Calling 911! What Role Does the Pediatrician Play?
| Autor: | Sergey Kunkov, Carl P. Kaplan, Ellen F. Crain, Devin Grossman |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Parents Pediatrics medicine.medical_specialty Adolescent Ambulances Psychological intervention Anxiety Health Services Misuse Logistic regression Physicians Primary Care Young Adult Hospitals Urban Patient Admission Surveys and Questionnaires Ethnicity medicine Humans Prospective Studies Young adult Child Physician's Role Prospective cohort study Diagnosis-Related Groups Physician-Patient Relations Hospitals Public business.industry Emergency Medical Service Communication Systems General Medicine Patient Acceptance of Health Care Hospitals Pediatric Triage Confidence interval Telephone Caregivers Pediatrics Perinatology and Child Health Public hospital Emergency Medicine Female New York City medicine.symptom Emergency Service Hospital business |
| Zdroj: | Pediatric Emergency Care. 29:726-728 |
| ISSN: | 0749-5161 |
| DOI: | 10.1097/pec.0b013e318294dd98 |
| Popis: | OBJECTIVE The objective of this study was to compare admission rates and medical interventions among children whose caregivers called their child's primary care provider (PCP) before taking an ambulance to the pediatric emergency department (PED) versus those who did not. METHODS This was a prospective cohort study of patients brought to an urban, public hospital PED via emergency medical system (EMS). Children were included if the caregiver called 911 to have them transported via EMS and was present in the PED. The main variable was whether the child's PCP was called before EMS utilization. Study outcomes were medical interventions, such as intravenous line insertion or laboratory tests, and hospital admission. χ Test and logistic regression were used to evaluate the relationship of the main variable to the study outcomes. RESULTS Six hundred fourteen patients met inclusion criteria and were enrolled. Five hundred eighty-five patients (95.3%) were reported to have a PCP. Seventy-four caregivers (12.1%) called their child's PCP before calling EMS. Two hundred seventy-seven patients (45.1%) had medical interventions performed; of these, 42 (15.2%) called their PCP (P = 0.03). Forty-two patients (6.8%) were admitted; among these, 14 (33.3%) called their PCP (P < 0.01). Adjusting for triage level, patients whose caregiver called the PCP before calling EMS were 3.2 times (95% confidence interval, 1.9-5.2 times) more likely to be admitted and 1.7 times (95% confidence interval, 1.1-2.9 times) more likely to have a medical intervention compared with patients whose caregivers did not call their child's PCP. CONCLUSIONS Children were more likely to be admitted or require a medical intervention if their caregiver called their PCP before calling EMS. The availability of a PCP for telephone triage may help to optimize EMS utilization. |
| Databáze: | OpenAIRE |
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