253579 Pediatric Emergency Care Capabilities: An Assessment of Indian Health Service Affiliated Tribal EMS Agencies in the United States

Sunday, October 30, 2011

Andrea Lynn Genovesi, MA , Intermountain Injury Control Research Center, University of Utah, Salt Lake City, UT
Betty Hastings, MSW , U.S. Department of Health and Human Services, Indian Health Service, Office of Emergency Services, Rockville, MD
Lenora Olson, MA, PhD , Intermountain Injury Control Center, University of Utah, Salt Lake City, UT

Purpose. Evaluate the capability of Indian Health Service (IHS) affiliated tribal EMS agencies to care for pediatric patients. Methods. Survey sent to 75 tribal agency directors. Results. Sixty-one agencies (81%) responded. Most agencies are stand-alone and operate Basic Life Support (BLS) ambulances. Pre-hospital runs for pediatric patients constituted 13% of total runs. Most directors (84%) indicated the need for pediatric continuing education. Almost half (49%) of the agencies have a Mass Casualties Plan, but 29% of directors reported responding to a mass casualty incident that involved a large number of pediatric patients that overwhelmed their service. Nine agencies (15%) do not have an EMS medical director. The top missing pieces of recommended pediatric equipment not carried on any of ambulances are Stethoscope, Suction catheters, Extremity splints, and Thermal blanket. Approximately half (53%) of agencies have EMS staff that participate in injury prevention activities. Most (95%) of the agencies collect EMS patient care data and half (48%) use the National EMS Information System (NEMSIS) 2.2.1 standard data elements. Over two thirds (76%) submit patient care data to the state EMS authority. Conclusions. Very little information exists on tribal EMS agencies ability to care for pediatric patients. Our survey indicates that in some areas, tribal EMS agencies are prepared to care for children including carrying most prehospital pediatric equipment, collecting and submitting patient care data and integration with the state EMS system. However, severe deficiencies remain including lack of medical direction and capacity to care for children during a mass causality.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Diversity and culture

Learning Objectives:
Evaluate the capability of Indian Health Service (IHS) affiliated tribal EMS agencies to care for pediatric patients.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a BA in Cultural Anthropology and an MA in Archaeology. I have been working for the National EMS for Children Data Analysis Resource Center for the past 5 years. I helped in the data collection and analysis for this study as well as serving as the lead author of the in-progress manuscript.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.