Emergency Services Survey
While a majority of U.S. communities have organized trauma systems in place, many of those systems are not equipped to handle children’s needs, according to a recent AAP survey.
Some 80 percent of the pediatricians who responded to a recent AAP Periodic Survey of Fellows report that their communities have an organized trauma system. Of those, 36.7 percent reported that their communities’ system does not address pediatric patients’ unique needs.
The survey was designed to assess pediatricians’ attitudes toward and involvement in community Emergency Medical Service for Children (EMS-C) systems. The AAP Committee on Pediatric Emergency Medicine requested the survey to gauge the extent of EMS-C systems in place at the local level.
Of the 1,600 U.S. AAP members surveyed, 1,201 returned the surveys for a response rate of 74 percent. The sample is representative of all U.S. AAP members.
The survey asked members what specific components of an EMS-C system their communities have. Most reported having rescue units (97 percent) and a hospital emergency department equipped and staffed to handle children (92 percent).
Many pediatricians reported having other EMS-C components: interhospital transport (88 percent); a well-defined mechanism for accessing the EMS, such as the 911 emergency telephone service (86 percent); and medical control, such as radio contact between physicians and rescuers (85 percent).
While the majority of pediatricians reported having well defined mechanisms for accessing the EMS-C, only half of the pediatricians surveyed reported that their communities have policies allowing rescue personnel to bypass the nearest hospitals in favor of hospitals that are more appropriate for children.
The survey also asked if the pediatricians gave advice to help set up the specific components of their EMS-C.
Among pediatricians who have hospital emergency departments in their communities equipped and staffed to handle children, 21 percent reported that they advised in the emergency department’s development.
The next highest rate of involvement was for interhospital transport, for which 11.5 percent of the respondents advised.
Among pediatricians surveyed who provide direct patient care, 77 percent reported that they educate parents during health supervision visits about what to do in case of emergencies. Twenty-three percent reported that they use audio, visual or written material to educate parents on emergencies. Sixty-six percent said they instruct parents on specifically where to go for emergencies.
When parents do use the emergency medical system, they don’t always notify their pediatrician first, the survey shows. Among pediatricians in direct care, 74 percent said they have had patients in the last six months who didn’t call their office before using the EMS.
Two-thirds of the pediatricians in direct patient care said they have taken a cardiopulmonary resuscitation recertification course in the past two years and 27 percent said they require all their office staff to be CPR certified.
