Wray Wayland ◽  
Beverly Ness
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Pediatric Patients ◽  
Life Support ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P < .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

The Institute of Medicine Report on Emergency Medical Services for Chi: Thoughts for Emergency Medical Technicians, Paramedics, and Emergency Physicians

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 199-205
Author(s):  
Richard T. Cook
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Care ◽  
Fellowship Training ◽  
Pediatric Emergency ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Institute Of Medicine ◽  
Emergency Physicians ◽  
Care Givers ◽  
Emergency Medical

The emergency medical technician, the paramedic, and the emergency physician, as well as emergency physicians who have additional expertise in emergency medical service (EMS) prehospital care or pediatric emergency medicine (through experience or formal fellowship training), will all find the Institute of Medicine's report, Emergency Medical Services for Chi (EMS-C), to be an invaluable background resource as well as a guide for EMS system and EMS-C-related planning. With both breadth and depth, it reviews many of the issues in EMS-C today from many perspectives and provides practical information to enable these care givers to understand better the "big picture" of EMS-C as well as to assist them in continuing to make a difference in the day-to-day emergency care for children. It is well referenced, engenders respect for all members of the team within the broad continuum of EMS-C, and provides encouragement to them to work together to identify and address issues and solve problems to improve the quality of care for our nation's children.

Apart from the Medical Complaints, Why do Patients Use Emergency Medical Services? Results of a Patient Survey

2021 ◽  
Author(s):  
Silke Piedmont ◽  
Anna Katharina Reinhold ◽  
Jens-Oliver Bock ◽  
Janett Rothhardt ◽  
Enno Swart ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Logistic Models ◽  
Patient Survey ◽  
Insurance Companies ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Care Providers ◽  
Emergency Medical

Abstract Introduction Many countries face an increased use of emergency medical services (EMS) with a decreasing percentage of life-threatening complaints. Though there is a broad discussion among experts about the cause, patients' self-perceived, non-medical reasons for using EMS remain largely unknown. Methods The written survey included EMS patients who had≥1 case of prehospital emergency care in 2016. Four German health insurance companies sent out postal questionnaires to 1312 insured patients. The response rate was 20%; 254 questionnaires were eligible for descriptive and interferential analyses (t-tests, chi2-tests, logistic models). Results The majority of respondents indicated that their EMS use was due to an emergency or someone else’s decision (≥84%; multiple checks allowed); 56% gave need for a quick transport as a reason. Other frequently stated reasons addressed the health care system (e. g., complaints outside of physicians’ opening hours) and insecurity/anxiety about one’s state of health (>45% of the respondents). “Social factors” were similarly important (e. g., 42% affirming, “No one could give me a ride to the emergency department or doctor’s office.”). Every fifth person had contact with other emergency care providers prior to EMS use. Respondents negating an emergency as a reason were less likely to confirm wanting immediate medical care on site or quick transports compared to those affirming an emergency. Patients using EMS at night more often denied having an emergency compared to patients with access to care during the day. Conclusion The study identified a bundle of reasons leading to EMS use apart from medical complaints. Attempts for needs-oriented EMS use should essentially include optimization of the health care and social support system and measures to reduce patients’ insecurity.

Emergency Medical Services and the Pediatric Patient: Are the Needs Being Met? II. Training and Equipping Emergency Medical Services Providers for Pediatric Emergencies

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 808-812 ◽  
Author(s):  
James S. Seidel
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Care ◽  
The United States ◽  
Pediatric Emergency ◽  
Emergency Medical Technicians ◽  
Medical Services ◽  
Didactic Training ◽  
Pediatric Emergencies ◽  
Emergency Medical ◽  
Intravenous Catheters

Emergency medical services have been organized to meet the needs of adult patients. A study was undertaken to determine the training in pediatrics offered to paramedics and emergency medical technicians throughout the United States and the equipment carried by prehospital care provider agencies. Most training (50%) takes place at colleges and universities and the remainder at hospitals and emergency medical services agencies. Many programs (40%) have less than ten hours of didactic training in pediatrics and 41% offer ten hours or less of clinical experience. Some programs offer no training in pediatric emergency medicine. The most common deficiencies in pediatric equipment included back-boards, pediatric drugs, resuscitation masks, and small intravenous catheters. More attention to training and equipping prehospital personnel for pediatric emergencies may help to improve outcomes of out-of-hospital resuscitations of infants and children.

Incidence and Outcomes after Out-of-Hospital Medical Emergencies in Gambia: A Case for the Integration of Prehospital Care and Emergency Medical Services in Primary Health Care

2018 ◽  
Vol 33 (6) ◽  
pp. 650-657
Author(s):  
Sunkaru Touray ◽  
Baboucarr Sanyang ◽  
Gregory Zandrow ◽  
Isatou Touray
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Prehospital Care ◽  
The Gambia ◽  
Medical Emergency ◽  
Medical Services ◽  
Primary Health ◽  
Emergency Medical ◽  
Medical Emergencies

