PATTERN OF BASIC LIFE-SUPPORT AMBULANCE USE IN AN URBAN PEDIATRIC POPULATION

To evaluate the pattern of use of basic life support (BLS) ambulances in a pediatric population, emergency medical service (EMS) and pediatr ic emergency department (FED) records from an urban hospital FED for a ll children transported to FED by ambulance during a 1-month study per iod were retrospectively reviewed. Excluded were: (1) advanced life su pport transport, (2) transport from other medical facility, (3) patien ts with chronic medical disability without acute decompensation, and ( 4) patients in police custody, BLS transport was considered inappropri ate if: (1) no intervention by BLS technicians, (2) minimal to no inte rvention in the FED, and (3) discharge without prescription medication . Of 376 ambulance transports evaluated, 238 (63%) met entry criteria, and 105 (44%) transports met criteria for being inappropriate, The me an charge for appropriate transport was $240.68, and for inappropriate , $237.12 (P = .2). The total charge for inappropriate transports was $26,523.20, Patients on federal assistance had a significantly higher rate of inappropriate transport (51%) compared with patients who had c ommercial insurance (30%) and those who self payed (42%). Trauma was t he most common cause for transport, 48% of which was inappropriate. It was concluded that inappropriate BLS transport of pediatric patients is common, This use is costly and may disrupt the delivery of EMS care to the remainder of the community. Efforts aimed at public education and providing alternative means of transport may significantly reduce charges and improve the delivery of EMS care. (Am J Emerg Med 1996;14: 250-253. Copyright (C) 1996 by W.B. Saunders Company)