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{
    "pk": 33507,
    "title": "Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings",
    "subtitle": null,
    "abstract": "<p><strong>Objectives:</strong> Barriers to healthcare in rural areas can delay treatment in pediatric patients who have experienced poisoning. We compared emergency medical services (EMS) response times and EMS-reported delays in responding to pediatric poisoning incidents between rural and urban settings using the 2021 National Emergency Medical Services Information System (NEMSIS). </p>\n<p><strong>Methods: </strong>The NEMESIS defines rural areas as locations with a population of &lt;50,000, not part of metropolitan areas, while all other locations are classified as urban (metropolitan) areas. In this study we included 11,911 patients (12% rural) &lt;18 years of age who were transported by EMS with a first-responder primary impression of poisoning. We compared study variables using rank-sum tests and chi-square tests. Multivariable analysis of outcomes included quantile regression and logistic regression for continuous data and categorical data, respectively.</p>\n<p><strong>Results:</strong> The median total prehospital time by EMS was 40 minutes (interquartile range 29-57), and the most common type of delay was scene delay (6%). On multivariable quantile regression, patients transported by rural EMS agencies experienced 6.6 minutes (95% confidence interval 5-8, P&lt;0.001) longer prehospital time than those transported by urban agencies. There were no differences between rural and urban EMS agencies in the occurrence of dispatch, response, scene, and transportation delays. </p>\n<p><strong>Conclusion: </strong>These results elucidate the need for equitable allocation of resources and training to enhance rural EMS responders. The additional nearly seven minutes translates into greater risk for the human body to remain physiologically unstable and not be optimally treated. Therefore, by integrating targeted interventions to rural pediatric populations, better care can be achieved across all geographic regions. Further research must be conducted to ascertain the specific factors, aside from delays, that result in the disparity between rural and urban prehospital response time.</p>",
    "language": "eng",
    "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": "pediatric poisoning"
        },
        {
            "word": "poisoning"
        },
        {
            "word": "EMS"
        },
        {
            "word": "NEMSIS"
        },
        {
            "word": "health disparities"
        },
        {
            "word": "Rural Medicine"
        },
        {
            "word": "prehospital"
        }
    ],
    "section": "Toxicology",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/945975f1",
    "frozenauthors": [
        {
            "first_name": "Aaron",
            "middle_name": "T.",
            "last_name": "Phillips",
            "name_suffix": "",
            "institution": "Brody School of Medicine, Department of Medical Education, Greenville, North Carolina",
            "department": ""
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Denning",
            "name_suffix": "",
            "institution": "Brody School of Medicine, Department of Medical Education, Greenville, North Carolina",
            "department": ""
        },
        {
            "first_name": "Em",
            "middle_name": "",
            "last_name": "Long-Mills",
            "name_suffix": "",
            "institution": "Brody School of Medicine, Department of Clinical and Educational Scholarship, Greenville, North Carolina",
            "department": ""
        },
        {
            "first_name": "Dmitry",
            "middle_name": "",
            "last_name": "Tumin",
            "name_suffix": "",
            "institution": "Brody School of Medicine, Department of Clinical and Educational Scholarship, Greenville, North Carolina",
            "department": ""
        },
        {
            "first_name": "Jennifer",
            "middle_name": "",
            "last_name": "Parker-Cote",
            "name_suffix": "",
            "institution": "Brody School of Medicine, Department of Emergency Medicine, Greenville, North Carolina",
            "department": ""
        },
        {
            "first_name": "Kathleen",
            "middle_name": "",
            "last_name": "Bryant",
            "name_suffix": "",
            "institution": "Brody School of Medicine, Department of Emergency Medicine, Greenville, North Carolina",
            "department": ""
        }
    ],
    "date_submitted": "2024-07-28T11:21:39.636000-07:00",
    "date_accepted": "2025-01-27T00:09:54.149000-07:00",
    "date_published": "2025-05-23T08:28:00-07:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/33507/galley/36409/download/"
        }
    ]
}