WKYT Investigates | Thinking small: How Ky. EMS agencies prepare for pediatric patients

Children make up a small percentage of patients. Experts say that’s why they have to be ready when the call does come in.
Children make up a small percentage of patients. Experts say that’s why they have to be ready when the call does come in.
Published: Aug. 23, 2021 at 3:49 PM EDT
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WILMORE, Ky. (WKYT) - A big part of a first responder’s job is to train for things he or she hopes never to have to do for real.

“We don’t want those bad things to happen,” said Lt. Matthew White with Jessamine County Emergency Medical Services, “but we definitely want to be there on somebody’s worst day.”

That is why Lt. White says special training and equipment are especially important to prepare them for the kinds of calls and patients they do not see as often - particularly children.

Lt. White is the agency’s pediatric emergency care coordinator. He says taking care of children in emergencies comes with its own struggles.

“Two o’clock in the morning, when those emotions are high, it’s very hard to have those thoughts, from a paramedic and EMT all the way up to a physician,” he said.

Experts say caring for adults in emergencies is fairly one-size-fits-all, but children - with different ages and widely varying sizes - have unique needs, not to mention drug dosages often based on weight.

And even though children remain a small percentage of the patients treated by EMS, experts say the challenges make it even more crucial that they are ready - through practice, repetition and having the right tools - when the call does come in.

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“If we don’t keep kids on the radar, then we’re not going to be prepared when we do encounter those pediatric patients,” said Morgan Scaggs, Kentucky EMS for Children project director.

Scaggs works with hospitals and EMS agencies across the commonwealth to help them better care for kids in emergencies.

The state has made strides in its goal to grow pediatric EMS efforts.

Two-thirds of agencies across Kentucky now have a pediatric emergency care coordinator, Scaggs says. Four years ago, less than a quarter did.

And state EMS guidelines now regulate the pediatric equipment that needs to be carried on ambulances.

A state report based on Kentucky State Ambulance Reporting System data shows EMS agencies across Kentucky responded to 41,163 pediatric incidents in 2019. That is 4.6 percent of total EMS response that year. Of those calls:

  • 48 percent were in kids ages 11-17
  • 24 percent were in kids ages 5-10
  • 27 percent were in kids up to age 4

The most common causes of injuries were car crashes and falls.

Of the places in Kentucky with the highest ratio of pediatric patients to population, seven of the 10 counties are in rural Appalachia. They include:

  • Perry (3rd)
  • McCreary (4th)
  • Floyd (5th)
  • Whitley (6th)
  • Powell (7th)
  • Boyd (8th)
  • Menifee (10th)

“We want to make sure that every child in Kentucky - no matter where they are - has access to quality care when it matters most,” Scaggs said.

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Jessamine Co. EMS was one of four agencies recognized this spring by the Kentucky Board of EMS (KBEMS) for the fourth straight year for going above and beyond in pediatric care. (A total of 24 agencies received an award of excellence in 2021.)

It is important there: Jessamine County had the 11th highest patient-to-population ratio for pediatric incidents, according to the KBEMS report.

Inside their ambulances, Jessamine Co. EMS stores pediatric equipment inside an easy-to-spot purple bag, with everything in a range of sizes for kids of all different ages.

“We have things from simple airways we can use, to masks and bags we use to ventilate patients, like we would an adult you see in the movies,” Lt. White said.

“We have a tape,” he said, unrolling it, “and an app on our phones. We can use this to get a rough age of the patient and then get ideal body weight from them, so we can start medicating, if we need to, appropriately.”

The goal is to give paramedics and EMTs one less thing to worry about, making sure they have the confidence and competence to know they are doing the best they can in a tough situation.

A WKYT Investigates analysis of EMS response data shows that reported pediatric incidents dropped 16 percent from 2019 to the pandemic year of 2020. Data for the first five months of 2021 shows that they are on pace to be higher than that this year, but still below 2019 levels.

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