Epidemiology of pediatric transports and non-transports in an urban Emergency Medical Services system.
OBJECTIVE
This study was done to describe an urban, Emergency Medical Service (EMS) system's experiences with pediatric patients and the rate and characteristics of non-transports in this setting.


METHODS
A retrospective analysis of all pediatric patients responded to by the Detroit Fire Department Division of EMS between January 1, 2002 and August 30, 2002 was done.


RESULTS
There were 5,976 pediatric EMS cases. Children 10 years of age or older accounted for 49.4% of transports, 53.8% of all patients had medical illness, and 38.8% of the patients belonged to the non-urgent category. A large percentage of patients were not transported (27.2%), most commonly secondary to parent/caregiver/patient refusals. The median number of minutes on-scene for refusals was longer than for transports (23.5 vs. 17.3, respectively)[difference = 6.2 minutes (95% CI: 5.6-6.9)]. The odds ratios (OR) for refusal was highest for assaults (2.09; 95% CI: 1.66-2.63), difficulty in breathing (1.38; 95% CI: 1.14-1.68), and motor vehicle accidents (1.19; 95% CI: 1.04-1.37).


CONCLUSIONS
In this system, the majority of pediatric patients are not severely ill, and a large number are not transported. Non-transports are more likely to be young adolescents, have been involved in assaults, and have a longer on-scene time.
Kannikeswaran
Nirupama
N
Carman and Ann Adams Department of Pediatrics, Division of Emergency Medicine, The Children's Hospital of Michigan, Detroit, MI 48201, USA. nkannike@dmc.org
Mahajan
Prashant V
PV
Dunne
Robert B
RB
Compton
Scott
S
Knazik
Stephen R
SR
D000293:Adolescent; D002648:Child; D004632:Emergency Medical Services; D006801:Humans; D008824:Michigan; D010372:Pediatrics; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000706:statistics & numerical data*; D014505:Urban Population; D014947:Wounds and Injuries / Q000145:classification