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Mockler S, Metelmann C, Metelmann B, Thies KC. Prevalence and severity of pediatric emergencies in a German helicopter emergency service: implications for training and service configuration. Eur J Pediatr 2023; 182:5057-5065. [PMID: 37656240 PMCID: PMC10640406 DOI: 10.1007/s00431-023-05178-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
This study primarily aims to determine the frequency of life-threatening conditions among pediatric patients served by the DRF, a German helicopter emergency service (HEMS) provider. It also seeks to explore the necessity of invasive procedures in this population, discussing the implications for HEMS crew training and service configuration based on current literature. We analyzed the mission registry from 31 DRF helicopter bases in Germany, focusing on 7954 children aged 10 or younger over a 5-year period (2014-2018). Out of 7954 identified children (6.2% of all primary missions), 2081 (26.2%) had critical conditions. Endotracheal intubation was needed in 6.5% of cases, while alternative airway management methods were rare (n = 14). Half of the children required intravenous access, and 3.6% needed intraosseous access. Thoracostomy thoracentesis and sonography were only performed in isolated cases. Conclusions: Critically ill or injured children are infrequent in German HEMS operations. Our findings suggest that the likelihood of HEMS teams encountering such cases is remarkably low. Besides endotracheal intubation, life-saving invasive procedures are seldom necessary. Consequently, we conclude that on-the-job training and mission experience alone are insufficient for acquiring and maintaining the competencies needed to care for critically ill or injured children. What is Known: • Pediatric emergencies are relatively rare in the prehospital setting, but their incidence is higher in helicopter emergency medical services (HEMS) compared to ground-based emergency services. What is New: • On average, HEMS doctors in Germany encounter a critically ill or injured child approximately every 1.5 years in their practice, establish an IV or IO access in infants or toddlers every 2 years, and intubate an infant every 46 years. • This low frequency highlights the insufficiency of on-the-job training alone to develop and maintain pediatric skills among HEMS crews. Specific interdisciplinary training for HEMS crews is needed to ensure effective care for critically unwell pediatric patients.
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Affiliation(s)
- Stefan Mockler
- Department of Anesthesiology, University Hospital Greifswald, Sauerbruchstr, 17475, Greifswald, Germany.
| | - Camilla Metelmann
- Department of Anesthesiology, University Hospital Greifswald, Sauerbruchstr, 17475, Greifswald, Germany
| | - Bibiana Metelmann
- Department of Anesthesiology, University Hospital Greifswald, Sauerbruchstr, 17475, Greifswald, Germany
| | - Karl Christian Thies
- Department of Anaesthesiology and Critical Care, EvKB, OWL University Medical Center, Campus Bielefeld Bethel, Burgsteig 13, 33617, Bielefeld, Germany
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Nielsen VM, Bruun NH, Søvsø MB, Kløjgård TA, Lossius HM, Bender L, Mikkelsen S, Tarpgaard M, Petersen JA, Christensen EF. Pediatric Emergencies in Helicopter Emergency Medical Services: A National Population-Based Cohort Study From Denmark. Ann Emerg Med 2022; 80:143-153. [DOI: 10.1016/j.annemergmed.2022.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022]
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Moors XRJ, Alink MO, Bouman S, Schober P, De Leeuw M, Hoogerwerf N, Bergsma M, Hartog DD, Houmes RJ, Stolker RJ. A Nationwide Retrospective Analysis of Out-of-Hospital Pediatric Cardiopulmonary Resuscitation Treated by Helicopter Emergency Medical Service in the Netherlands. Air Med J 2021; 40:410-414. [PMID: 34794780 DOI: 10.1016/j.amj.2021.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/28/2021] [Accepted: 08/06/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE There is generally limited but conflicting literature on the incidence, causes, and outcomes of pediatric out-of-hospital cardiac arrest. This study was performed to determine the incidence and outcome of pediatric out-of-hospital cardiac arrest reported by all helicopter emergency medical services in the Netherlands and to provide a description of causes and treatments and, in particular, a description of the specific interventions that can be performed by a physician-staffed helicopter emergency medical service. METHODS A retrospective analysis was performed of all documented pediatric (0 < 18 years of age) out-of-hospital cardiac arrests from July 2015 to July 2017, attended by all 4 Dutch helicopter emergency medical service teams. RESULTS Two hundred two out-of-hospital cardiac arrests were identified. The overall incidence in the Netherlands is 3.5 out-of-hospital cardiac arrests in children per 100,000 pediatric inhabitants. The overall survival rate for out-of-hospital cardiac arrest was 11.4%. Eleven (52%) of the survivors were in the drowning group and between 12 and 96 months of age. CONCLUSION Helicopter emergency medical services are frequently called to pediatric out-of-hospital cardiac arrests in the Netherlands. The survival rate is normal to high compared with other countries. The 12- to 96-month age group and drowning seem to have a relatively favorable outcome.
