Pediatrics Research Today is a free monthly online journal that collates and summarizes the latest research about Pediatrics, including details on child development, perinatal medicine, child health care.

What are the characteristics and outcomes of nontransported pediatric patients?

Kahalé J, Osmond MH, Nesbitt L, Stiell IG

Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

BACKGROUND: The authors have demonstrated that 28% of children cared for by paramedics are not transported to hospital by ambulance. OBJECTIVE: To determine the characteristics, reasons, and outcomes for this nontransported population. METHODS: This was a prospective cohort study in a single city with a two-tiered emergency medical services system. Enrolled were all children aged < 16 years assessed by paramedics but not transported to hospital over a five-month period. Data were collected from ambulance call reports, phone interviews, and hospital charts. Descriptive statistics were used. RESULTS: Over five months, there were 345 nontransported pediatric patients with a mean age of 6 years, and 58.3% were male. The dispatch priority was urgent in 68.1% of cases and prompt in 30.4% of cases. The primary problems were almost evenly split between trauma (50.7%) and medical (45.2%) causes. Paramedics listed the following reasons for nontransport: parent will take the child to a physician (27.8%), parent will monitor the child's condition (25.8%), and no reason documented (46.4%). Phone interview was conducted with 106 parents (30.7%): 76.4% believed there was a true emergency at the time of the 9-1-1 call, 75.5% stated that the paramedics did not recommend that the child be transported to hospital by ambulance, and 29.2% stated that the paramedics said ambulance transport was not necessary. Fifty-one children were seen in an emergency department (ED) within 48 hours of the 9-1-1 call. The majority (91.3%) were discharged home from the ED, while a small minority (8.7%) were admitted to hospital. No deaths were reported. CONCLUSIONS: Most nontransported children did not require immediate or urgent medical care. Both parents and paramedics gave input into the nontransport decision, and the short-term outcome of this population appeared to be good. Paramedic documentation for the reasons for nontransport should be improved.

Published 18 January 2006 in Prehosp Emerg Care, 10(1): 28-34.
Full-text of this article is available online (may require subscription).

© 2005-2008 Pediatrics Research Today. All Rights Reserved.