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{
    "pk": 18408,
    "title": "Pediatric Outcomes of Emergency Medical Services Non-Transport Before and During the COVID-19 Pandemic",
    "subtitle": null,
    "abstract": "<b>Introduction:</b> Pediatric patients account for 6–10% of emergency medical services (EMS) activations in the United States. Approximately 30% of these children are not transported to an emergency department (ED). Adult data in the literature reports higher hospitalization and complications following non-transport. Few studies discuss epidemiology and characteristics of pediatric non-transport; however, data on outcome is limited. Our primary aim was to determine outcomes of non-transported children within our urban EMS system before and during the COVID-19 pandemic. Our secondary objective was to explore reasons for non-transport.<p></p><p><b><b>Methods: </b></b>This was a prospective, descriptive pilot study. We compared EMS data for September 2019 (pre-COVID-19) to September 2020 (pandemic). Included were children aged 0–17 years who activated EMS and did not receive transport to the primary hospital for the EMS capture area. We defined outcomes as repeat EMS activation, ED visits, and hospital admissions, all within 72 hours. Data was obtained via electronic capture. We used descriptive statistics to analyze our data, chi square for categorical data, stepwise logistic regression, and univariate logistic regression to test for association of covariates with non-transport.</p><p></p><p><b><b><b>Results:</b> </b></b>There were 1,089 pediatric EMS activations in September 2019 and 780 in September 2020. Non-transport occurred in 633 (58%) in September 2019 and 412 (53%) in September 2020. Emergency medical services was reactivated within 72 hours in the following: 9/633 (1.4%) in 2019; and 5/412 (1.2%) in 2020 (P = 0.77). Visits to the ED occurred in 57/633 (9%) in 2019 and 42/412 (10%) in 2020 (P = 0.53). Hospital admissions occurred in 10/633 (1.5%) in 2019 and 4/412 (0.97%) in 2020 (P = 0.19). One non-transported patient was admitted to the intensive care unit in September 2020 (&lt;1%) and survived. Hispanic ethnicity, age &gt;12 years, and fever were associated with repeat EMS activation. The most common reason for non-transport in both study periods was that the parent felt an ambulance</p>was not necessary (47%).<b><b><p><b><b>Conclusion:</b> </b>In our system, non-transport of pediatric patients occurred in &gt;50% of EMS activations with no significant adverse outcome. Age &gt;12 years, fever, and Hispanic ethnicity were more common in repeated EMS activations. The most common reason for non-transport was parents feeling it was not necessary. Future studies are needed to develop reliable EMS guidelines for pediatric non-transport.</p></b></b>",
    "language": null,
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "pediatric"
        },
        {
            "word": "EMS"
        },
        {
            "word": "Non-transport"
        },
        {
            "word": "COVID"
        }
    ],
    "section": "Pediatrics",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/1t5945bc",
    "frozenauthors": [
        {
            "first_name": "Lori",
            "middle_name": "",
            "last_name": "Pandya",
            "name_suffix": "",
            "institution": "University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Emergency Medicine, Dallas, Texas",
            "department": "None"
        },
        {
            "first_name": "Brandon",
            "middle_name": "",
            "last_name": "Morshedi",
            "name_suffix": "",
            "institution": "University of Arkansas for Medical Sciences, Deprtment of Emergency Medicine, Little Rock, Arkansas",
            "department": "None"
        },
        {
            "first_name": "Brian",
            "middle_name": "",
            "last_name": "Miller",
            "name_suffix": "",
            "institution": "University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas",
            "department": "None"
        },
        {
            "first_name": "Halim",
            "middle_name": "",
            "last_name": "Hennes",
            "name_suffix": "",
            "institution": "University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Emergency Medicine, Dallas, Texas",
            "department": "None"
        },
        {
            "first_name": "Mohamed",
            "middle_name": "",
            "last_name": "Badawy",
            "name_suffix": "",
            "institution": "University of Texas Southwestern Medical Center, Department of Pediatrics, Division of Emergency Medicine, Dallas, Texas",
            "department": "None"
        }
    ],
    "date_submitted": "2023-07-24T17:21:36Z",
    "date_accepted": "2023-07-24T17:21:36Z",
    "date_published": "2024-02-09T14:00:00Z",
    "render_galley": {
        "label": "Final Article",
        "type": "pdf",
        "path": "https://journalpub.escholarship.org/westjem/article/18408/galley/9606/download/"
    },
    "galleys": [
        {
            "label": "Final Article",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18408/galley/9606/download/"
        }
    ]
}