2012-2016 Utah Pediatric emergency care status state & regional

1. P E D I A T R I C E M E R G E N C Y C A R E
S T A T U S R E P O R T - S T A T E & R E G I O N A L
O B S E R V A T I O N S F R O M
P R E - H O S P I T A L D A T A 2 0 1 2 - 2 0 1 6
U TA H E M S C C O O R D I N AT O R W O R K S H O P
S E P T E M B E R 9 , 2 0 1 7
Y U K I K O Y O N E O K A , D A T A A N A L Y S T
B U R E A U O F E M S A N D P R E P A R E D N E S S
U T A H D E P A R T M E N T O F H E A L T H

3. 2015 PEDIATRIC (AGE 0-18) POPULATION ESTIMATE
U.S. VS. UTAH
Data Source: The Henry J. Kaiser Family Foundation, State Health Facts, 2015 Population Distribution by Age
Utahans makes up 0.94%
of US population
Utah’s children age 0-18
makes up 1.2%
of US children
of the same age group
1/3 of Utahans are
under age 19.
Utah has 7% more
children than
national average.

4. 2012-2016 STATEWIDE 911 CALLS
FOR PEDIATRIC PATIENTS
PERCENTAGE OF 911 CALLS
MADE FOR PEDIATRIC AND
ADULT PATIENTS
PERCENTAGE OF PEDIATRIC 911
CALLS BY AGE GROUP
Peds.,
11%
Adults,
89%
692, 422
87,797
Age 0 to…
Age 6 to 12,
20%
Age 13 to18,
52%
• Average
156,044 calls/year
(5.2% of Utahans)
• Adult average
138,484 calls/year
(4.5% of Utahans)
• Peds. average
17,559 calls/year
(0.6% of Utahans)
Cancelled and patient- not-found
runs were excluded.

5. UTAH CENSUS POPULATION AND PEDS. 911 CALLS
DISTRIBUTIONS BY 8 EMSC REGIONS
IT IS PROPORTIONAL
2016 UTAH CENSUS ESTIMATE*
POPULATION N= 3,051,217
PEDIATRIC 911 CALLS 2012-2016 N =
87,797
*Source: United States Census Bureau / American Fact Finder.
"Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2016".

6. 2012-2016 911 CALLS
FOR ADULT VS. PEDIATRIC PATIENTS
BY 8 EMSC REGIONS
Least
Most

7. 2012-2016 PEDIATRIC 911 CALLS
BY AGE GROUP BY 8 EMSC REGIONS
Least
Most

8. STATEWIDE TOP 5 REASONS FOR 911 CALLS
AGE 0-5

9. TOP 5 REASONS FOR 911 CALLS
AGE 0-5 BY 8 EMSC REGIONS
Ranking Region1 Region2 Region3 Region4 Region5 Region6 Region7 Region8
1 Seizure
Breathing
Problem
Traffic
Incident
Traffic
Incident
Breathing
Problem
Traffic
Incident
Traffic
Incident
Traffic
Incident
2
Traffic
Incident
Seizure
Breathing
Problem
Breathing
Problem
Seizure
Breathing
Problem
Seizure
Breathing
Problem
3
Breathing
Problem
Falls Seizure Seizure
Traffic
Incident
Seizure Falls Transfer
4 Choking
Traffic
Incident
Transfer Transfer Falls Falls
Breathing
Problem
Seizure
5 Falls Sick Person Choking Choking Transfer Sick Person Choking Sick Person

10. STATEWIDE 911 CALL TYPE
BY EMS PRIMARY IMPRESSION
FOR PEDIATRIC PATIENTS AGE 0-5

11. 911 CALL TYPE
FOR PEDIATRIC PATIENTS AGE 0-5
BY 8 EMS REGIONS
Is “N/A” used too often in place of a real value?

