EMERGENCY MEDICINE JOURNAL

Why Advanced Life Support is Dispatched for School Emergencies?

The Utilization of Emergency Medical Services for Pediatric Patients
Jessica O. Pinto
Medical Student at Rutgers New Jersey Medical School, Newark, New Jersey,
USA

Introduction
School healthcare is an evolving field as more children are mainstreamed into schools and school
nurses take on more responsibilities. Very little has been written in the Emergency Medical
Services (EMS) literature regarding the types of emergencies that result in EMS being called to
schools. The purpose of our study is to classify the school emergencies for which Advanced Life
Support (ALS) is required and determine which interventions are needed for these children.

Methods
The design consists of a retrospective cohort. The setting is a large, suburban hospital-based
EMS system. Prehospital medical records for patients ages 5-18 for which ALS was dispatched
to a school over a 5-year period were reviewed. Calls in which ALS was cancelled were not
included. Dispatch classification, past medical histories, medications administered, procedures
performed, and patient demographics were obtained. Descriptive statistics and 95% confidence
intervals were calculated.

Results
Researchers collected a total of 85,579 ALS dispatches. After stratifying the data, only 486 of the
collected ALS dispatches were for children at school. The most common dispatch categories were
Respiratory (21%), Syncope (19%), Seizures (15%), and Trauma (14%). 60% (CI: 56-64) of
patients had a past medical history (other than seasonal allergies) documented. Only 6% (CI: 4-
8) of patients had a medication administered. If albuterol/atrovent are excluded, then less than
1% (0.6%, CI: 0-1.3) of patients were treated with a medication. 27% (CI: 23-32) of patients had
a procedure performed. However, if IV placement and EKG are excluded, then only one patient
(0.2%, CI: 0-0.6) had a procedure done, and that procedure was physical restraints.

Conclusion
Although there are a wide range of conditions that result in the dispatch of ALS providers to a
school, the prevalence of school children needing ALS interventions is very small. The majority
of interventions are for asthma and other respiratory illnesses. This study provides support that
may help guide dispatch resources and educational programs for school nurses.

For further research view/ paper visit @ https://goo.gl/D458t2