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Affiliation(s)
- Xavier R J Moors
- Department of Anesthesiology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands; HEMS Lifeliner 2, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Michelle Oude Alink
- Department of Anesthesiology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Stef Bouman
- Department of Anesthesiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Patrick Schober
- Department of Anesthesiology, Amsterdam University Medical Center, VU Medical Center, Amsterdam, The Netherlands; HEMS Lifeliner 1, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Marcel De Leeuw
- Department of Anesthesiology, Amsterdam University Medical Center, VU Medical Center, Amsterdam, The Netherlands; HEMS Lifeliner 1, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Nico Hoogerwerf
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; HEMS Lifeliner 3, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Margot Bergsma
- Department of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands; HEMS Lifeliner 4, University Medical Center Groningen, Groningen, The Netherlands
| | - Dennis Den Hartog
- Trauma Research Unit Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert Jan Houmes
- HEMS Lifeliner 2, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatric Intensive Care, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Robert Jan Stolker
- Department of Anesthesiology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
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Oude Alink MB, Moors XRJ, Karrar S, Houmes RJ, Hartog DD, Stolker RJ. Characteristics, management and outcome of prehospital pediatric emergencies by a Dutch HEMS. Eur J Trauma Emerg Surg 2021; 48:989-998. [PMID: 33543366 PMCID: PMC9001565 DOI: 10.1007/s00068-020-01579-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/16/2020] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Michelle Berdien Oude Alink
- Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands. .,Department of Pediatric Anesthesiology, Erasmus University Medical Center Rotterdam-Sophia Children's Hospital, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Xavier Roland Johnny Moors
- Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands.,HEMS, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Senned Karrar
- Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | - Robert Jan Houmes
- 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
| | - Dennis Den Hartog
- Department of Surgery-Traumatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert Jan Stolker
- Department of Anesthesiology, Erasmus University Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands
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Abstract
Introduction The concept of response time with minimal interval is intimately related to the practice of emergency medicine. The factors influencing this time interval are poorly understood. Problem In a process of improvement of response time, the impact of the patient's age on ambulance departure intervals was investigated. METHOD This was a 3-year observational study. Departure intervals of ambulances, according to age of patients, were analyzed and a multivariate analysis, according to time of day and suspected medical problem, was performed. RESULTS A total of 44,113 missions were included, 2,417 (5.5%) in the pediatric group. Mean departure delay for the adult group was 152.9 seconds, whereas it was 149.3 seconds for the pediatric group (P =.018). CONCLUSION A statistically significant departure interval difference between missions for children and adults was found. The difference, however, probably was not significant from a clinical point of view (four seconds). Schnegg B , Pasquier M , Carron PN , Yersin B , Dami F . Prehospital Emergency Medical Services departure interval: does patient age matter? Prehosp Disaster Med. 2016;31(6):608-613.
