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Respiratory illness is the most common pediatric emergency in ambulatory settings

 

Key clinical point: Respiratory illness was the most common pediatric emergency in ambulatory settings.

Major finding: Among pediatric emergency medical services from ambulatory settings, 58% were caused by respiratory illness.

Study details: A retrospective observational study of 38,841 EMS transports in the Indianapolis metropolitan area over 3 years.

Disclosures: No relevant financial disclosures were reported. There was no external funding.

Source: Yuknis M et al. Pediatrics. 2018. doi: 10.1542/peds.2017-3082.


 

FROM PEDIATRICS

Respiratory illness was the most common pediatric emergency in ambulatory settings, followed by psychiatric and behavioral illness, seizures, and syncope, according to results published July 20 in Pediatrics.

Investigators conducted a retrospective observational study of data from the Indianapolis emergency medical services (EMS) system between Jan. 1, 2012, and Dec. 31, 2014. All patients younger than 18 years were eligible.

Of 38,841 pediatric EMS transports in the Indianapolis metropolitan area during the 3-year period, fewer than 1% (322) were verified as originating from an ambulatory practice, reported Matthew L. Yuknis, MD, and his coauthors at Indiana University, Indianapolis. Respiratory distress was the most common emergency (58%), followed by psychiatric and behavioral illness (6%), seizure (6%), and syncope (5%).

The most common interventions were use of supplemental oxygen (27%), albuterol (26%), and intravascular access (11%). The most common critical care interventions were administration of fluid bolus (2%), benzodiazepine (2%), or racemic or intramuscular epinephrine (1%). None required use of an artificial airway, cardiopulmonary resuscitation, intraosseous access, or bag mask ventilation, Dr. Yuknis and his colleagues said.

The average time from call to on-scene arrival was 6 minutes (ranging from less than 1 to 15 minutes). The average patient transport time was 13 minutes (ranging from less than 1 to 38 minutes). The average annual frequency of pediatric outpatient emergencies was 42 emergencies per 100,000 people under 18 years of age. Lower socioeconomic status was correlated with increased frequency of emergencies in ambulatory settings, the authors reported.

“These findings update and clarify existing literature with regard to the frequency of pediatric emergencies in the ambulatory setting, the conditions these patients present with, and the use of EMS data to define these events,” the authors wrote. Additionally, the findings can be used to “inform future decisions regarding necessary equipment and procedures.”

No relevant financial disclosures were reported. There was no external funding.

SOURCE: Yuknis M et al. Pediatrics. 2018. doi: 10.1542/peds.2017-3082.

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