Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings
Objectives: Barriers to healthcare in rural areas can delay treatment in pediatric patients who have experienced poisoning. We compared emergency medical services (EMS) response times and EMS-reported delays in responding to pediatric poisoning incidents between rural and urban settings using the 20...
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| Format: | Article |
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eScholarship Publishing, University of California
2025-05-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/945975f1 |
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| author | Aaron T. Phillips Michael Denning Em Long-Mills Dmitry Tumin Jennifer Parker-Cote Kathleen Bryant |
| author_facet | Aaron T. Phillips Michael Denning Em Long-Mills Dmitry Tumin Jennifer Parker-Cote Kathleen Bryant |
| author_sort | Aaron T. Phillips |
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| description | Objectives: Barriers to healthcare in rural areas can delay treatment in pediatric patients who have experienced poisoning. We compared emergency medical services (EMS) response times and EMS-reported delays in responding to pediatric poisoning incidents between rural and urban settings using the 2021 National Emergency Medical Services Information System (NEMSIS). Methods: The NEMESIS defines rural areas as locations with a population of <50,000, not part of metropolitan areas, while all other locations are classified as urban (metropolitan) areas. In this study we included 11,911 patients (12% rural) <18 years of age who were transported by EMS with a first-responder primary impression of poisoning. We compared study variables using rank-sum tests and chi-square tests. Multivariable analysis of outcomes included quantile regression and logistic regression for continuous data and categorical data, respectively. Results: The median total prehospital time by EMS was 40 minutes (interquartile range 29–57), and the most common type of delay was scene delay (6%). On multivariable quantile regression, patients transported by rural EMS agencies experienced 6.6 minutes (95% confidence interval 5–8, P<0.001) longer prehospital time than those transported by urban agencies. There were no differences between rural and urban EMS agencies in the occurrence of dispatch, response, scene, and transportation delays. Conclusion: These results elucidate the need for equitable allocation of resources and training to enhance rural EMS responders. The additional nearly seven minutes translates into greater risk for the human body to remain physiologically unstable and not be optimally treated. Therefore, by integrating targeted interventions to rural pediatric populations, better care can be achieved across all geographic regions. Further research must be conducted to ascertain the specific factors, aside from delays, that result in the disparity between rural and urban prehospital response time. |
| format | Article |
| id | doaj-art-283b3cacbca64471946d8518308aec43 |
| institution | Kabale University |
| issn | 1936-900X 1936-9018 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj-art-283b3cacbca64471946d8518308aec432025-08-20T03:28:05ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182025-05-0126365065610.5811/westjem.33507wjem-26-650Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban SettingsAaron T. Phillips0Michael Denning1Em Long-Mills2Dmitry Tumin3Jennifer Parker-Cote4Kathleen Bryant5Brody School of Medicine, Department of Medical Education, Greenville, North CarolinaBrody School of Medicine, Department of Medical Education, Greenville, North CarolinaBrody School of Medicine, Department of Clinical and Educational Scholarship, Greenville, North CarolinaBrody School of Medicine, Department of Clinical and Educational Scholarship, Greenville, North CarolinaBrody School of Medicine, Department of Emergency Medicine, Greenville, North CarolinaBrody School of Medicine, Department of Emergency Medicine, Greenville, North CarolinaObjectives: Barriers to healthcare in rural areas can delay treatment in pediatric patients who have experienced poisoning. We compared emergency medical services (EMS) response times and EMS-reported delays in responding to pediatric poisoning incidents between rural and urban settings using the 2021 National Emergency Medical Services Information System (NEMSIS). Methods: The NEMESIS defines rural areas as locations with a population of <50,000, not part of metropolitan areas, while all other locations are classified as urban (metropolitan) areas. In this study we included 11,911 patients (12% rural) <18 years of age who were transported by EMS with a first-responder primary impression of poisoning. We compared study variables using rank-sum tests and chi-square tests. Multivariable analysis of outcomes included quantile regression and logistic regression for continuous data and categorical data, respectively. Results: The median total prehospital time by EMS was 40 minutes (interquartile range 29–57), and the most common type of delay was scene delay (6%). On multivariable quantile regression, patients transported by rural EMS agencies experienced 6.6 minutes (95% confidence interval 5–8, P<0.001) longer prehospital time than those transported by urban agencies. There were no differences between rural and urban EMS agencies in the occurrence of dispatch, response, scene, and transportation delays. Conclusion: These results elucidate the need for equitable allocation of resources and training to enhance rural EMS responders. The additional nearly seven minutes translates into greater risk for the human body to remain physiologically unstable and not be optimally treated. Therefore, by integrating targeted interventions to rural pediatric populations, better care can be achieved across all geographic regions. Further research must be conducted to ascertain the specific factors, aside from delays, that result in the disparity between rural and urban prehospital response time.https://escholarship.org/uc/item/945975f1 |
| spellingShingle | Aaron T. Phillips Michael Denning Em Long-Mills Dmitry Tumin Jennifer Parker-Cote Kathleen Bryant Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings Western Journal of Emergency Medicine |
| title | Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings |
| title_full | Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings |
| title_fullStr | Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings |
| title_full_unstemmed | Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings |
| title_short | Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings |
| title_sort | comparing prehospital time among pediatric poisoning patients in rural and urban settings |
| url | https://escholarship.org/uc/item/945975f1 |
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