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Emergency Medical Services Assessment and Treatment of Children with Special Health Care Needs Before and After Specialized Paramedic Training

Published online by Cambridge University Press:  28 June 2012

Daniel W. Spaite ,
Katherine J. Karriker ,
Carol Conroy ,
Marsha Seng ,
Norma Battaglia  and
Ronald M. Salik
Daniel W. Spaite
Affiliation:
Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, Arizona, 85721-0468, USA
Katherine J. Karriker
Affiliation:
Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, Arizona, 85721-0468, USA
Carol Conroy*
Affiliation:
Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, Arizona, 85721-0468, USA
Marsha Seng
Affiliation:
Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, Arizona, 85721-0468, USA
Norma Battaglia
Affiliation:
Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, Arizona, 85721-0468, USA
Ronald M. Salik
Affiliation:
Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, Arizona, 85721-0468, USA
*
College of Public Health Division of Epidemiology & Biostatistics, 1435 N Fremont, Room 128, 210468 UA, Tucson, Arizona 85721-0468 USA, E-mail: cconroy@email.arizona.edu
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Abstract

Introduction:

This study evaluates whether a continuing education program for paramedics, focusing on Children with Special Health Care Needs, improved paramedics' assessment and management.

Methods:

Emergency Medical Services responses for children, 21 years of age or younger, with a congenital or acquired condition or a chronic physical or mental illness, were identified. The responses before and after the specialized education program were reviewed by a multidisciplinary team to evaluate assessment and management of the children. Interreviewer agreement between the nurses on the team and between the physicians on the team was assessed. We also evaluated whether there was an improvement in assessment and care by paramedics completing our education program.

Results:

Significant improvement was seen in appropriate assessment and overall care by paramedics who completed our specialized education program. Reviewers also noted an appropriate rating for the initial assessment category more often for responses involving paramedics who had the training. Agreement on whether assessment and treatment was appropriate for all five reviewers varied considerably, ranging from 32% to 93%. Overall there was a high percentage of agreement (>70%) between the nurses and between the physicians on most items. However, kappa statistics did not generally reflect good agreement except for most of the focused assessment items and some treatment and procedure items.

Conclusion:

Most of the documentation on the EMS records indicated appropriate assessment and treatment during all responses for Children with Special Health Care Needs. Nevertheless, the results indicate that paramedics may improve their assessment and management of these children after specialized continuing education.

Resumen

Introducción:

Este estudio evalúa un programa de educación continua de paramédicos, centrándose en niños con necesidades de cuidados especiales a la salud, mejorando la evaluación y manejo paramédico.

Métodos:

Respuesta de Servicios Médicos de Emergencia para niños de 21 años de edad o más jóvenes, con enfermedad congénita o crónica, física o mental, fueron identificados. La respuesta antes y después del programa de educación fue revisada por un grupo multidisciplinario, para evaluar y manejar a los niños. Se estableció un acuerdo para entrevistas entre enfermeras y médicos del grupo. También se evaluó, si existió mejoría en la evaluación y cuidado por paramédicos completando nuestro programa educacional.

Resultados:

Se observo significante mejoría por evaluación apropiada y cuidado general de paramédicos, quienes completaron nuestro programa de educación especializada. Los entrevistadores también notaron una apropiada posición para la categoría de evaluación inicial, más frecuentemente por la respuesta que involucro a paramédicos que tuvieron el entrenamiento. El acuerdo en que si la evaluación y tratamiento fue apropiados varió considerablemente entre los cinco evaluadores, en un rango de 32% a 93%. En general existió un alto porcentaje de acuerdo (> 70%) entre las enfermeras y los médicos en la mayoría de los puntos.

Conclusión:

La mayoría de la documentación sobre los Servicios Médicos de Emergencia indican evaluación y tratamiento apropiados durante la respuesta para niños con Necesidades de Cuidados Especiales de Salud. No obstante, los resultados indican que paramédicos pueden mejorar su evaluación y manejo después de educación continua especializada.

Keywords

children with special health care needseducationemergency medical servicesEMSparamedicspediatrictraining
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 16 , Issue 2: T. Michael Moles Memorial Issue , June 2001 , pp. 96 - 101
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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