ArticlePrehospital emergency care
Out-of-Hospital Pediatric Patient Safety Events: Results of the CSI Chart Review.
Article in Prehospital emergency care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- How safe is prehospital care? A systematic review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2021Pooled it
- Measurement and monitoring patient safety in prehospital care: a systematic review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2021Pooled it
- Feasibility and acceptability of pediatric expert teleconsultation during critical ambulance transports: a pilot randomized controlled simulation trial.Resuscitation plus · 2026Article
- Analysis of factors affecting organizational engagement between pre-hospital and hospital emergency departments: a qualitative study.BMC emergency medicine · 2025Article
- Improving Situational Awareness During Interfacility Transport Using a Transport Monitoring and Communication Application: A Simulation-Based Pilot Study.Journal of patient safety · 2025Article
- Epinephrine Dosing by Emergency Medicine Residents During a Simulated Prehospital Pediatric Cardiac Arrest.AEM education and training · 2025Article
- Adaption of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care of children.BMC emergency medicine · 2024Article
- Pre-hospital care for children: a descriptive study from Central Norway.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Adverse Safety Events in Emergency Medical Services Care of Children With Out-of-Hospital Cardiac Arrest.JAMA network open · 2024Article
- Identifying high cognitive load activities during simulated pediatric cardiac arrest using functional near-infrared spectroscopy.Resuscitation plus · 2023Article
- A chart review tool to systematically assess the safety of prehospital care for children with out-of-hospital cardiac arrest.Journal of the American College of Emergency Physicians open · 2022Article
- Analysis of an Intervention for Emergency Medical Services Personnel to Reduce Epinephrine Dosing Errors in Infants.JAMA network open · 2022Article
- Pilot Paramedic Survey of Benefits, Risks, and Strategies for Pediatric Prehospital Telemedicine.Pediatric emergency care · 2021Article
- Characterizing prehospital response to neonatal resuscitation.Resuscitation plus · 2021Article
- Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Article
- Vital sign monitoring during out-of-hospital pediatric advanced airway management.Journal of the American College of Emergency Physicians open · 2020Article
- Article
- Simulating Teamwork for Better Decision Making in Pediatric Emergency Medical Services.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2020Article
- Adverse events in prehospital emergency care: a trigger tool study.BMC emergency medicine · 2019Article
- Medic One Pediatric (MOPed) cards: standardising paramedic paediatric resuscitation.BMJ open quality · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectiveStudies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events.
methodsAs part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period. Regression models were used to identify factors associated with increased risk of potentially severe safety events. Patient safety events were categorized as: Unintended injury; Near miss; Suboptimal action; Error; or Management complication ("UNSEMs") and their severity and potential preventability were assessed.
resultsOverall, 265 of 378 (70.1%) unique charts contained at least one UNSEM, including 146 (32.8%) errors and 199 (44.7%) suboptimal actions. Sixty-one UNSEMs were categorized as potentially severe (23.3% of UNSEMs) and nearly half (45.3%) were rated entirely preventable. Two factors were associated with heightened risk for a severe UNSEM: (1) age 29 days to 11 months (OR 3.3, 95% CI 1.25-8.68); (2) cases requiring resuscitation (OR 3.1, 95% CI 1.16-8.28). Severe UNSEMs were disproportionately higher among cardiopulmonary arrests (8.5% of cases, 34.4% of severe UNSEMs).
conclusionsDuring high-risk out-of-hospital care of pediatric patients, safety events are common, potentially severe, and largely preventable. Infants and those requiring resuscitation are important areas of focus to reduce out-of-hospital pediatric patient safety events.
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Registered trials
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