Paramedic Initiated Non-transport Of Pediatric Patients

Paramedic Initiated Non-transport Of Pediatric Patients

Haines C J; Lutes R E; Blaser M; Christopher N C

Prehospital Emergency Care

2006

2006-04

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.

children; emergency medical-services; Emergency Medicine; EMS; Environmental & Occupational Health; life; non-transport; Pediatrics; physician; pramedic triage; prehospital evaluation; Public; system

Journal Article or Conference Abstract Publication

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