AbstractBackgroundThe Gambia is going through a rapid epidemiologic transition with a dual disease burden of infections and non-communicable diseases occurring at the same time. Acute, time-sensitive, medical emergencies such as trauma, obstetric emergencies, respiratory failure, and stroke are leading causes of morbidity and mortality among adults in the country.ProblemData on medical emergency care and outcomes are lacking in The Gambia. Data on self-reported medical emergencies among adults in a selection of Gambian communities are presented in this report.MethodsA total of 320 individuals were surveyed from 34 communities in the greater Banjul area of The Gambia using a survey instrument estimating the incidence of acute medical emergencies in an adult population. Self-reported travel time to a health facility during medical emergencies and patterns of health-seeking behavior with regard to type of facility visited and barriers to accessing emergency care, including cost and medical insurance coverage, are presented in this report.ResultsOf the 320 individuals surveyed, 262 agreed to participate resulting in a response rate of 82%. Fifty-two percent of respondents reported an acute medical emergency in the preceding year that required urgent evaluation at a health facility. The most common facility visited during such emergencies was a health center. Eighty-seven percent of respondents reported a travel time of less than one hour during medical emergencies. Out-of-pocket cost of medications accounted for the highest expenditure during emergencies. There was a low awareness and willingness to subscribe to health insurance among individuals surveyed.Conclusion: There is a high incidence of acute medical emergencies among adults in The Gambia which are associated with adverse outcomes due to a combination of poor health literacy, high out-of-pocket expenditures on medications, and poor access to timely prehospital emergency care. There is an urgent need to develop prehospital acute care and Emergency Medical Services (EMS) in the primary health sector as part of a strategy to reduce mortality and morbidity in the country.TourayS, SanyangB, ZandrowG, TourayI. Incidence and outcomes after out-of-hospital medical emergencies in Gambia: a case for the integration of prehospital care and Emergency Medical Services in primary health care. Prehosp Disaster Med. 2018;33(6):650–657.

Into the Fray: Integration of Emergency Medical Services and Special Weapons and Tactics (SWAT) Teams

1996 ◽  
Vol 11 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Jeffrey S. Jones ◽  
Kevin Reese ◽  
Greg Kenepp ◽  
Jon Krohmer
Keyword(s):  
Emergency Medical Services ◽  
Medical Training ◽  
Metropolitan Areas ◽  
Prehospital Care ◽  
Chemical Exposure ◽  
Medical Services ◽  
Specialized Training ◽  
Care Providers ◽  
Medical Support ◽  
Emergency Medical

AbstractIntroduction:The purpose of this study was to determine current experience and training of emergency medical support personnel for special weapons and tactics (SWAT) teams in North America.Methods:This cross-sectional, epidemiologic survey was sent to SWAT unit commanders from the 200 largest metropolitan areas. Questions included basic demographics, specialized training of emergency medical services (EMS) personnel, and where such personnel are deployed during tactical operations. Unit commanders also were asked to estimate the number and type of injuries sustained during tactical operations and to list any recommendations to improve the EMS response.Results:A total of 150 surveys was completed, for a response rate of 75%. The most common medical support (69%) was a civilian ambulance on standby at a predesignated location. Ninety-four percent of these prehospital care providers had no specialized training, and could not enter an area that was not secured tactically. Police officers with first aid or EMT training comprised the next largest group of medical support. Overall, 31% of SWAT commanders depended on remote EMS dispatch by radio to the scene when injuries occurred. Thirty-eight percent of respondents reported a significant injury had occurred during their tactical operations within the past 24 months. Common injuries included gunshot wounds, chemical exposure, and fractures. However, 78% (117/150) of respondents did not have a medical director, and 23% (35/150) of teams did not have an EMS preplan or protocol.Conclusion:The results suggest a need for established EMS protocols, medical direction, and specialized tactical medical training, especially in large metropolitan areas.

Collegiate-Based Emergency Medical Services (EMS): A Survey of EMS Systems on College Campuses

2006 ◽  
Vol 21 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Jonathan Fisher ◽  
Adam Ray ◽  
Scott C. Savett ◽  
Mark E. Milliron ◽  
George J. Koenig
Keyword(s):  
Emergency Medical Services ◽  
Life Support ◽  
International Schools ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Medical Systems ◽  
Emergency Medical ◽  
Levels Of Service ◽  
Emergency Medical Systems

AbstractIntroduction:Collegiate-based emergency medical systems (CBEMS) are a unique model for the delivery of prehospital care. The National Collegiate Emergency Medical Services Foundation (NCEMSF) was founded to serve as a resource for CBEMS groups. The purpose of this investigation is to describe the current state of CBEMS organizations.Methods:The NCEMSF maintains a Web-based, data collection system to gather data on CBEMS organizations. Collegiate-based emergency medical services are defined as emergency medical services in a university or college campus setting. The abstracted data from the NCEMSF registry were analyzed using descriptive statistics.Results:The NCEMSF registry contained data on 175 groups, and 145 groups were identified as providing CBEMS. The levels of service provided by the groups were: (1) first responder, 8.3%; (2) basic life support (BLS) 66.2%; (3) intermediate life support (ILS) 4.8%; (4) advanced life support (ALS), 9.7%; and (5) combination BLS/ALS, 8.3%. Transport capabilities were provided by 31.7% of the CBEMS. The average response time was estimated at 2.6 minutes (95% confidence interval (CI), 2.35–2.91 minutes). Early defibrillation using a automated external defibrillator (AED) or ALS was available by 75.9% (95% CI, 68.8–83.0) of CBEMS. Service to the community beyond the campus was provided by 21.3% of CBEMS groups. Forty-eight percent of the services operate 24 hours/day, seven days/week. The average call volume per year was 568 responses (95% CI, 315–820), and the groups averaged 29 (95% CI, 25–34) members. During the past five years, an average of 4.3 new CBEMS groups were formed per year. Eleven of the CBEMS are based at international schools.

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