Evidence map›Paper›PMID 33413571›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2021

Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study.

Jelena Oulasvirta, Heini Harve-Rytsälä, Mitja Lääperi, Markku Kuisma, Heli Salmi

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
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  4. Prehospital vital sign monitoring in paediatric patients: an interregional study of educational interventions.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Jelena OulasvirtaDivision of Anesthesiology; Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, HUS, P.O. Box 340, FI-00029, Helsinki, Finland. jelena.oulasvirta@helsinki.fi.ORCID http://orcid.org/0000-0001-6750-4615
Heini Harve-RytsäläDepartment of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, HUS, P.O.Box 340, FI-00029, Helsinki, Finland.
Mitja LääperiDepartment of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, HUS, P.O.Box 340, FI-00029, Helsinki, Finland.
Markku KuismaDepartment of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, HUS, P.O.Box 340, FI-00029, Helsinki, Finland.
Heli SalmiNew Children's Hospital, University of Helsinki and Helsinki University Hospital, HUS, P.O. Box 347, FI-00029, Helsinki, Finland.
University of Helsinki · FI

Funding

Lastentautien Tutkimussäätiö not applicable
6 · The paper itself

Abstract

backgroundThe challenges encountered in emergency medical services (EMS) contacts with children are likely most pronounced in infants, but little is known about their out-of-hospital care. Our primary aim was to describe the characteristics of EMS contacts with infants. The secondary aims were to examine the symptom-based dispatch system for nonverbal infants, and to observe the association of unfavorable patient outcomes with patient and EMS mission characteristics.

methodsIn a population-based 5-year retrospective cohort of all 1712 EMS responses for infants (age < 1 year) in Helsinki, Finland (population 643,000, < 1-year old population 6548), we studied 1) the characteristics of EMS missions with infants; 2) mortality within 12 months; 3) pediatric intensive care unit (PICU) admissions; 4) medical state of the infant upon presentation to the emergency department (ED); 5) any medication or respiratory support given at the ED; 6) hospitalization; and 7) surgical procedures during the same hospital visit.

results1712 infants with a median age of 6.7 months were encountered, comprising 0.4% of all EMS missions. The most common complaints were dyspnea, low-energy falls, and choking. Two infants died on-scene. The EMS transported 683 (39.9%) infants. One (0.1%) infant died during the 12-month follow-up period. Ninety-one infants had abnormal clinical examination upon arrival at the ED. PICU admissions (n = 28) were associated with young age (P < 0.01), a history of prematurity or problems in the neonatal period (P = 0.01), and previous EMS contacts within 72 h (P = 0.04). The adult-derived dispatch codes did not associate with the final diagnoses of the infants.

conclusionsInfants form a small but distinct group in pediatric EMS care, with specific characteristics differing from the overall pediatric population. Many EMS contacts with infants were nonurgent or medically unjustified, possibly reflecting an unmet need for other family services. The use of adult-derived symptom codes for dispatching is not optimal for infants. Unfavorable patient outcomes were rare. Risk factors for such outcomes include quickly renewed contacts, young age and health problems in the neonatal period.

Indexed as

Emergency Medical ServicesInfant CarePatient Acceptance of Health CareFemaleFinlandHumansInfantMaleMedical AuditResearch DesignRetrospective StudiesRisk FactorsAmbulanceEmergency departmentEmergency medical servicesInfantPediatric emergency carePrehospital emergency care

Identifiers

PMID33413571
PMCPMC7789394
OpenAlexW3119016528

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.