Out of Hospital emergency pediatric assistance and resuscitation in a rural area in the interior of the country

Abstract

Introduction and Aim: The rapid response vehicles (VMER) are intended for emergency pre-hospital medical intervention, and 5-15% of their activations are for pediatric patients. The aim of the study was to characterize the assistance of the pediatric VMER-Vila Real services, to better identify gaps and develop strategies to correct them.

Materials and Methods: Retrospective review of children reports’ less than 18 years of age assisted by VMER-Vila Real between January 2005 and December 2012 (eight years).

Results: During the study period, VMER-Vila Real was activated 8131, of which 463 (5.7%) were children less than 18 years with with a mean age of 8.2 years. The mean time of arrival at the site of assistance was 18 minutes. In 22.2% of situations, rendez-vous was made. The main reason for activation was acute disease (39.5%), of which 43.2% presented seizures. Trauma accounted for 36.5%. Acute disease was more prevalent in children under two years of age and trauma in adolescents (p <0.001). Advanced life support procedures were instituted in 5.2% of patients. Three hundred ninety-eight patients were transported to local hospitals (86%). There were 13 deaths (2.8%) during this period.

Discussion: The main reasons for the activation were acute illness in patients under two years of age and trauma in the adolescence. The average time of arrival at patients’ location, high percentage of rendez-vous and deliveries can be justified by the peculiar regional topography. The total number of activations within this age group, which presents itself with specific needs in terms of treatment, puts in evidence the need of additional investment in the training of human resources.