12. STATEWIDE TOP 5 REASONS FOR 911 CALLS
AGE 6-12

13. TOP 5 REASONS FOR 911 CALLS
AGE 6-12 BY 8 EMSC REGIONS
Ranking Region1 Region2 Region3 Region4 Region5 Region6 Region7 Region8
1
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
2
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
3 Seizure Seizure Falls Falls Seizure Falls Falls
Breathing
Problem
4 Hazmat Falls
Not
Recorded
Seizure Falls
Breathing
Problem
Person Down Seizure
5 Falls
Breathing
Problem
Seizure
Breathing
Problem
Breathing
Problem
Seizure
Breathing
Problem
Hazmat

14. STATEWIDE 911 CALL TYPE
BY EMS PRIMARY IMPRESSION
FOR PEDIATRIC PATIENTS AGE 6-12

15. 911 CALL TYPE
FOR PEDIATRIC PATIENTS AGE 6-12
BY 8 EMS REGIONS
Is “N/A” used too often in place of a real value?

16. STATEWIDE TOP 5 REASONS FOR 911 CALLS
AGE 13-18

17. TOP 5 REASONS FOR 911 CALLS
AGE 13-18 BY 8 EMSC REGIONS
Ranking Region1 Region2 Region3 Region4 Region5 Region6 Region7 Region8
1
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traffic
Incident
Traumatic
Injury
2
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traumatic
Injury
Traffic
Incident
3
Psychiatric
Problem
Psychiatric
Problem
Not
Recorded
Overdose Seizure Unconscious Falls
Breathing
Problem
4 Seizure Overdose Falls Assault Unconscious Seizure Unconscious Falls
5 Overdose Seizure Seizure
Not
Recorded
Overdose Overdose Person Down Transfer

18. STATEWIDE 911 CALL TYPE
BY EMS PRIMARY IMPRESSION
FOR PEDIATRIC PATIENTS AGE 13-18

19. 911 CALL TYPE
FOR PEDIATRIC PATIENTS AGE 13-18
BY 8 EMS REGIONS
Is ”N/A” used too often in place of a real value?

20. About ¼of EMS primary impression
for pediatric emergency was
NOT RECORDED….

21. MEDIAN “UNIT NOTIFIED TO SCENE” MINUTES
FOR PEDIATRIC EMERGENCY
BY 8 EMSC REGIONS

22. MEDIAN SCENE-TO-ED MINUTES
FOR TOP 5 911 CALL REASONS
FOR AGE 0-5 BY 8 EMSC REGIONS

23. MEDIAN SCENE-TO-ED MINUTES
FOR TOP 5 911 CALL REASONS
FOR AGE 6-12 BY 8 EMSC REGIONS

24. MEDIAN SCENE-TO-ED MINUTES
FOR TOP 5 911 CALL REASONS
FOR AGE 13-18 BY 8 EMSC REGIONS

25. STATEWIDE TOP 5 COMMONLY USED DRUGS*
FOR PEDIATRIC PATIENTS
Ranking Age 0-5 Age 6-12 Age 13-18
1 Albuterol Sulfate Fentanyl Ondansetron
2 Midazolam Albuterol Sulfate Fentanyl
3 Acetaminophen Ondansetron Morphine Sulfate
4 Epinephrine Midazolam Midazolam
5 Ibuprofen Morphine Sulfate Naloxone
*Oxygen, normal saline, and other values not related to drugs are
excluded

26. TOP 5 DRUGS* FOR PEDIATRIC PATIENTS
AGE 0-5 BY REGIONS
*Oxygen, normal saline, and other values not related to drugs are
excluded
Ranking Region1 Region2 Region3 Region4 Region5 Region6 Region7 Region8
1 Acetaminophen Midazolam
Albuterol
Sulfate
Albuterol
Sulfate
Albuterol
Sulfate
Albuterol Sulfate
Morphine
Sulfate
Albuterol
Sulfate
2
Albuterol
Sulfate
Albuterol
Sulfate
Fentanyl Acetaminophen
Morphine
Sulfate
Midazolam
Albuterol
Sulfate
Lidocaine
3 Midazolam Acetaminophen Epinephrine Lactated Ringers Diphenhydramine Acetaminophen
Oral
Glucose
Midazolam
4 Epinephrine Epinephrine Burn cream Morphine Sulfate Lactated Ringers Ondansetron
5 Ibuprofen Ibuprofen Diphenhydramine Epinephrine Ondansetron Epinephrine

