Epidemiology of prehospital emergency medical service use in Korean children

Lee, Se Uk; Suh, Dongbum; Kim, Hahn Bom; Jung, Jin Hee; Hong, Ki Jeong; Lee, Jin Hee; Jang, Hye Young; Noh, Hyun; Jung, Jae Yun; Kim, Do Kyun; Kwak, Young Ho

doi:10.15441/ceem.14.024

Cited by 9 publications

(5 citation statements)

References 10 publications

(10 reference statements)

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“…Over one-third of elderly patients, and about half of patients older than 85 years, use 119 ambulances as a means of transportation to the ED. In contrast to elderly patients, 119 ambulances are called for under 30% of pediatric patients [12]. Therefore, ambulance medical equipment and environments should be tailored to the needs of elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department

et al. 2018

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ObjectiveAs aging progresses, clinical characteristics of elderly patients in the emergency department (ED) vary by age. We aimed to study differences among elderly patients in the ED by age group.MethodsFor 2 years, patients aged 65 and older were enrolled in the study and classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ≥85 years. Participants’ sex, reason for ED visit, transfer from another hospital, results of treatment, type of admission, admission department and length of stay were recorded.ResultsDuring the study period, a total 64,287 patients visited the ED; 11,236 (17.5%) were aged 65 and older, of whom 14.4% were 85 and older. With increased age, the female ratio (51.5% vs. 54.9% vs. 69.1%, P<0.001), medical causes (79.5% vs. 81.3% vs. 81.7%, P=0.045), and admission rate (35.3% vs. 42.8% vs. 48.5%, P<0.001) increased. Admissions to internal medicine (57.5% vs. 59.3% vs. 64.7%, P<0.001) and orthopedic surgery (8.5% vs. 11.6% vs. 13.8%, P< 0.001) also increased. The ratio of admission to intensive care unit showed no statistical significance (P=0.545). Patients over age 85 years had longer stays in the ED (330.9 vs. 378.9 vs. 407.2 minutes, P<0.001), were discharged home less (84.4% vs. 78.9% vs. 71.5%, P<0.001), and died more frequently (6.3% vs. 10.4% vs. 13.0%, P<0.001).ConclusionWith increased age, the proportion of female patients and medical causes increased. Rates of admission and death increased with age and older patients had longer ED and hospital stays.

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Section: Discussionmentioning

confidence: 99%

Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department

et al. 2018

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“…Factors that contribute to paediatric frequent EMS use across the literature are not well understood, although a common finding identified in our review was that paediatric frequent users were more likely to use EMS for medical rather than trauma reasons 23–25. This is contrary to the epidemiological evidence which suggests that trauma can be a larger contributor to paediatric EMS use 17 37 38. While categorisation of medical reasons varied and were applied inconsistently, common issues included respiratory and breathing problems, mental health and seizures.…”

Section: Discussionmentioning

confidence: 70%

Paediatric frequent use of emergency medical services: a systematic review

et al. 2022

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BackgroundFrequent use of emergency medical services (EMS) is recognised to be a global phenomenon, although paediatric frequent use is poorly understood. This systematic review aimed to understand how paediatric frequent use of EMS is currently defined, identify factors associated with paediatric frequent use of EMS and determine effectiveness of interventions for paediatric patients who frequently use EMS.MethodsFour electronic databases (Medline, CINAHL, Web of Science and PsycINFO) were searched to September 2022 for primary, peer-reviewed research studies published in English from January 2000. Studies were included that examined frequent use (>1 contact during study period) of EMS or other services with arrival via EMS. Paediatric patients were defined as <18 years of age or otherwise defined by study authors as paediatric/adolescent/children. Data were extracted using a structured proforma, and quality was assessed using the Standard Quality Assessment Criteria for Quantitative Studies but did not influence inclusion decisions. Data were presented using narrative synthesis.ResultsThe search resulted in 4172 unique references, with 12 papers included in the review from 7 countries. Four were EMS studies, and eight Emergency Department with arrival via EMS. All studies used retrospective designs, with no interventional studies identified. Paediatric frequent EMS users were more likely to use services for medical reasons rather than trauma, including respiratory complaints, mental health and seizures, but data on gender and ethnicity were inconclusive and silent on socioeconomic status. There was no consistency in definitions of either a paediatric patient or of frequent use.ConclusionThe broad range of reasons for frequent use suggests that a single intervention is unlikely to be effective at addressing the causes of frequent use. There is a need for further research to better identify the underlying reasons for frequent EMS use among paediatric patients and to develop interventions in this population.

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“…The 119 EMS headquarters' were located across 17 different provinces, each of which was operated and maintained within the same structure as the electronic EMS database [13]. The database included patient demographic characteristics and information related to injury events [14]. The 2014 EMS-IPP sample database uses multi-stage cluster sampling designed to obtain a nationally representative sample of injured pediatric patients transported via EMS.…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

The influence of age on transfer of pediatric trauma patients after initial transport to hospitals with a higher capacity for general emergency care

et al. 2022

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The aim of this study was to investigate factors associated with the decision to transfer, rather than admit, pediatric trauma patients who were initially transported to emergency departments with a high capacity for general emergency care (regional emergency centers, RECs). Methods: In this retrospective analysis of the 2014 emergency medical services (EMS) sample of injured pediatric patients, we included injured patients below 19 years of age who were transported by EMS to an REC. The main exposure variable was age, which was categorized into four groups by 5-year intervals. The primary outcome was the emergency department (ED) disposition of the patients (admission versus transfer). A multivariable logistic regression analysis was conducted to estimate the effect of age group on ED disposition. Results: Data from 2,031 patients were analyzed. The transfer rate was 49.5%. In a univariate analysis, no statistically significant associations were found between severity or age group and ED disposition (19.9% vs. 18.6%, P=0.76; 20.1% vs. 16.8%, P=0.49; respectively). After adjusting for potential covariates, age group had a significant effect on transfer. When compared to 15-19 years old, the younger age groups had higher adjusted odds ratios (aORs) for transfer (0-4 years old, aOR 7.65 [95% CI, 1.24 to 47.38]; 5-9 years old, aOR 14.48 [95% CI, 2.08 to 100.55]; 10-14 years old, aOR 5.03 [95% CI, 10.5 to 26.79]). Conclusion: Younger pediatric patients with moderate to severe trauma are more likely to be transferred to another hospital despite initial transportation to a REC.

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Epidemiology of prehospital emergency medical service use in Korean children

Cited by 9 publications

References 10 publications

Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department

Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department

Paediatric frequent use of emergency medical services: a systematic review

The influence of age on transfer of pediatric trauma patients after initial transport to hospitals with a higher capacity for general emergency care

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