PC3051: Emergency Medical Service Providers and Children and Youth with Special Health Care Needs: A First Responders Needs Assessment Survey

Background: Children and youth with special health care needs (CYSHCN) compromise 19.6% of all children. Due to their medical complexity, CYSHCN are more likely to seek and require care from emergency medical service (EMS) first responders. However, best practices of the needs and interactions between these stakeholders are understudied. As such, our objective was to understand the needs EMS first responders and their perceived preparedness when responding to emergencies for CYSHCN in Pennsylvania.

Methods: An internet-based, voluntary survey (Qualtrics) was distributed via email to EMS first responders in Pennsylvania by community based and governmental partners within the EMS field. Data collection occurred from February and April 2020.

Questions included perceived preparedness when responding to CYSHCN-related calls, awareness of resources for EMS providers and families, and challenges when interacting with this population. Preliminary analyses are a subset of the sample (respondents with prior experience of responding to calls with CYSHCN). Responses were analyzed for emergent themes and analyzed using descriptive statistics.

Results: 415 complete responses were collected. The majority of the sample (54%) identified as basic life support providers. The remaining respondents were: Supervisor/chief, ALS provider and other administrator.

Respondents answered affirmative to the question series for this analysis. Three major qualitative themes emerged regarding challenges encountered by responders; barriers in communication (i.e., language barriers, CYSHCN who are non-verbal), lack of adequate training (i.e., knowledge of pediatric medical equipment, atypical emotional or pain responses), and insufficient application of patient information (i.e., prehospital readiness via emergency medical forms, underutilization of the 911 call center). The figures below display descriptive quotes and summaries for each theme.

Conclusion: There is a paucity of research exploring interactions between EMS first responders and CYSHCN. Addressing the challenges identified may improve experiences of these stressful events and reduce negative outcomes. Potential solutions include prehospital readiness for all stakeholders, such as caregivers maintaining emergency medical information sheets, training EMS responders on pediatric medical equipment, and standardizing the relaying of pertinent information prior to scene arrival. Limitations included an inability to ask follow-up questions due to the nature of the survey.