title: Prevalence of Unique Pediatric Pathologies Encountered by Paramedic Students Across Age Groups.
abstract: Introduction Traditionally, Emergency Medical Services (EMS) educators have divided the pediatric population into age groups to assist in targeting their clinical and didactic curriculum. Currently, the accrediting body for paramedic training programs requires student exposure to pediatric patients based entirely on age without specifying exposure to specific pathologies within each age stratification. Identifying which pathologies are most common within the different pediatric age groups would allow educators to design curriculum targeting the most prevalent pathologies in each age group and incorporating the physiologic and psychological developmental milestones commonly seen at that age. Hypothesis It was hypothesized that there are unique clusterings of pathologies, represented by paramedic student primary impressions, that are found in different age groups which can be used to target provider education.
  
  
  METHODS
  This is a retrospective review of prospectively collected data documented by paramedic students in the Fisdap (Field Internship Student Data Acquisition Project; Saint Paul, Minnesota USA) database over a one-year period. For the purposes of this study, pediatric patients were defined arbitrarily as those between the ages of 0-16 years. All paramedic student primary impressions recorded in Fisdap for patients aged 0-16 years were abstracted. Primary impression by age was calculated and graphed. The frequency of primary impression was then assessed for significance of trend by age with an alpha ≤.05 considered significant.
  
  
  RESULTS
  The following primary impressions showed clinically and statistically significant variability in prevalence among different pediatric age groups: respiratory distress, medical-other, abdominal pain, seizure, overdose/poisoning, behavioral, and cardiac. In patients less than 13 years old, respiratory and other-medical were the most common two primary impressions and both decreased with age. In patients 5-16 years old, the prevalence of abdominal pain and behavioral/psych increased. Bimodal distributions for overdose were seen with one spike in the toddler and another in the adolescent population. Seizures were most common in the age group associated with febrile seizure. Sepsis was seen most often in the youngest patients and its prevalence decreased with age.
  
  
  CONCLUSIONS
  There are statistically significant variations in the frequency of paramedic student primary impressions as a function of age in the pediatric population. Emphasizing paramedic student exposure to the most common pathologies encountered in each age group, in the context of the psychological and physiological milestones of each age, may improve paramedic student pediatric practice. Ernest EV , Brazelton TB , Carhart ED , Studnek JR , Tritt PL , Philip GA , Burnett AM . Prevalence of unique pediatric pathologies encountered by paramedic students across age groups. Prehosp Disaster Med. 2016; 31(4):386-391.
authors.affiliation: 1Regions Hospital,Emergency Medical Services,Saint Paul,MinnesotaUSA.
authors.forename: Eric V
authors.initials: EV
authors.lastname: Ernest
authors.affiliation: 2University of Wisconsin School of Medicine and Public Health,Madison,WisconsinUSA.
authors.forename: Tom B
authors.initials: TB
authors.lastname: Brazelton
authors.affiliation: 3Assistant Professor of Emergency Services,Jefferson College of Health Sciences,Roanoke,VirginiaUSA.
authors.forename: Elliot D
authors.identifier: http://orcid.org/0000-0003-4127-0640
authors.initials: ED
authors.lastname: Carhart
authors.affiliation: 4Center for Prehospital Medicine,Carolinas Medical Center,Charlotte,North CarolinaUSA.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Studnek
authors.affiliation: 5Director of EMS and Trauma,HealthONE,Denver,ColoradoUSA.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Tritt
authors.affiliation: 6FISDAP,Saint Paul,MinnesotaUSA.
authors.forename: Genghis A
authors.initials: GA
authors.lastname: Philip
authors.affiliation: 1Regions Hospital,Emergency Medical Services,Saint Paul,MinnesotaUSA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Burnett
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008910:Minnesota / Q000453:epidemiology; D000070316:Pediatric Emergency Medicine / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies
keywords: CoAEMSP Committee on Accreditation of Educational Programs for the EMS Professions; EMS Emergency Medical Services; medical education; paramedic education; pediatric