Characteristics, management and outcome of prehospital pediatric emergencies by a Dutch HEMS.

Autor: Oude Alink MB; Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands. m.oudealink@erasmusmc.nl.; Department of Pediatric Anesthesiology, Erasmus University Medical Center Rotterdam-Sophia Children's Hospital, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. m.oudealink@erasmusmc.nl., Moors XRJ; Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands.; HEMS, Erasmus University Medical Center, Rotterdam, The Netherlands., Karrar S; Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands., Houmes RJ; HEMS, Erasmus University Medical Center, Rotterdam, The Netherlands.; Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands., Hartog DD; Department of Surgery-Traumatology, Erasmus University Medical Center, Rotterdam, The Netherlands., Stolker RJ; Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2022 Apr; Vol. 48 (2), pp. 989-998. Date of Electronic Publication: 2021 Feb 04.
DOI: 10.1007/s00068-020-01579-8
Abstrakt: Background: In prehospital care, the Helicopter Emergency Medical Service (HEMS) can be dispatched for critically injured or ill children. However, little detail is known about dispatches for children, in terms of the incidence of prehospital interventions and overall mortality. The primary objective of this study is to provide an overview of pediatric patient characteristics and incidence of interventions.
Methods: A retrospective chart review of all patients ≤ 17 years who received medical care by Rotterdam HEMS from 2012 until 2017 was carried out.
Results: During the study period, 1905 pediatric patients were included. 59.1% of patients were male and mean age was 6.1 years with 53.2% of patients aged ≤ 3 years. 53.6% were traumatic patients and 49.7% were non-traumatic patients. 18.8% of patients were intubated. Surgical procedures were performed in 0.9%. Medication was administered in 58.1% of patients. Cardiopulmonary resuscitation (CPR) was necessary in 12.9% of patients, 19.9% were admitted to the intensive care unit and 14.0% needed mechanical ventilation. Overall mortality was 9.5%. Mortality in trauma patients was 5.5% and in non-trauma group 15.3%. 3.9% of patients died at the scene.
Conclusions: Patients attended by HEMS are at high risk of prehospital interventions like CPR or intubation. EMS has little exposure to critically ill or injured children. Hence, HEMS expertise is required to perform critical procedures. Trauma patients had higher survival rates than non-traumatic patients. This may be explained by underlying illnesses in non-traumatic patients and CPR as reason for dispatch. Further research is needed to identify options for improving prehospital care in the non trauma pediatric patients.
(© 2021. The Author(s).)
Databáze: MEDLINE
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