TY  - JOUR
TI  - Characteristics and outcomes of critically ill childrentransported by ambulance in a Turkish prehospital system:a multicenter prospective cohort study
AB  - Background. The most underdeveloped area in the care of critically-ill-children (CIC) is the prehospital period.Appropriate prehospital assessment and life-saving-interventions (LSI) of this population are challenging andrequire dedicated resources to ensure the best outcomes. We aimed to determine the characteristics and outcomesof CIC transported to the Turkish Pediatric Emergency Departments (EDs). The frequency and distribution ofLSI administered by prehospital providers on route and in the EDs were also investigated. Methods. This prospective study was conducted at 4 metropolitan cities and 9 tertiary pediatric EDs betweenAugust 2014-August 2015. A survey based study evaluated all CIC who were brought by ambulance to theparticipant EDs. CIC were defined as a patient who requires LSI or needs intensive care admission for anyreason. Patient demographics, clinical features, reason for transport, performed procedures in the ambulanceor ED were sought. Finally, the short-term outcomes of transported CIC and transport-associated risks wereanalyzed.Results. During the study period, a total 2094 children were brought by ambulance to all participant EDs.Only 227 (10.8%) of them were critically-ill. Emergency Medical Services (EMS) providers were less likely toperform procedures in CIC if they were staffed with paramedics (p<0.001). Most procedures were performedon children aged one or older (p<0.001). No procedure was performed in the ambulance for nearly one fourthof patients who received LSI in the EDs. If the EMS did not have a physician, prehospital providers wereless likely to provide immediate LSIs (p<0.001). CIC were more likely referred from secondary/tertiary carehospitals. The short-term mortality rate was higher ifthe ambulance was staffed by only paramedics.Conclusion. This study demonstrated that Turkishprehospital pediatric emergency care is deficient. Weoffer a clinical overview of pediatric emergencies toaid EMS directors, policymakers, and ED directors inplanning the care of CIC
AU  - Tuygun, Nilden
AU  - ANIL, Murat
AU  - Yurtseven, Ali
AU  - YILMAZ, Hayri Levent
AU  - Çelik, Tanju
AU  - besli, esen
AU  - Gültekingil Keser, Ayşe
AU  - Bal, Alkan
AU  - Çelik, Tuğçe
AU  - AKÇA, Halise Akça
AU  - TEKSAM, OZLEM
AU  - sarı gökay, sinem
AU  - TEKİN, Deniz
AU  - saz, eylem ulaş
AU  - Duman, Murat
AU  - TURAN, Caner
AU  - oguz, sinan
AU  - Gokalp, Gamze
DO  - 10.24953/turkjped.2021.01.007
PY  - 2021
JO  - Turkish Journal of Pediatrics
VL  - 63
IS  - 1
SN  - 0041-4301
SP  - 59
EP  - 67
DB  - TRDizin
UR  - http://search/yayin/detay/506787
ER  -