Out-of-hospital paediatric emergencies: a prospective, population-based study.
BACKGROUND
We wanted to study the incidence, distribution and characteristics of paediatric out-of-hospital emergency care on a population level. This knowledge could ameliorate the design and education of emergency medical services and their personnel.


METHODS
We studied all (n = 1863) emergency medical services responses and the patient records for paediatric patients (age 0-16 years) in Helsinki, Finland (population 603,968, paediatric population 92,742) during a 12-month period (2012). Patient characteristics, diagnoses, time intervals, medical treatments, procedures, vital measurements and outcome of out-of-hospital treatment were available for analysis.


RESULTS
The incidence of emergency medical services -treated paediatric out-of-hospital emergencies was 3.8/1000 inhabitants and 20/1000 1-16-year-old inhabitants. This formed 4.5% of all emergency calls, while children have a threefold share of the population (15%). Falls, dyspnoea, seizures and poisonings account for half of all emergencies. Few patients suffered from a life-threatening condition or trauma. Cardiac arrest or need for advanced life support measures (e.g. intubation) was rare. After evaluation by the emergency medical services, only half of the patients (56%) needed ambulance transportation to hospital. Only 30 (3.7%) of the non-transported patients made an unpremeditated visit to the emergency department after the original contact with the emergency medical services. All of them were well upon arrival to the emergency department.


CONCLUSIONS
Paediatric out-of-hospital emergencies are infrequent and have specific characteristics differing from the adult population. The design and training of emergency medical services and their personnel should focus on evaluation and management of the most frequent situations.
Emergency Medical Services, Department of Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
H
H
Harve
Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.|Anaesthesiology and Intensive Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
H
H
Salmi
Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
E
E
Rahiala
National Institute for Health and Welfare, Helsinki, Finland.
P
P
Pohjalainen
Emergency Medical Services, Department of Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
M
M
Kuisma
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies