Characteristics of paediatric patients with altered conscious state attended by road ambulances in a metropolitan area - An 8 year observational study.

Background: Out-of-hospital paediatric emergencies represent are rare and little is known about characteristics of paediatric patients with severe illness. This study seeks to describe the paediatric population with altered conscious state.

Methods: A retrospective electronic data review was conducted of paediatric patients (≤ 4 years) attended by road ambulances between January 2006 and December 2013. Patients with a Glasgow Coma Scale (GCS) score ≤9 were included.

Results: A total of 4533 children were included in the study, 55.9% of which were male. The majority of patients (48.7%) were between one and four years old. Pre-existing neurologic conditions were identified in 26.8% of patients. Seizures were the most common reason for emergency call (68.7%) and were more frequent in children 1-4 years (80.4%) than in <1 year (32.6%), 5-8 years (75.3%) or 9-14 years (53.9%, p < 0.001). Vital signs (heart rate, systolic blood pressure, oxygen saturation, GCS) improved or remained stable from time of first contact with Emergency Medical Service (EMS) to arrival at hospital.

Conclusions: Seizure was the most common reason for ambulance attendances to children with altered conscious state, and most frequently occurred in preschool children. Pre-existing conditions were frequent. Vital signs and level of conscious stateof patients improved during paramedic management.