Advanced Prehospital Care for Pediatric Emergencies

Applebaum D Annals of Emergency Medicine 1985 Vol 14 Pages 656-659

During an 18-month study period, the mobile intensive care unit (MICU) in Jerusalem (population of about 450,000) responded to 307 pediatric emergencies, representing 5% of the total MICU case load even though children make up 36% of the community. The most common medical problems were seizures (100 cases - 32%), and conditions related to trauma, (77 cases - 23%). Forty-one cases (13%) were cardiac arrests. Nineteen patients were pronounced dead without a resuscitation attempt; resuscitation was attempted in 22 patients. Four patients were stabilized for admission to the hospital, but there were no long-term survivors. Eighteen cardiac arrest patients (82%) were found in asystole, and most had previous serious medical problems. Based on this experience, the author suggests that children are less likely to require or benefit from advanced levels of prehospital care compared to the adult population. He concludes that when resources for advanced care are limited, priority should be given to adult emergencies.