title: Documentation of pediatric vital signs by EMS providers over time.
abstract: BACKGROUND
  Pediatric patients make up approximately 10% of EMS transports nationwide. Previous studies demonstrated that pediatric patients do not consistently have a full set of vitals signs obtained in the prehospital setting [1]. In certain conditions, such as traumatic head injury and shock, unrecognized hypotension and/or hypoxia are associated with increased morbidity and mortality [2,3].
  
  
  OBJECTIVE
  
  
  
  OBJECTIVE
  To measure how often EMS providers obtain blood pressure (BP), heart rate (HR), pulse oximetry (Po), and respiratory rate (RR) on pediatric transport patients in the state of Utah from 2007 to 2014.
  
  
  OBJECTIVE
  To assess whether educational interventions improved the percentage of pediatric transport patients with a full set of vital signs documented.
  
  
  RESULTS
  The trend of documenting the four critical vital signs improved over time for all four categories. Measurement of Po increased most consistently across all age groups. Blood pressure remained the most inconsistently obtained vital sign, especially in younger pediatric patients. The educational interventions introduced in late 2010 correlated with an increase in vital sign attainment.
  
  
  CONCLUSIONS
  Assessment of pediatric vitals signs is a critical part of the evaluation and care of pediatric patients in the prehospital setting. Utah EMS providers improved their practice of documenting four pediatric vital signs over time after educational interventions. Obtaining a BP, especially in younger children, continues to be a challenge. More work remains to achieve the state goal of documenting all vital signs in >90% of pediatric transports.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84108, United States. Electronic address: Hilary.hewes@hsc.utah.edu.
authors.forename: Hilary
authors.initials: H
authors.lastname: Hewes
authors.affiliation: Bureau of Emergency Medical Services and Preparedness, Utah Department of Health, PO Box 142004, Salt Lake City, UT 84114, United States.
authors.forename: Shari
authors.initials: S
authors.lastname: Hunsaker
authors.affiliation: Bureau of Emergency Medical Services and Preparedness, Utah Department of Health, PO Box 142004, Salt Lake City, UT 84114, United States.
authors.forename: Mathew
authors.initials: M
authors.lastname: Christensen
authors.affiliation: Bureau of Emergency Medical Services and Preparedness, Utah Department of Health, PO Box 142004, Salt Lake City, UT 84114, United States. Electronic address: jrwhitney@utah.gov.
authors.forename: Jolene
authors.initials: J
authors.lastname: Whitney
authors.affiliation: Bureau of Emergency Medical Services and Preparedness, Utah Department of Health, PO Box 142004, Salt Lake City, UT 84114, United States; Primary Children's Hospital, 100 Mario Capecchi Dr., Salt Lake City, UT 84132, United States. Electronic address: Tia.Dalrymple@imail.org.
authors.forename: Tia
authors.initials: T
authors.lastname: Dalrymple
authors.affiliation: Bureau of Emergency Medical Services and Preparedness, Utah Department of Health, PO Box 142004, Salt Lake City, UT 84114, United States; Division of Emergency Medicine, Department of Surgery, University of Utah School of Medicine, 30N 1900 E 1C026, Salt Lake City, UT 84132, United States. Electronic address: Peter.taillac@hsc.utah.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Taillac
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D001795:Blood Pressure Determination; D002648:Child; D002675:Child, Preschool; D004282:Documentation; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000193:education; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010092:Oximetry; D056152:Respiratory Rate; D012189:Retrospective Studies; D014589:Utah; D055986:Vital Signs
keywords: Blood pressure; EMS (emergency medical services); Pediatrics; Performance improvement; Vital signs