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Taubenböck S, Lederer W, Kaufmann M, Kroesen G. HEMS in Alpine Rescue for Pediatric Emergencies. Wilderness Environ Med 2016; 27:409-14. [PMID: 27377920 DOI: 10.1016/j.wem.2016.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 03/11/2016] [Accepted: 03/12/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The objective of this study was to describe the pediatric emergencies encountered by the Christophorus-1 helicopter emergency medical service (HEMS) during a period of 2 years. METHODS Emergency treatment of pediatric casualties by HEMS was evaluated at a helicopter base. Children up to 14 years who were treated by HEMS emergency physicians from Christophorus-1 during primary missions in the alpine region were retrospectively enrolled. RESULTS Of the 1314 HEMS operations conducted during a 2-year investigation period, pediatric emergencies accounted for 114 (8.7%). Trauma was the most common emergency indication (91.3%) in alpine areas, and 77.5% of the indications were related to skiing and snowboarding; 11.3% of the prehospital pediatric emergencies were classified as life-threatening. Interventions on site were rendered in 46.3% of cases. Mean and SD intervals for approach were 11.0 ± 3.0 minutes; for treatment, 14.0 ± 6.0 minutes; and for transport, 8.0 ± 4.0 minutes. Intervals on site were significantly longer whenever it was necessary to search for an interim landing place (P < .001) or perform rope extrication (P < .001). Aggravating environmental conditions such as low temperature (78.8%), rocky terrain (18.8%), or precipitation (12.5%) were common. CONCLUSIONS Rapid procedures are preferred to sustained on-scene treatment, particularly when surrounding conditions are hostile. HEMS emergency physicians attempt to keep on-site intervals short and treatment and monitoring to the essential to minimize delay in rescue.
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Affiliation(s)
- Stefan Taubenböck
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Lederer
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
| | - Marc Kaufmann
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Gunnar Kroesen
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
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Demaret P, Lebrun F, Devos P, Champagne C, Lemaire R, Loeckx I, Messens M, Mulder A. Pediatric pre-hospital emergencies in Belgium: a 2-year national descriptive study. Eur J Pediatr 2016; 175:921-30. [PMID: 27075015 DOI: 10.1007/s00431-016-2723-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 03/17/2016] [Accepted: 03/30/2016] [Indexed: 11/27/2022]
Abstract
UNLABELLED This study aims to describe the pediatric physician-staffed EMS missions at a national level and to compare the pediatric and the adult EMS missions. Using a national database, we analyzed 254,812 interventions including 15,294 (6 %) pediatric emergencies. Less children than adults received an intravenous infusion (52.7 versus 77.1 %, p < 0.001), but the intra-osseous access was used more frequently in children (1.3 versus 0.8 %, p < 0.001). More children than adults benefited from a therapeutic immobilization (16.3 versus 13.2 %, p < 0.001). Endotracheal intubation was rare in children (2.1 %) as well as cardiopulmonary resuscitation (1.2 %). Children were more likely than adults to suffer from a neurological problem (32.4 versus 21.3 %, p < 0.001) or from a trauma (27.1 versus 16.8 %, p < 0.001). The prevalence of the pediatric diagnoses showed an age dependency: the respiratory problems were more prevalent in infants (40.3 % of the 0-12-months old), 52.1 % of the 1-4-year-old children suffered from a neurological problem, and the prevalence of trauma raised from 14.8 % of the infants to 47.1 % of the 11-15 year olds. CONCLUSION Pre-hospital pediatric EMS missions are not frequent and differ from the adult interventions. The pediatric characteristics highlighted in this study should help EMS teams to be better prepared to deal with sick children in the pre-hospital setting. WHAT IS KNOWN • Pediatric and adult emergencies differ. • Pediatric life-threatening emergencies are not frequent. What is New: • This study is the first to describe a European national cohort of pediatric physician-staffed EMS missions and to compare the pediatric and the adult missions at a national level. • This large cohort study confirms scarce regional data indicating that pediatric pre-hospital emergencies are not frequent and mostly non-life-threatening.
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Affiliation(s)
- Pierre Demaret
- Division of pediatric critical care medicine, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium.
