Ambulance use by high-acuity patients in a pediatric ED

The objective of this study was to analyze ambulance usage by highest acuit y patients as compared with all patients in a suburban pediatric hospital E D. A 1-year retrospective records analysis was conducted of all highest acu ity patients (those patients triaged as emergent or critical or admitted to the intensive care unit), A total of 245 patients made 270 high-acuity vis its to the ED in 1995. Thirty-one (13%) of the high-acuity patients arrived via ambulance; the rest arrived via private vehicle, The 31 high-acuity pa tients constituted 8% of the total number of patients arriving by ambulance . There was no significant difference in ambulance usage between insurance groups in the high-acuity patients. Only high-acuity patients with neurolog ic symptoms (primarily seizures) had a greater relative use of EMS transpor tation, with 39% of these patients arriving via ambulance (odds ratio 6.6, 95% confidence interval 2.6, 16.6). High acuity patients account for the mi nority of total ambulance usage in our ED. (Am J Emerg Med 2000;18:679-682, Copyright (C) 2000 by W.B. Saunders Company).