Adequacy of EMS data collection during pediatric cardiac arrest: are EMTs getting the whole story?
OBJECTIVE
To compare the initial emergency medical services (EMS) prehospital assessment of medical and traumatic cardiopulmonary arrest in the pediatric patient with that of the Office of the Medical Investigator (OMI) and assess differences and implications for EMS training and prevention.


METHODS
Retrospective review of ambulance run forms with the OMI autopsy confirmations.


METHODS
An urban EMS system and the state Office of the Medical Investigator.


METHODS
Patients 15 years of age or less who were treated by prehospital personnel from November 1, 1990, to October 31, 1991, for a medical or traumatic arrest.


METHODS
None.


RESULTS
Ambulance runs were reported for 2,586 pediatric patients. Of these, 42 (1.6%) had suffered arrests, with 32 (76%) medical arrests and ten (24%) traumatic arrests. Children 1 year of age or less accounted for 75% of the medical arrests, while children more than 1 year of age accounted for 80% of the traumatic arrests (p = 0.003). Overall mortality was 81%. When EMS prehospital assessments of medical and traumatic arrests were compared with autopsy reports, there was good agreement for sudden infant death syndrome (SIDS) (kappa = 0.70), but poor agreement for child abuse (kappa = 0.37).


CONCLUSIONS
The authors found good agreement between EMS prehospital assessments and autopsy diagnoses for identifying pediatric SIDS, but child abuse was not well identified prior to autopsy.
Graham
S D
SD
University of New Mexico, Department of Emergency Medicine, UNM School of Medicine, Ambulatory Care Center, Albuquerque 87131-5246, USA.
Olson
L M
LM
Sapien
R E
RE
Tandberg
D
D
Sklar
D P
DP
D000293:Adolescent; D017677:Age Distribution; D002423:Cause of Death; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002675:Child, Preschool; D003334:Coroners and Medical Examiners; D003625:Data Collection / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records / Q000592:standards*; D009516:New Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D013398:Sudden Infant Death / Q000453:epidemiology; D014504:Urban Health