Wj. Brady et al., PATTERN OF BASIC LIFE-SUPPORT AMBULANCE USE IN AN URBAN PEDIATRIC POPULATION, The American journal of emergency medicine, 14(3), 1996, pp. 250-253
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)