Vital signs assessment, documentation, and influencing factors in pediatric prehospital care: A qualitative descriptive study of advanced-level paramedics' experiences.
International emergency nursing · 2026-04-04 · Qualitative study
Abstract
AIMS: To explore advanced-level paramedics' experiences of measuring, interpreting and documenting pediatric vital signs in prehospital care, and to identify contextual factors that influence these practices. METHODS: We conducted a qualitative cross-sectional descriptive study. Fifty-six advanced-level paramedics were recruited through a national emergency medical services social media forum. Data were collected in February-March 2025 using an online semi-structured questionnaire and analyzed using inductive-deductive content analysis. FINDINGS: Measurement practices varied in systematicity and incorporated modified assessment approaches. These were shaped by the child's appearance, symptoms, urgency, paramedic- and child-related factors, caregiver involvement, and equipment-related aspects. Paramedics interpreted pediatric vital signs using assessment tools, physician consultation, and visual impressions of the child's condition, and the process was perceived as time-consuming. Interpretation was influenced by children's emotional and behavioral responses, physiological characteristics, and paramedics' interpretive competence. Electronic documentation was valued for efficiency but reported as posing safety risks, limited pediatric suitability, and insufficient flexibility. CONCLUSIONS: Advanced-level paramedics use a variety of approaches when assessing pediatric patients and adapt their practices according to personal and contextual factors. However, variability in practice and limitations in documentation systems may compromise patient safety and quality of care.