- Intensive care unit, CHC, Clinique Saint-Joseph, Rue de Hesbaye 75, 4000, Liège, Belgium.
| | - Frédéric Lebrun
- Division of pediatric critical care medicine, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium
- Division of pediatric emergencies, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium
| | - Philippe Devos
- Intensive care unit, CHC, Clinique Saint-Joseph, Rue de Hesbaye 75, 4000, Liège, Belgium
| | - Caroline Champagne
- Division of pediatric emergencies, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium
| | - Roland Lemaire
- Division of pediatric emergencies, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium
| | - Isabelle Loeckx
- Division of pediatric critical care medicine, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium
| | - Marie Messens
- Division of pediatric emergencies, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium
| | - André Mulder
- Division of pediatric critical care medicine, Department of Pediatrics, CHC, Clinique de l'Espérance, Rue Saint-Nicolas 447, 4420, Liège, Belgium
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Harve H, Salmi H, Rahiala E, Pohjalainen P, Kuisma M. Out-of-hospital paediatric emergencies: a prospective, population-based study. Acta Anaesthesiol Scand 2016; 60:360-9. [PMID: 26489697 DOI: 10.1111/aas.12648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 09/14/2015] [Accepted: 09/19/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND We wanted to study the incidence, distribution and characteristics of paediatric out-of-hospital emergency care on a population level. This knowledge could ameliorate the design and education of emergency medical services and their personnel. METHODS We studied all (n = 1863) emergency medical services responses and the patient records for paediatric patients (age 0-16 years) in Helsinki, Finland (population 603,968, paediatric population 92,742) during a 12-month period (2012). Patient characteristics, diagnoses, time intervals, medical treatments, procedures, vital measurements and outcome of out-of-hospital treatment were available for analysis. RESULTS The incidence of emergency medical services -treated paediatric out-of-hospital emergencies was 3.8/1000 inhabitants and 20/1000 1-16-year-old inhabitants. This formed 4.5% of all emergency calls, while children have a threefold share of the population (15%). Falls, dyspnoea, seizures and poisonings account for half of all emergencies. Few patients suffered from a life-threatening condition or trauma. Cardiac arrest or need for advanced life support measures (e.g. intubation) was rare. After evaluation by the emergency medical services, only half of the patients (56%) needed ambulance transportation to hospital. Only 30 (3.7%) of the non-transported patients made an unpremeditated visit to the emergency department after the original contact with the emergency medical services. All of them were well upon arrival to the emergency department. CONCLUSION Paediatric out-of-hospital emergencies are infrequent and have specific characteristics differing from the adult population. The design and training of emergency medical services and their personnel should focus on evaluation and management of the most frequent situations.
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Affiliation(s)
- H. Harve
- Emergency Medical Services; Department of Emergency Care; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - H. Salmi
- Children's Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Anaesthesiology and Intensive Care; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - E. Rahiala
- Children's Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - P. Pohjalainen
- National Institute for Health and Welfare; Helsinki Finland
| | - M. Kuisma
- Emergency Medical Services; Department of Emergency Care; University of Helsinki and Helsinki University Hospital; Helsinki Finland
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Influence of adult role modeling on child/adolescent helmet use in recreational sledging: an observational study. Wien Klin Wochenschr 2015; 128:266-70. [PMID: 26438101 DOI: 10.1007/s00508-015-0862-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND During recreational sledging (tobogganing), the head represents the most frequent injured body region with approximately one-third of all sledging injuries among children and adolescents. Whether children are wearing a helmet or not might be influenced on parental encouragement and role modeling of helmet use. Therefore, the aim of this study was to evaluate the impact of adult helmet use on child/adolescent helmet use in recreational sledging. METHODS More than 500 adults sitting together with another adult or child/adolescent on a two-seater sledge were interviewed during two winter seasons at the bottom of six sledging tracks on demographics, mean frequency of sledging per season, self-estimated skill level, risk-taking behavior, and the use of a helmet. RESULTS Total helmet use of all observed persons was 41.0 %. Helmet use among interviewed adults significantly increased with increasing age up to 45 years, frequency of sledging, and skill level, respectively. Helmet use of interviewed adults was 46.5 % if a child/adolescent was sitting on the same sledge and 29.8 % (odds ratios (OR): 2.1, 95 % confidence intervals (CI): 1.4-2.9, p < 0.001) when sledging together with another adult. Helmet use was 71.3 % among children/adolescents and 26.7 % among adults (OR: 6.8, 95 % CI: 4.6-10.1, p < 0.001) sitting on the same sledge as the interviewed person, respectively. CONCLUSION Adults were wearing more often a helmet during recreational sledging when sitting together with a child/adolescent on the sledge. However, helmet use during sledging is clearly below 50 %. Thus, more intense educational campaigns on helmet use are urgently needed for tobogganists.
