What are the characteristics and outcomes of nontransported pediatric patients?

Prehosp Emerg Care. 2006 Jan-Mar;10(1):28-34. doi: 10.1080/10903120500373322.


Background: The authors have demonstrated that 28% of children cared for by paramedics are not transported to hospital by ambulance.

Objective: To determine the characteristics, reasons, and outcomes for this nontransported population.

Methods: This was a prospective cohort study in a single city with a two-tiered emergency medical services system. Enrolled were all children aged < 16 years assessed by paramedics but not transported to hospital over a five-month period. Data were collected from ambulance call reports, phone interviews, and hospital charts. Descriptive statistics were used.

Results: Over five months, there were 345 nontransported pediatric patients with a mean age of 6 years, and 58.3% were male. The dispatch priority was urgent in 68.1% of cases and prompt in 30.4% of cases. The primary problems were almost evenly split between trauma (50.7%) and medical (45.2%) causes. Paramedics listed the following reasons for nontransport: parent will take the child to a physician (27.8%), parent will monitor the child's condition (25.8%), and no reason documented (46.4%). Phone interview was conducted with 106 parents (30.7%): 76.4% believed there was a true emergency at the time of the 9-1-1 call, 75.5% stated that the paramedics did not recommend that the child be transported to hospital by ambulance, and 29.2% stated that the paramedics said ambulance transport was not necessary. Fifty-one children were seen in an emergency department (ED) within 48 hours of the 9-1-1 call. The majority (91.3%) were discharged home from the ED, while a small minority (8.7%) were admitted to hospital. No deaths were reported.

Conclusions: Most nontransported children did not require immediate or urgent medical care. Both parents and paramedics gave input into the nontransport decision, and the short-term outcome of this population appeared to be good. Paramedic documentation for the reasons for nontransport should be improved.

MeSH terms

  • Adolescent
  • Age Distribution
  • Allied Health Personnel / statistics & numerical data
  • Child
  • Child, Preschool
  • Cohort Studies
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Ontario / epidemiology
  • Outcome and Process Assessment, Health Care
  • Pediatrics / statistics & numerical data*
  • Prospective Studies
  • Sex Distribution
  • Transportation of Patients / statistics & numerical data
  • Triage / statistics & numerical data