EVALUATION OF A MODEL FOR IMPROVING EMERGENCY MEDICAL AND TRAUMA SERVICES FOR CHILDREN IN RURAL-AREAS

Study objective: To evaluate the effectiveness of a rural emergency me dical and trauma services project in increasing the knowledge and conf idence of emergency care personnel in the management of acutely ill an d injured children. Methods: This prospective, quasi-experimental stud y used an untreated control group design with pretest and posttest of prehospital and hospital-based emergency care personnel in two rural c ounties in central Ohio. Project evaluation compared 50 emergency care providers from the intervention county with 43 emergency care provide rs from the control county. Changes in knowledge and confidence of the se personnel in the assessment and management of pediatric emergencies were compared. Results: Providers in the intervention county demonstr ated a significantly greater increase in test scores regarding knowled ge of pediatric emergencies than did providers in the control county ( P=.001). Significantly greater improvement was also seen when comparis ons of test scores were made for field (P=.02) and hospital (P=.03) em ergency care personnel separately. Self-reports on a visual analog sca le indicated that providers in the project intervention county had a s ignificantly greater decrease in anxiety than did control subjects whe n presented a scenario of a child experiencing a respiratory arrest (P =.01). On the basis of scores from a five-point likert scale, emergenc y personnel in the intervention county had a greater increase in confi dence regarding management of the pediatric airway (P=.0003) and a gre ater increase in the belief that they had adequate pediatric training (P=.000001) after participating in the project than emergency personne l in the control county. Conclusion: The rural pediatric emergency med ical and trauma services project was effective in increasing the knowl edge and confidence of emergency care personnel in the management of a cutely ill and injured children. This project offers a model that can be replicated in other rural areas nationally.