27. TOP 5 DRUGS* FOR PEDIATRIC PATIENTS
AGE 6-12 BY REGIONS
Ranking Region1 Region2 Region3 Region4 Region5 Region6 Region7 Region8
1 Fentanyl
Albuterol
Sulfate
Lactated
Ringers
Albuterol
Sulfate
Morphine
Sulfate
Ondansetron
Lactated
Ringers
Albuterol
Sulfate
2 Ondansetron Ondansetron
Albuterol
Sulfate
Ondansetron
Lactated
Ringers
Morphine
Sulfate
Morphine
Sulfate
Fentanyl
3
Albuterol
Sulfate
Fentanyl Fentanyl Fentanyl Fentanyl Fentanyl Ondansetron
Morphine
Sulfate
4 Epinephrine Midazolam
Morphine
Sulfate
Lactated
Ringers
Albuterol
Sulfate
Albuterol
Sulfate
Albuterol
Sulfate
Midazolam
5 Midazolam
Morphine
Sulfate
Epinephrine
Morphine
Sulfate
Ondansetron Midazolam Aspirin Ondansetron
*Oxygen, normal saline, and other values not related to drugs are

28. TOP 5 DRUGS* FOR PEDIATRIC PATIENTS
AGE 13-18 BY REGIONS
Ranking Region1 Region2 Region3 Region4 Region5 Region6 Region7 Region8
1 Fentanyl Ondansetron
Lactated
Ringers
Ondansetron
Morphine
Sulfate
Ondansetron
Lactated
Ringers
Fentanyl
2 Ondansetron Fentanyl
Morphine
Sulfate
Morphine
Sulfate
Ondansetron
Morphine
Sulfate
Morphine
Sulfate
Morphine
Sulfate
3 Naloxone
Morphine
Sulfate
Fentanyl
Lactated
Ringers
Fentanyl Fentanyl Ondansetron Ondansetron
4 Midazolam Midazolam Ondansetron Fentanyl
Lactated
Ringers
Midazolam
Albuterol
Sulfate
Albuterol
Sulfate
5
Morphine
Sulfate
Naloxone
Albuterol
Sulfate
Albuterol
Sulfate
Naloxone Naloxone Aspirin Naloxone
*Oxygen, normal saline, and other values not related to drugs are excluded

29. NUMBER OF PEDIATRIC PATIENTS’ DEATHS
2012-2016
• There were 2,454 deaths* in Utah children (age 0-18)
between 2012 and 2016.
• That is about 491 deaths per year.
• Of those, 604 deceased children (24.6%) were linked
with our pre-hospital Patient Care Reports (PCR) by
their demographic information.
* Data Source: Utah Office of Vital Records and Statistics

30. PEDIATRIC PATIENTS’ MANNER OF DEATHS
2012-2016 BY AGE GROUP (N=604)
Data Source: Utah Office of Vital Records and Statistics

31. PEDIATRIC PATIENTS’ PLACE OF DEATHS
2012-2016 BY AGE GROUP (N=604)
Data Source: Utah Office of Vital Records and Statistics

32. PEDIATRIC PATIENTS
WHO SUSTAINED INJURY BEFORE DEATH
2012-2016 BY AGE GROUP (N=604)
Data Source: Utah Office of Vital Records and Statistics

33. PEDIATRIC PATIENTS’ NUMBER OF DEATHS
2012-2016 BY 8 EMSC REGIONS (N=604)

34. A C K N O W L E D G E M E N T
S PE CIAL THA NKS TO
TIA DICKSON, RN
FOR HE R PROFOUND
KNOW LEDGE IN PE D IATRIC
E ME RGE NCY CA RE A ND HE R
VALUABLE SUGGE STIONS!

35. QUESTIONS?
Y U K I KO Y O N E O K A , D ATA A N A LY S T
B E M S P, U TA H D E PA R T M E N T O F H E A LT H
Y Y O N E O K A @ U TA H . G O V

36. YOU ARE SUPER HEROES!
THANK YOU FOR SAVING OUR CHILDREN’S LIVES!