When Should EMS Call a Child a Small Adult: Inconsistency in Protocol Definitions

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Published: Apr 3, 2024
DOI: https://doi.org/10.56068/KCYD7018
Keywords:
pediatric, emergency medical services, ambulance, prehospital, prehospital care, Pediatrics, EMS, paramedicine

Main Article Content

Elise Solazzo, BA, EMT-B
Department of Emergency Medicine, Alpert Medical School, Brown University
Kerry McCans, BS, EMT-P
Department of Pediatrics and Emergency Medicine, School of Medicine, University of Pittsburgh
Sylvia Owusu-Ansah, MD, MPH, FAAP
Department of Pediatrics and Emergency Medicine, School of Medicine, University of Pittsburgh
Kenneth A. Williams, MD, FACEP, FAEMS
Department of Emergency Medicine, Alpert Medical School, Brown University

Abstract

Age may be a factor in Emergency Medical Services (EMS) treatment of patients, and understanding of age-related patient differences is important to those providing care in the prehospital environment. The US Health Resources and Services Administration’s Maternal Child Health Bureau (HRSA MCHB) through their Emergency Medical Services for Children (EMSC) program has coordinated a focus on pediatric EMS care. However, there is a wide variety of age and other categorizations used to define the pediatric EMS population. This paper reviews the current state of pediatric EMS categorization from several sources, including national-level agencies and organizations, EMS Protocols, and other sources, and provides an overview of the anatomic, physiologic, and behavioral parameters that are generally expected within the range of pediatric ages. We found that, of 32 states publishing statewide EMS protocols online, there was great variability in the definition of a pediatric patient. The age at which states identified the transition from pediatric to adult patient ranged from 12-18 years old, and several states used non-aged-based definitions.

Article Details

How to Cite
Solazzo, E., McCans, K., Owusu-Ansah, S., & Williams, K. (2024). When Should EMS Call a Child a Small Adult: Inconsistency in Protocol Definitions. International Journal of Paramedicine, (6), 171–184. https://doi.org/10.56068/KCYD7018
Issue
No. 6 (2024): April - June, 2024
Section
Special Reports
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Author Biographies

Elise Solazzo, BA, EMT-B, Department of Emergency Medicine, Alpert Medical School, Brown University

Elise Solazzo is an EMT based in Massachusetts who received her BA in Slavic Studies from Brown University in May 2022. She intends to matriculate to the Icahn School of Medicine at Mount Sinai in August of 2023.

Kerry McCans, BS, EMT-P, Department of Pediatrics and Emergency Medicine, School of Medicine, University of Pittsburgh

Kerry McCans is a fourth-year medical student at Lewis Katz School of Medicine at Temple University. She graduated in 2018 with a BS in Emergency Medicine from the University of Pittsburgh, earning her paramedic certification in 2017.

Sylvia Owusu-Ansah, MD, MPH, FAAP, Department of Pediatrics and Emergency Medicine, School of Medicine, University of Pittsburgh

Sylvia Owusu-Ansah, MD, MPH, FAAP has been dedicated to the pediatric and EMS legislative advocacy for over a decade. She has been involved in pre-hospital care at the local and state level and has been an advocate of Emergency Services for Children (EMSC) at the federal level for the past 8 years. As an EMS fellow, she served as an assistant medical director to Howard County Maryland. She also works with government agencies such as the Secret Service, Marshals Service and Immigration and Customs Service (ICE), and served during the most recent presidential inauguration. She has also developed numerous health education curricula for schools over the past decade. She is currently playing a significant role as co-site PI for Development and Testing of Pediatric Cervical Spine Injury Risk Tool (C-spine) NICHD funded PECARN study.

Kenneth A. Williams, MD, FACEP, FAEMS, Department of Emergency Medicine, Alpert Medical School, Brown University

Kenneth A Williams, MD, FACEP, FAEMS is Professor of Emergency Medicine (clinician educator track) and EMS Division Director at the Warren Alpert Medical School of Brown University.  He is also Medical Director for LifePACT Critical Care Transport at Rhode Island Hospital, Medical Director for the RI DOH Center for EMS, and Past Chair, Medical Director's Council, for the National Association of State EMS Officials.

Dr. Williams is a graduate of the University of Massachusetts Medical School and completed his emergency medicine residency at the University of Pittsburgh in 1987, where he was a Chief Resident in 1986-1987 and received a resident research award from the Emergency Medicine Foundation. He was UMASS Life Flight Medical Director for 10 years before coming to Brown in 1997. From 1999 until the project ended, Dr. Williams was Medical Director and Principal Investigator for the Rhode Island Disaster Initiative, the federally funded disaster research project that founded Rhode Island Hospital's Lifeguard EMS Critical Care transport program, now LifePACT. Dr. Williams is past President of RI ACEP and the Air Medical Physician Association.

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