36 Not transporting all paediatric out-of-hospital setting patients by ambulance seems to be safe

• Published in: BMJ open 2017-05, Vol.7 (Suppl 3), p.A14-A15
• Main Authors: Oulasvirta, J, Harve-Rytsälä, H, Kuisma, M
• Format: Article
• Language: English
• Subjects: Ambulance services; Emergency services; Patients; Pediatrics
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-EMSabstracts.36

AimWe examined the safety of not transporting all paediatric out-of-hospital (OOH) emergency patients to emergency department by ambulance.MethodsWe report observations from a dataset covering all (n=2387) emergency medical services (EMS) responses for paediatric patients (age 0 to 15 years) in 2015 in Helsinki, Finland (population 628 208, paediatric population 93 054 during 2015). Time intervals, patient characteristics, vital measurements, diagnoses, medical treatments, procedures and outcomes were analysed.ResultsThe incidence of EMS-treated paediatric OOH emergencies was 3.8 per 1 000 inhabitants and 25,7 per 1 000 in 0–15 year-old inhabitants. There were 1 069 (44.8%) non-transported paediatric patients. In 926 (86.6%) cases decision of not transporting a patient was made without consulting a doctor. 176 (16.5%) of non-transported patients got to a tertiary university hospital emergency department within 3 days by other means, comprising 184 visits. 115 (62.5%) of the visits were encouraged by emergency medical personnel. Only 3 patients’ appearance was other than good at presentation. 90 (8.4%) of the patients were medicated at the emergency department. 21 (2.0%) of the patients were given respiratory support (including any form of inhalations). 28 (2.6%) had to be admitted to the hospital; 11 (1.0%) of them for more than 2 nights. None of the non-transported patients were admitted to the intensive care unit within 3 days following the call or died during the 1 year follow-up period.ConclusionTransporting selectively those paediatric patients by ambulance, who need transportation the most, appears to be safe in the light of this dataset.ReferenceFinnish Official Statistics – Suomen virallinen tilasto (SVT): Väestörakenne [verkkojulkaisu]. ISSN=1797-5379. Helsinki: Tilastokeskus [Internet]. [cited 2017 Jan 15]. Available from: http://www.stat.fi/til/vaerak/tau.htmlConflict of interestNone declared.FundingHelsinki University Central Hospital, The Finnish Society of Anaesthesiologists