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159 Emergency medical services response time and paediatric mortality and morbidity in the Urban setting
  1. Amy B Couperthwaite1,
  2. Ian E Blanchard2,3,
  3. Dirk A Chisholm4,
  4. Christopher J Doig3,5,
  5. Alberto Nettel-Aguirre3,4,
  6. Gregory Vogelaar2,
  7. Wadhah Almansoori2,
  8. Tania Embree4,
  9. Don Voaklander6,7,
  10. Brent E Hagel2,3
  1. 1Department of Kinesiology and Health Sciences, York University, Canada
  2. 2Alberta Health Services Emergency Medical Services, Canada
  3. 3Department of Community Health Sciences, University of Calgary, Canada
  4. 4Department of Paediatrics, University of Calgary, Canada
  5. 5Department of Critical Care Medicine and Internal Medicine, University of Calgary, Canada
  6. 6Alberta Centre for Injury Control and Research, Canada
  7. 7School of Public Health, University of Alberta, Canada

Abstract

Background The standard response time benchmark for Emergency Medical Services (EMS) has been set at eight minutes or less for ground ambulances in many parts of the world. It has not been extensively studied, especially in paediatric patients who suffered a traumatic injury. As injury is the leading cause of death for those under the age of 18 it is important to determine if this benchmark for EMS response time may be a factor in paediatric mortality and morbidity outcomes.

Methods All paediatric calls made to EMS between April 2010 to September 2013 in the cities of Calgary and Edmonton, Alberta, Canada were examined to select patients who had suffered a traumatic injury. These records were then linked to emergency department records and hospitalisation records using a deterministic linkage strategy using personal healthcare number, sex, and receiving facility. Patients were excluded if they were ≥18 years old, attended to outside of Calgary or Edmonton areas or suffered a medical complaint not related to an injury. Response time, the exposure, was defined as time of call to 9–1–1 to arrival of ambulance on scene. Response time was dichotomized into <8 minutes and ≥8 minutes. The main measure of morbidity was hospital admission. Adjusted risk ratios were calculated using Poisson regression.

Results 42 620 patients were attended to between April 2010 and September 2013. Overall, 6778 patients were included in the study. 52 patients died and 628 patients were admitted to hospital. The adjusted mortality risk ratio given a response time of ≥8 minutes was 0.635 (95% CI: 0.346–1.166; p = 0.143). The adjusted hospital admission risk ratio given a response time of ≥8 minutes was 1.165 (95% CI: 0.985–1.379; p = 0.075).

Conclusions A response time of ≥8 minutes was not associated with a difference in all cause mortality or hospital admission for paediatric patients suffering from a traumatic injury.

  • emergency medical services
  • response time
  • paediatric trauma
  • paediatric trauma mortality

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