Pediatric poisonings in children younger than five years responded to by paramedics.

Background: Treatment of poisonings in children has been well studied, but few data are available on the various causes of the poisoning episodes in the pediatric population.

Objectives: To describe the incidence and demographics of accidental poisonings incurred by children<5 years old in the County of San Diego, California who accessed paramedics through the 9-1-1 system.

Methods: Eight years of prehospital records for children<5 years of age were searched for poisoning cases.

Impact of the San Diego county firestorm on emergency medical services.

Background: In October 2003, San Diego County, California, USA, experienced the worst firestorm in recent history. During the firestorm, public health leaders implemented multiple initiatives to reduce its impact on community health using health updates and news briefings. This study assessed the impact of patients with fire-related complaints on the emergency medical services (EMS) system during and after the firestorm.

Paramedic self-reported medication errors.

Background: Continuing quality improvement (CQI) reviews reflect that medication administration errors occur in the prehospital setting. These include errors involving dose, medication, route, concentration, and treatment.

Methods: A survey was given to paramedics in San Diego County.

Adult foreign body airway obstruction in the prehospital setting.

Background: Although the treatment of foreign body airway obstruction in adults has been well studied, few data exist on the characterization of prehospital experiences.

Objectives: To describe the frequency, etiologies, and treatments of foreign body airway obstruction in adults in the prehospital setting and to discuss the relative efficacies of treatments and presenting factors that predict overall patient outcome.

Methods: A San Diego County prehospital database was retrospectively reviewed for all adult patients over a 17-month period with data extracted on demographic characteristics, incident outcome, patient disposition, item involved in obstruction, location of episode, initial vital signs, initial level of consciousness, pertinent medical history, treatments initiated by bystanders and paramedics, and response to those treatments.

Paramedic self-reported medication errors.

Background: Continuing quality improvement (CQI) reviews reflect that medication administration errors occur in the prehospital setting. These include errors involving dose, medication, route, concentration, and treatment.

Methods: A survey was given to paramedics in San Diego County.

Evaluation of pediatric glucose monitoring and hypoglycemic therapy in the field.

As specific indications for glucose monitoring in pediatric patients are not standardized, we sought to evaluate our EMS system regarding the use of this test, so that objective data can be used for prehospital provider education. We performed a 5-year electronic search of prehospital records to assess pediatric patients who had glucose monitoring performed, with subgroup analysis on those requiring therapy. We found that 6018 pediatric patients received glucose monitoring with the most common chief complaints for testing including: seizure, "other medical," trauma head/neck, and OD/poisoning.

Community trial to decrease ambulance diversion hours: the San Diego county patient destination trial.

Study Objective: Emergency department (ED) ambulance diversion is a major issue in many communities. When patients do not reach requested facilities, challenges in care are compounded by lack of available medical records and delays in transferring admitted patients back to the originally requested facility. We seek to evaluate a community intervention to reduce ambulance diversion.

9-1-1 responses for shopping cart and stroller injuries.

Background: On average, 24,000 children a year are treated in the emergency departments (EDs) for shopping cart injuries, with over 650 children a year requiring hospital admission. The authors sought to evaluate the incidence and outcomes of children in the community evaluated by paramedics because they were injured in shopping cart or stroller-related incidences.

Methods: Retrospective design in which prehospital patients records were searched for all patients under 14 years old who were injured in an incident involving a shopping cart or stroller and were responded to by paramedics.

Airway obstruction in children aged less than 5 years: the prehospital experience.

Background: Treatment of choking in children has been well studied, but few data are available on the various causes of the choking episodes in the pediatric population.

Objectives: To assess frequency and to stratify etiologies of children less than 5 years of age who had a 911 advanced life support (ALS) ambulance response for airway obstruction.

Methods: A prehospital database was searched and information was collected defining type of obstruction, age of the child, parents' action, paramedic treatment, and incident outcome.