[Changed profile of requirements in pediatric prehospital emergency care-a retrospective analysis of the Karlsruhe pediatric ambulance service].
Wiener medizinische Wochenschrift (1946) · 2026-07-08 · Registry study
Abstract
BACKGROUND: Paediatric emergencies account for only 5% of emergency deployments, but conversely, they pose a challenge for most emergency doctors. METHODS: We retrospectively recorded 1055 deployments (2015-2024) of the Karlsruhe pediatric emergency ambulance and compared it with 1169 deployments (2003-2013) focusing on disease indications of the patients being treated. RESULTS: Small children formed the largest group (2003-2013: 45.3%; 2015-2024: 32.2%); deployments were seen more often in boys (2003-2013: 53.3%, 4.6% not identified; 2015-2024: 48.8%, 12.2% not identified). In all cases, 57.7% (2003-2013) and 69.4% (2015-2024) involved minor injuries/diseases. Most common were trauma (2003-2013: 25.9%; 2015-2024: 29.2%) and neurological diseases (2003-2013: 26.2%; 2015-2024: 20.7%). We observed a decrease of respiratory disorders (-7.2%), resuscitation (-2.2%), and sudden infant death syndrome (-0.8%); a rise in psychiatric presentations (+5.4%), ingestion/intoxication (+2.4%) and allergies/anaphylaxis (+2.4%). Females had an increased probability of psychiatric emergencies (OR 3.5; 95% CI 1.7-5.5). During the COVID-19-pandemic (2020/2021), the frequency of deployments dropped (-50%), psychiatric (+4.3%; OR 2.5; 95% CI 1.2-5.4) and obstetrics diagnoses (+3.8%) rose while trauma decreased (-11.1%; OR 0.6; 95% CI 0.4-0.8). A specific therapy was initiated in 82.2% (2003-2013) and 58.7% (2015-2024) of all the deployments. CONCLUSION: Our results revealed changes in the range of deployments between the two time frames as well as during the Covid-19 pandemic. We believe that the provision of preclinical emergency care for children-with their particular needs and range of disease indications (compared to adults) warrants discussion considering the need for reforms and additional medical qualifications.