Characteristics and outcomes of critically ill children transported by ambulance in a Turkish prehospital system: a multicenter prospective cohort study

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dc.contributor.authorSaz, Eylem Ulas
dc.contributor.authorTuran, Caner
dc.contributor.authorAnil, Murat
dc.contributor.authorBal, Alkan
dc.contributor.authorGokalp, Gamze
dc.contributor.authorYilmaz, Hayri Levent
dc.contributor.authorTekin, Deniz
dc.date.accessioned2021-05-03T20:33:20Z
dc.date.available2021-05-03T20:33:20Z
dc.date.issued2021
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground. The most underdeveloped area in the care of critically-ill-children (CIC) is the prehospital period. Appropriate prehospital assessment and life-saving-interventions (LSI) of this population are challenging and require dedicated resources to ensure the best outcomes. We aimed to determine the characteristics and outcomes of CIC transported to the Turkish Pediatric Emergency Departments (EDs). The frequency and distribution of LSI administered by prehospital providers on route and in the EDs were also investigated. Methods. This prospective study was conducted at 4 metropolitan cities and 9 tertiary pediatric EDs between August 2014-August 2015. A survey based study evaluated all CC who were brought by ambulance to the participant EDs. CIC were defined as a patient who requires LSI or needs intensive care admission for any reason. Patient demographics, clinical features, reason for transport, performed procedures in the ambulance or ED were sought. Finally, the short-term outcomes of transported CIC and transport-associated risks were analyzed. Results. During the study period, a total 2094 children were brought by ambulance to all participant EDs. Only 227 (10.8%) of them were critically-ill. Emergency Medical Services (EMS) providers were less likely to perform procedures in CIC if they were staffed with paramedics (p<0.001). Most procedures were performed on children aged one or older (p<0.001). No procedure was performed in the ambulance for nearly one fourth of patients who received LSI in the EDs. If the EMS did not have a physician, prehospital providers were less likely to provide immediate LSIs (p<0.001). CIC were more likely referred from secondary/tertiary care hospitals. The short-term mortality rate was higher if the ambulance was staffed by only paramedics. Conclusion. This study demonstrated that Turkish prehospital pediatric emergency care is deficient. We offer a clinical overview of pediatric emergencies to aid EMS directors, policymakers, and ED directors in planning the care of CIC.en_US
dc.identifier.doi10.24953/turkjped.2021.01.007en_US
dc.identifier.endpage67en_US
dc.identifier.issn0041-4301
dc.identifier.issue1en_US
dc.identifier.pmid33686827en_US
dc.identifier.scopus2-s2.0-85102677142en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage59en_US
dc.identifier.urihttps://doi.org/10.24953/turkjped.2021.01.007
dc.identifier.urihttps://hdl.handle.net/11454/69985
dc.identifier.volume63en_US
dc.identifier.wosWOS:000625637300007en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTurkish J Pediatricsen_US
dc.relation.ispartofTurkish Journal of Pediatricsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectprehospital careen_US
dc.subjectcritically ill childrenen_US
dc.subjectambulanceen_US
dc.subjectemergency medical serviceen_US
dc.subjectparamedicen_US
dc.titleCharacteristics and outcomes of critically ill children transported by ambulance in a Turkish prehospital system: a multicenter prospective cohort studyen_US
dc.typeArticleen_US

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