Prehospital Emergency Service for Internal Medicine Problems in Pediatrics; Causes, Time Indices and Outcomes

Objective: Although pediatric pre-hospital emergency medical services (EMS) are a main challenge of health care systems, few data exists over it. Current study of ambulance calls for medical causes relating to children in Tehran was conducted with the following aims: 1) assessment of the frequency of causes of EMS call, 2) assessment of time indices of service providing by EMS, and 3) to assess the correlation between outcomes and time indices.
Material & Methods: In this retrospective study, all calls to Tehran EMS system (Dial 115) for medical causes of children =<15 years old in Tehran between December 2005 and May 2006 were extracted. Demographic variables, accident type, patient outcome before hospital arrival, and ambulance time indices (response time, scene time, total run time, total run time hospital, transport time, round trip time) were registered.
Findings: 1052 (15.5%) calls were for children. From these, 717 (68%) were due to problems of medic problems. The most frequent problem was epilepsy (26.8%), unconsciousness (18.1%) and respiratory disorders (15.2%). 12 (5. 6%) subjects died before ambulance arrival, but no one died between scene and hospital arrival. Mean (SD) delay time, response time and scene time were 3.8 ± 1.8, 15.1 ± 6.9, and 23.5 ± 10.9, respectively. The pre-hospital mortality was not correlated with any of the time intervals.
Conclusion:One of six ambulance calls in Tehran is related to pediatric patients, most of them with a medical cause. Epilepsy, unconsciousness and respiratory disorders as the most frequent causes for EMS calls for medical problems highlights the need for planning for training of the EMS personnel with these problems. There is still a need for further improvement in time intervals of EMS services, which may be possible by proper management and equipping by more ambulances.

Keywords
Prehospital Emergency Care , Pediatrics , Tehran , Time indices , Mortality