EMS Agency Characteristics and Adverse Events in Pediatric Out-of-Hospital Cardiac Arrest Among 49 U.S. EMS Agencies.
Objectives: Pediatric out-of-hospital cardiac arrest (OHCA) impacts 15,000–25,000 children annually in the U.S. The objective of this study was to determine if specific Emergency Medical Services (EMS) agency factors, such as pediatric volume and preparedness factors, including hours of required ped...
| Publicado en: | Prehospital Emergency Care Vol. 29; no. 8; pp. 1039 - 1046 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189081631&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189081631 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10903127 FZB jtl: Prehospital Emergency Care issn: 10903127 maglogo: Y pubinfo: dt: 2025 vid: 29 iid: 8 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 189081631 182789573 189081631 189081631 10.1080/10903127.2025.2461284 189081631 ppf: 1039 ppct: 7 formats: tig: atl: EMS Agency Characteristics and Adverse Events in Pediatric Out-of-Hospital Cardiac Arrest Among 49 U.S. EMS Agencies. aug: au: Hansen, Matthew L. Walker-Stevenson, Grace Bahr, Nathan Harrod, Tabria Meckler, Garth Eriksson, Carl Idris, Ahamed Aufderheide, Tom P. Daya, Mohamud R. Fink, Ericka L. Jui, Jonathan Luetje, Maureen Martin-Gill, Christian Mcgaughey, Steven Pelletier, Jonathan H. Thomas, Danny Guise, Jeanne-Marie affil: Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon sug: subj: Emergency Medical Services Organizations Prehospital Care Heart Arrest Prognosis Heart Arrest Prognosis Quality of Health Care Evaluation Adverse Health Care Event Risk Factors Risk Assessment Human Funding Source United States Male Female Infant Child, Preschool Child Adolescence Retrospective Design Record Review Organizational Efficiency Organizational Structure Paramedics Professional Knowledge Age Factors Descriptive Statistics Confidence Intervals Regression Univariate Statistics Multivariate Statistics Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Male Female ab: Objectives: Pediatric out-of-hospital cardiac arrest (OHCA) impacts 15,000–25,000 children annually in the U.S. The objective of this study was to determine if specific Emergency Medical Services (EMS) agency factors, such as pediatric volume and preparedness factors, including hours of required pediatric training, pediatric emergency care coordinator (PECC), or pediatric informational resources are associated with improved quality of care or adverse events for pediatric OHCA. Methods: We conducted a retrospective chart review of EMS clinical records and EMS agency survey among five agencies in the Portland OR, Pittsburgh PA, Milwaukee WI, San Bernardino CA, Atlanta GA, and Dallas TX regions. We reviewed medical records of children who experienced an EMS-treated OHCA between 2013 and 2019 using a validated structured chart review tool to identify adverse safety events (ASEs). Agencies who contributed medical records completed a survey that described elements of pediatric preparedness and organizational structure relevant to pediatric care. We first conducted a descriptive analysis of agency and patient characteristics, followed by an evaluation of the association of agency factors that we hypothesized could improve pediatric care and reduce the occurrence of ASEs. Results: Twenty-two agencies with a total of 659 OHCA patient encounters completed the survey. The Broselow system was used by 81% of agencies, local protocol guides were used in 86% of agencies. Forty-five percent of agencies had a designated pediatric emergency care coordinator (PECC). Agencies reported a similar number of hours for pediatric and neonatal simulation (1.3 and 1.5 h, respectively) and skills training (2.0 and 2.5 h, respectively) annually. We found that younger patient age significantly increased the risk of an ASE. In both univariate and multivariate analyses, several hypothesized variables were not associated with decreased risk of an ASE, including pediatric and neonatal skills/simulation training hours, conducting pediatric-specific quality reviews, and having an identified PECC. Conclusions: In this large medical record review of EMS-treated pediatric OHCA cases, pediatric training, pediatric care coordination, and conducting pediatric quality reviews were not associated with reduced ASEs. Additional research is needed to understand how EMS agencies can improve the quality of care for pediatric OHCA, especially for infants. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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