@article{ref1,
title="Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study",
journal="Scandinavian journal of trauma, resuscitation and emergency medicine",
year="2021",
author="Harve-Rytsälä, Heini and Oulasvirta, Jelena and Salmi, Heli and Kuisma, Markku and Lääperi, Mitja",
volume="29",
number="1",
pages="e13-e13",
abstract="BACKGROUND: The 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. <br><br>METHODS: In 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. <br><br>RESULTS: 1712 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. <br><br>CONCLUSIONS: Infants 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.<p /> <p>Language: en</p>",
language="en",
issn="1757-7241",
doi="10.1186/s13049-020-00816-8",
url="http://dx.doi.org/10.1186/s13049-020-00816-8"
}