Pediatric emergency care in a metropolitan area

Regional emergency medical services (EMS) system planning requires a data base describing the population to be served. No such regional data base exists for childhood emergencies. This study was undertaken for two reasons: (1) to establish, in a metropolitan region, the demographics of the population and the type of clinical problems for which pediatric emergency care is sought, and (2) to determine if the critical care categories used for EMS planning accurately reflect the emergency care needs of pediatric patients in the region. All pediatric visits (6,190) to 13 area hospitals during 1 month were reviewed. The most common diagnostic categories seen were trauma (48%) and infectious illness (29%). Six hundred and six visits satisfied criteria for inclusion in one of the following critical care categories: trauma, poisonings, burns, spinal cord injuries, behavioral disorders, cardiovascular illness, and a general category designated "medical." The last group was the largest of the categories (185 visits) and contained the greatest number of seriously or critically ill children. Of the total visits, 9.5% were by children 1 year or under, and 19.1% were by children 13 to 16 years old. For visits of a serious or critical nature, these age groups comprised 16% and 29%, respectively, of the total for such visits. This study documents that the emergency care needs of children differ from those of adults and deserve special attention in the planning of emergency care systems.