Jens Aage Kølsen Petersen

Pediatric Emergencies in Helicopter Emergency Medical Services: A National Population-Based Cohort Study From Denmark

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Vibe M.L. Nielsen, Aalborg Universitet
  • ,
  • Niels H. Bruun, Aalborg Universitet
  • ,
  • Morten B. Søvsø, Aalborg Universitet, Region Nordjylland
  • ,
  • Torben A. Kløjgård, Aalborg Universitet
  • ,
  • Hans M. Lossius, Norwegian Air Ambulance Foundation, University of Stavanger
  • ,
  • Lars Bender, Aalborg Universitet
  • ,
  • Søren Mikkelsen, Syddansk Universitet
  • ,
  • Mona Tarpgaard, Københavns Universitet
  • ,
  • Jens A.K. Petersen
  • Erika F. Christensen

Study objective: To examine the diagnostic pattern, level of severity of illness or injuries, and mortality among children for whom a physician-staffed helicopter emergency medical service (HEMS) was dispatched. Methods: Population-based cohort study including patients aged less than 16 years treated by the Danish national HEMS from October 1, 2014, to September 30, 2018. Diagnoses were retrieved from inhospital medical records, and the severity of illness or injuries was assessed by a severity score on scene, administration of advanced out-of-hospital care, need for intensive care in a hospital, and mortality. Results: In total, 651 HEMS missions included pediatric patients aged less than 1 year (9.2%), 1 to 2 years (29.0%), 3 to 7 years (28.3%), and 8 to 15 years (33.5%). A third of the patients had critical emergencies (29.6%), and for 20.1% of the patients, 1 or more out-of-hospital interventions were performed: intubation, mechanical chest compressions, intraosseous vascular access, blood transfusion, chest tube insertion, and/or ultrasound examination. Among the 525 patients with hospital follow-up, the most frequent hospital diagnoses were injuries (32.2%), burns (11.2%), and respiratory diseases (7.8%). Within 24 hours of the mission, 18.1% of patients required intensive care. Twenty-nine patients (5.1%, 95% confidence interval [CI] 3.6 to 7.3) died either on or within 1 day of the mission, and the cumulative 30-day mortality was 35 of 565 (6.2%, 95% CI 4.5 to 8.5) (N=565 first-time missions). Conclusion: On Danish physician-staffed HEMS missions, 1 in 5 pediatric patients required advanced out-of-hospital care. Among hospitalized patients, nearly one-fifth of the patients required immediate intensive care and 6.2% died within 30 days of the mission.

OriginalsprogEngelsk
TidsskriftAnnals of Emergency Medicine
Vol/bind80
Nummer2
Sider (fra-til)143-153
Antal sider11
ISSN0196-0644
DOI
StatusUdgivet - aug. 2022

Bibliografisk note

Funding Information:
The authors express gratitude to all staff at the Danish Air Ambulance (https://www.akutlaegehelikopter.dk/en/). They explicitly thank the data manager Thomas Bøttern Christensen for the substantial task of extracting data from the HEMS file database. Author contributions: VMLN obtained funding and drafted the study protocol, which was revised by MBS, NHB, LB, HML, JAKP, SM, MT, and EFC. TAK and NHB performed data management, and NHB and VMLN analyzed the data. VMLN drafted the original manuscript, and all authors made substantial revisions and accepted the manuscript in its final wording. VMLN take responsibility for the paper as a whole. Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). Dr. Nielsen has received a research grant from the Danish Air Ambulance Research Foundation. Dr. Christensen is supported by an unrestricted grant to her professorship (grant ID 20046/aau) from the philanthropic fund of the TrygFoundation to Aalborg University. Drs. Tarpgaard and Petersen are part-time employed at the Danish Air Ambulance. Drs. Christensen and Mikkelsen are members of the Danish Air Ambulance research committee. However, neither of them were parties to the decision to support the grant application from Dr. Nielsen. The funders did not influence the conduction of the study. The remaining authors have none to declare.

Funding Information:
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org ). Dr Nielsen has received a research grant from the Danish Air Ambulance Research Foundation. Dr Christensen is supported by an unrestricted grant to her professorship (grant ID 20046/aau) from the philanthropic fund of the TrygFoundation to Aalborg University . Drs Tarpgaard and Petersen are part-time employed at the Danish Air Ambulance .

Publisher Copyright:
© 2022 American College of Emergency Physicians

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