شاخص‌های زمانی ارایه خدمات اورژانس پیش‌بیمارستانی برای کودکان در تهران؛ 1385

    Background & Aim: A significant part of "Golden Hour" for urgent health care of children is wasted in prehospital setting, and delays in providing health care may be followed by undesirable outcomes. The current study was conducted with the aim of assessing time indices of pediatric prehospital emergency care in Tehran. Patients and Method: In this cross-sectional observational study, 115 calls requesting urgent health care services for children at the age of 15 and less were extracted from all recorded calls between 2005 and 2006. Demographic variables, accident type, very early outcomes, and time indices(Response time, Scene time, Total run time, Transport time, Round trip time) were registered. We described qualitative variables using frequency tables, and mean and standard deviation were used to describe quantitative variables. Independent t-test and Chi-square were applied to analyze the data. Results: Out of 6787 calls, 1052(15.5%) were related to children. 717(68%) of these calls were because of the problems of internal medicine and the rest(32%) were related to trauma. Road accident(18.7%), epilepsy(18.3%), unconsciousness(12.4%) and respiratory disorders(10.4%) were among the most common causes for 115 calls. 21 subjects(5.36%) died before ambulance arrival, but no one died while being taken to the hospital. The means(SD) of response time, scene time, total run time, transport time, round trip time were 14.98±6.72, 20.90±11.12, 52.60±23.98, 18.45±12.10 and 60.79±30.34 respectively. The mean ages of deceased and survived patients were 7.95±5.04 and 10.74±4.41 respectively(p=0.009). Average ambulance response time was 16.75±3.88 vs. 14.23±6.31 in deceased and survived patients respectively(p=0.022), which was indicative of a significant difference. Conclusion: Some of the time indices in this study are at the level of reported standards around the world but some others are not. The rate of very early mortality in our country is higher than other countries. Therefore, careful planning to improve time indices, assessing the causes of prolonged time indices, and making effective interventions are highly recommended. Also, staff training courses should focus on more common problems such as trauma, convulsion, unconsciousness, and respiratory disorders.