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DTSTART:20241103T020000
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DESCRIPTION:Program: Injury Control and Emergency Health Services Session:
  Research Addressing Trauma Services\, Emergency Medicine\, and EMS Respo
 nse Posters Presenter : Margaret Zhang Author : Linda Degutis See all aut
 hors and presenters → Abstract Background/Purpose Emergency Medical Servi
 ces (EMS) is a valuable resource for evaluating\, treating\, and coordina
 ting care for individuals who have sustained a traumatic brain injury (TB
 I). Among adults who have sustained a TBI\, there is frequent refusal of 
 EMS transport. This raises a public health concern because it can put a b
 urden on resource utilization and reveal misperceptions regarding risk fo
 llowing head injuries. Less is known about whether similar patterns of no
 n-transport exist among children with TBIs. The purpose of this study is 
 to describe the epidemiology of pediatric head injuries attended by EMS a
 nd to identify factors associated with non-transport for these patients. 
 Methods We used the 2022 National Emergency Medical Services Information 
 (NEMSIS) data and included patients ages 2-17 years. Individuals were cla
 ssified as having a TBI if they had an ICD-10 code related to injuries to
  the skull and brain in the primary impression\, secondary impression\, p
 rimary symptom\, or secondary symptom fields. We also included individual
 s who had both documented possible injury and head-related chief complain
 t. Our primary outcome was whether the patient was transported or not\, i
 dentified using eDisposition.12 (Incident/Patient Disposition). We calcul
 ated descriptive statistics for patient and incident characteristics\, st
 ratified by transport status\, and used Chi-square or Wilcoxon rank-sum t
 ests to calculate differences between groups. We conducted simple and mul
 tivariable logistic regressions to generate odds ratios and 95% confidenc
 e intervals to identify factors associated with non-transport. Results In
  2022\, 34.2% of 136\,218 encounters in our cohort resulted in non-transp
 ort. The majority of all TBI patients were male\, ages 12-17\, White\, ha
 d a GCS score of 15\, and had a low initial acuity. Nearly half of all in
 cidents happened between 12 and 9 PM\, and most encounters were in an urb
 an setting. The most common locations of encounters were roadside and res
 idential\, with more encounters resulting in non-transport happening at a
  residential location and more encounters resulting in transport happenin
 g at the roadside. ALS attended 82.7% of incidents resulting in non-trans
 port and 77.1% of incidents resulting in transport. In the multivariable 
 analyses\, non-transport was more likely among children ages 6-11 (OR: 1.
 06\, 95%CI: 1.01-1.12) and less likely among children ages 12-17 (OR: 0.9
 4\, 95%CI: 0.90-0.98) compared to children ages 2-5. Non-transport was le
 ss likely among children with GCS<15 compared to GCS of 15 (OR: 0.11\, 95
 %CI: 0.09-0.13) and among children with an emergent or critical initial a
 cuity compared to low (emergent OR: 0.27\, 95%CI 0.26-0.29\; critical OR:
  0.18\, 95%CI 0.15-0.21). Similarly\, odds of non-transport were lower am
 ong incidents happening in suburban or rural settings compared to urban s
 ettings. Incidents resulting in non-transport were more likely to be atte
 nded by ALS compared to BLS (OR: 1.95\; 95% CI: 1.85-2.04). Conclusions T
 here are significant patient and incident-level factors associated with t
 he decision to not transport children who have sustained a TBI\, with urb
 anicity\, GCS\, and provider-documented initial acuity being strong predi
 ctors of non-transport. A better understanding of non-transport could inf
 orm patient care\, decision-making\, and have implications for healthcare
  utilization\, ultimately supporting the broader goal of improving popula
 tion health outcomes.\n\nSpeakers:\nMargaret Zhang\; Linda Degutis\n\nAdm
 ission:\nRegistrationFees: APHA Event Registration is Required\n\nDetails
  URL:\nhttps://medicine.yale.edu/event/predictors-of-non-transport-for-em
 s-incidents-of-pediatric-head-injuries/\n
DTEND;TZID=America/New_York:20251102T160000
DTSTAMP:20260418T081918Z
DTSTART;TZID=America/New_York:20251102T150000
GEO:38.903500;-77.022987
LOCATION:801 Allen Y Lew Pl NW\, Washington\, DC\, United States
SEQUENCE:0
STATUS:Confirmed
SUMMARY:2123.0 - Predictors of non-transport for EMS incidents of pediatri
 c head injuries
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