Original Contributions
Improving emergency medical services for children with special health care needs: Does training make a difference?*,**,*

https://doi.org/10.1053/ajem.2001.27146Get rights and content

Abstract

This study evaluated the impact of a paramedic training program on emergency medical services (EMS) responses for children with special health care needs. EMS responses for children with a congenital or acquired condition or a chronic physical or mental illness, were reviewed. Responses, related to the child's special health care need, involving paramedics who had completed our training program were compared with responses with paramedics not participating in the training. There was significantly more advanced life support treatment for responses with paramedics completing the training program compared with other responses. However, there was no significant difference in transport to a hospital or in-hospital admission between these 2 groups. This finding suggests that existing EMS protocols may play a more important role in emergency treatment and transport of children with special health care needs than specialized training of already certified paramedics. (Am J Emerg Med 2001;19:474-478. Copyright © 2001 by W.B. Saunders Company)

Section snippets

Methods

We defined CSHCN as children, 21 years of age or younger, with a congenital or acquired condition or chronic physical or mental illness, affecting physical or mental growth and development, who require one or more of the following: an assistive technology device; prolonged or frequent hospitalization; or a specialized approach to assessment or management. This operational definition was developed by reviewing pre-existing definitions used by federal, state, and local agencies. Our case

Results

The analytic results presented here are limited to 172 responses (out of 332 responses occurring after our training program was completed) that were related to the child's special health care need. An example of a related response was a call for shortness of breath caused by an acute asthma attack. An unrelated response was a response for a child with diabetes who was injured in a motor vehicle crash. Of these 172 responses, 119 (69.2%) involved a paramedic who had completed our training

Discussion

The purpose of this study was to determine if specialized training for paramedics about CSHCN resulted in differences in treatment, transport and admission to the hospital. Our study found that few ALS interventions were deemed necessary, despite the fact that there was ALS capability (ALS trained paramedics and equipment) available during the majority of responses. This was true both for responses with our training group paramedics and for comparison group paramedics. One significant

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  • Cited by (0)

    *

    Supported in part by The Robert Wood Johnson Foundation Grant no. 030671.

    **

    Address reprint requests to Daniel W. Spaite, MD, FACEP, Arizona Emergency Medicine Research Center, University of Arizona, 245057 UA, Tucson, AZ 85724.

    *

    0735-6757/01/1906-0004$35.00/0

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