title: Ambulance use by high-acuity patients in a pediatric ED.
abstract: The objective of this study was to analyze ambulance usage by highest acuity patients as compared with all patients in a suburban pediatric hospital ED. A 1-year retrospective records analysis was conducted of all highest acuity patients (those patients triaged as emergent or critical or admitted to the intensive care unit). A total of 245 patients made 270 high-acuity visits to the ED in 1995. Thirty-one (13%) of the high-acuity patients arrived via ambulance; the rest arrived via private vehicle. The 31 high-acuity patients constituted 8% of the total number of patients arriving by ambulance. There was no significant difference in ambulance usage between insurance groups in the high-acuity patients. Only high-acuity patients with neurologic symptoms (primarily seizures) had a greater relative use of EMS transportation, with 39% of these patients arriving via ambulance (odds ratio 6.6, 95% confidence interval 2.6,16.6). High-acuity patients account for the minority of total ambulance usage in our ED.
authors.affiliation: A.I. duPont Hosital for Children, Wilmington, DE 19899, USA. Skost@nemours.org
authors.forename: S
authors.initials: S
authors.lastname: Kost
authors.forename: K
authors.initials: K
authors.lastname: Cronan
authors.forename: M
authors.initials: M
authors.lastname: Gorelick
authors.forename: J
authors.initials: J
authors.lastname: Arruda
mesh_terms: D000552:Ambulances / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003691:Delaware; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007348:Insurance, Health; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014187:Transportation of Patients / Q000706:statistics & numerical data