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Investigation of the status of interhospital transport of critically ill pediatric patients. World J Pediatr 2015; 11:67-73. [PMID: 25822701 DOI: 10.1007/s12519-015-0004-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 01/07/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND With the unequal distribution of medical resources in developing countries, critically ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources. Although a large number of critically ill children are transferred each day in China, the standard process of inter-hospital transport is not formulated. METHODS We retrospectively analyzed the data collected during transport. A total number of 9231 patients (≤14 years) who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1, 2009 to June 30, 2012 were included in the study. RESULTS Nearly half of the critically ill children were neonates (48.72%) and two thirds of the children were suffering from respiratory, neurological and cardiac diseases. Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression. Mobilization time in non-working hours was longer than the working hours (OR=1.186, 95% CI=1.059-1.329). Our study showed that mobilization time for neonates was shorter than that for older children (OR=0.801, 95% CI=0.692-0.928). The mobilization time of referral cases was shorter in areas within a radius of 50 km than in those within a radius of over 250 km (OR=0.427, 95% CI=0.350-0.521). Referred patients in summer needed a significantly shorter mobilization time than in winter (OR=0.705, 95% CI=0.616-0.806). CONCLUSION Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.
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Thermische Verletzungen in der ÖAMTC-Luftrettung. Unfallchirurg 2014; 117:334-40. [DOI: 10.1007/s00113-012-2321-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Selig HF, Hüpfl M, Trimmel H, Voelckel WG, Nagele P. Pediatric trauma in the Austrian Alps: the epidemiology of sport-related injuries in helicopter emergency medical service. High Alt Med Biol 2012; 13:112-7. [PMID: 22724614 DOI: 10.1089/ham.2011.1082] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND/PURPOSE We aimed to examine the epidemiological characteristics and injury patterns of pediatric trauma in helicopter emergency medical service (HEMS) caused by sports/outdoor activities in alpine environment. METHODS This retrospective cohort study analyzed 912 primary HEMS missions for pediatric trauma (0-14 years of age) in Austrian Alps between 1 January 2006 and 30 June 2007. Children were stratified by age into toddlers (3-5 years), children in early (6-9 years), and late school age (10-14 years). RESULTS The majority of pediatric sports-related trauma in alpine environment was caused by skiing (82.1%; n=749). Pediatric patients were predominately in late school age and boys (72.8%, n=664 and 61.0%, n=556, respectively) and a minority (16.0%, n=146) was severely injured. Overall, fracture (47.0%, n=429), contusion (17.9%, n=163), and traumatic brain injury (17.0%, n=155) were the most common prehospital diagnoses. The most frequent pattern of injury was related to the head/face and spine (36.3%, n=331). CONCLUSIONS The knowledge about epidemiological characteristics of HEMS use for injured children in alpine environment may be essential for training requirements of HEMS crews and operational considerations of HEMS providers. The incidence of head and spinal injuries requires support for initiatives to promote helmet wear and appropriate risk behavior amongst skiers and snowboarders.
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Affiliation(s)
- Harald F Selig
- Department of Anesthesiology and General Intensive Care and Pain Therapy, Medical University of Vienna, Vienna, Austria.
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