Prehospital emergency care for children at school and nonschool locations

Objective: The purpose of this study was to ascertain whether school-based emergency medical services (EMS) incidents are different from nonschool-bas ed EMS incidents for school-aged children. Methods. We examined South Dakota EMS incident reports involving children a ges 5 to 18 years old from 1994 through 1996 (n = 12 603). Patient characte ristics, dispatch reason, primary medical complaint, injury type, contribut ing factor of injury, and performed interventions were analyzed. Results. During the study period, there were 140 455 total EMS incident rep orts, of which 12 603 (9.0%) were for school-aged children. EMS dispatches to a school represented 755 (6.0%) of all EMS incidents for school-aged chi ldren. The number of school-based EMS incidents was highest at the beginnin g of the school year, whereas the number of nonschool-based EMS incidents w as highest during the summer months. School-based EMS incidents peaked at n oon, whereas nonschool-based EMS incidents peaked after school. For both lo cations, the average age of the patient was 14 years old. The dispatch reas on for school-based EMS incidents differed from those for nonschool-based E MS incidents. The top three school-based EMS dispatch reasons were falls (3 6.2%), other trauma (27.0%), and medical illness (24.5%). Motor vehicle cra shes (30.8%), medical illness (26.2%), and other trauma (11.4%) were the le ading nonschool-based EMS dispatch reasons. Injuries accounted for a signif icantly greater proportion of school-based than nonschool-based EMS inciden ts (70.7% vs 62.6%). Excluding pain, the most frequent type of injury was a fracture or dislocation in school-based EMS incidents and open soft-tissue injury in nonschool-based EMS incidents. A total of II students sustained an injury resulting in paralysis. The body region that was most commonly in jured was a lower extremity (23%) in school-based incidents, whereas the he ad was the most commonly injured body region in nonschool-based incidents ( 20%). Sports were the largest contributing factor in school-based incidents , whereas alcohol/drug use was the largest contributing fatter in nonschool -based EMS incidents among school-aged children. A medical illness was the primary complaint for 206 (27.3%) of the school-based incidents and 3599 (3 0.4%) of the nonschool-based incidents. The chief medical complaints were b reathing difficulty (18.4%), seizure (16%), and other illness (12.3%) for s chool-based EMS incidents. Other illness (20.0%), breathing difficulty (13. 7%), and abdominal pain (12.0%) were the chief complaints for nonschool-bas ed EMS incidents. Treatment was rendered by the EMS provider in 11 753 (93. 3%) of the incidents. Frequency of EMS intervention was the same for school -based incidents and nonschool-based incidents. Transportation to a medical facility was more frequent in school-based incidents than nonschool-based incidents. Conclusion. Compared with nonschool-based EMS incidents, school-based EMS i ncidents are more often attributable to injury, more often related to a spo rts activity, and more often result in transport to a medical facility. Und erstanding the characteristics of school emergencies resulting in an EMS di spatch may help emergency medical providers be better prepared for school-b ased incidents. School personnel may benefit from increased knowledge about the EMS system and EMS programs. In addition, EMS incident data may provid e useful information about school-based injuries and may provide a means fo r injury surveillance.