Children and Restraints Study in Emergency Ambulance Transport

Author:

Cochran-Caggiano Nicholas1,Till Sara2,Holt Christian3,Lang Nicholas2,Ata Ashar4,Cerone Jennifer5,Dailey Michael W.4

Affiliation:

1. Department of Emergency Medicine, Upstate Medical University, Syracuse

2. Albany Medical College, Albany, NY

3. Division of Emergency Medicine, Department of Medicine, University of Chicago, Chicago, IL

4. Department of Emergency Medicine

5. Division of Neonatology, Department of Pediatrics, Albany Medical Center, Albany, NY.

Abstract

ObjectivesThe aims of this study were to identify the pediatric transport methods used by Emergency Medical Services (EMS) personnel in our area and to highlight the need for federal standards to unify prehospital transport of children.MethodsChildren and Restraints Study in Emergency Ambulance Transport is a retrospective observational study of EMS arrivals to an academic pediatric emergency department for 1 year. Review of existing security footage from the ambulance entrance focused on the appropriateness of the selected restraints and the correctness of their application. A total of 3034 encounters were adequate for review and were matched to an emergency department encounter. Weight and age were identified from the chart. Patient weight was used in conjunction with video review to assess for the appropriateness of restraint selection.ResultsA total of 53.5% (1622) of patients were transported using a weight appropriate device or restraint system. In 77.1% of all cases (2339), the devices or restraint systems were applied incorrectly. The best results were observed for commercial pediatric restraint devices (54.5% secured appropriately) and for convertible car seats (55.5%). Ambulance cot was used alone in 69.35% of all transports despite it being the appropriate choice in just 18.2% of transports.ConclusionsOur findings confirmed that most pediatric patients transported by EMS are not appropriately secured and are at increased injury in a crash and potentially during normal vehicle operation. Opportunity exists for regulators, industry, and leaders in EMS and pediatrics to develop fiscally and operationally prudent techniques and devices to improve the safety of children in ambulances.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Emergency Medicine,Pediatrics, Perinatology and Child Health

Reference11 articles.

1. Determinants of pediatric EMS utilization in children with high-acuity conditions;Prehosp Emerg Care,2018

2. Pediatric transport practices among prehospital providers;Pediatr Emerg Care,2020

3. Ambulance transport of noncritical children: emergency medical service providers' knowledge, opinions, and practice;Clin Pediatr (Phila),2014

4. Child and provider restraints in ambulances: knowledge, opinions, and behaviors of emergency medical services providers;Acad Emerg Med,2008

5. Use of restraints in ambulances: a state survey;Pediatr Emerg Care,1998

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