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ObjectivesThe aim of this study is to determine diagnostic patterns in the prehospital paediatric population, age distribution, the level of monitoring and the treatment initiated in the prehospital paediatric case. Hypothesis was that advanced prehospital interventions are rare in the paediatric patient population.SettingWe performed a retrospective population-based registry cohort study of children attended by a physician-staffed emergency medical service (EMS) unit (P-EMS), in the Odense area of Denmark during a 10-year study period.ParticipantsWe screened 44 882 EMS contacts and included 5043 children. Patient characteristics, monitoring and interventions performed by the P-EMS crews were determined.ResultsWe found that paediatric patients were a minority among patients attended by P-EMS units: 11.2% (10.9 to 11.5) (95% CI) of patients were children. The majority of the children were ConclusionPrehospital paediatric contacts are uncommon, more frequently involving smaller children. Monitoring or at least documentation of basic vital parameters is infrequent and may be an area for improvement. Advanced and potentially life-saving prehospital interventions provide a dilemma since these likely occur too infrequently to allow service providers to maintain their technical skills working solely in the prehospital environment.

Background It is cumbersome to ask patients for location of occurrence and irrelevant to the treatment upon arrival at hospitals. Since data on location of occurrence are found in ambulances and pre-hospital mobile emergency care units (MECU) information could easily be recorded. It is therefore of interest to explore the potential and possible biases of combining hospital- and pre-hospital data on traffic injury as an alternative to lengthy interviews once patients arrive at the hospital. The specific aim of this study was to assess complement and combined proportions of patients known from ambulances, MECU and trauma registries. Methods Any patient record documented as “acute traffic injury” in the primary geographic catchment area of Kolding Hospital (level 2 trauma) and Odense University Hospital (level 1 trauma) in Denmark occurring in 2013 was included if identified in at least one of the three registries(hospital trauma, MECU, Ambulance Service). Records were merged on civil registration number and date of injury. Transfers between hospitals were excluded. No other service or hospitals provide service in the area. Results Primary data consisted of 8895 records (patients) from the ambulance service, 669 from the medical emergency care unit and 564 from the trauma registries (excluding transfers). By matching on civil registration number and date 97 patients were found in all three registries, 140 only in hospitals trauma, 8683 only in pre-hospital and 8147 only in ambulance data. For 69% of the trauma registry patients location of occurrence where known. Conclusions For the present geographical region in Denmark pooling data from these registries seems a promising way for identifying place of occurrence. However, immediate merge were only valid with manual cumbersome review. Further analysis must look into whether the recorded locations are valid indications of actual places and gives sufficient input to the planning of preventive measures in municipalities.

BACKGROUND: Prehospital care provided by specially trained, physician-based emergency services (P-EMS) is an integrated part of the emergency medical systems in many developed countries. To what extent P-EMS increases survival and favourable outcomes is still unclear. The aim of the study was thus to investigate ambulance runs initially assigned 'life-saving missions' with emphasis on long-term outcome in patients treated by the Mobile Emergency Care Unit (MECU) in Odense, DenmarkMETHODS: All MECU runs are registered in a database by the attending physician, stating, among other parameters, the treatment given, outcome of the treatment and the patient's diagnosis. Over a period of 80 months from May 1 2006 to December 31 2012, all missions in which the outcome of the treatment was registered as 'life saving' were scrutinised. Initial outcome, level of competence of the caretaker and diagnosis of each patient were manually established in each case in a combined audit of the prehospital database, the discharge summary of the MECU and the medical records from the hospital. Outcome parameters were final outcome, the aetiology of the life-threatening condition and the level of competences necessary to treat the patient.RESULTS: Of 25 647 patients treated by the MECU, 701 (2.7%) received prehospital 'life saving treatment'. In 596 (2.3%) patients this treatment exceeded the competences of the attending emergency medical technician or paramedic. Of these patients, 225 (0.9%) were ultimately discharged to their own home.CONCLUSIONS: The present study demonstrates that anaesthesiologist administrated prehospital therapy increases the level of treatment modalities leading to an increased survival in relation to a prehospital system consisting of emergency medical technicians and paramedics alone and thus supports the concept of applying specialists in anaesthesiology in the prehospital setting especially when treating patients with cardiac arrest, patients in need of respiratory support and trauma patients.