The current study assesses the relationship between continuing education (CE) with a focus on pediatrics and children with special heath care needs and how CE influences the knowledge and comfort levels of prehospital providers who treat these cases. Data are survey responses provided by paramedic and emergency medical technician (EMT) level providers (N = 575) in Los Angeles County. Regression models assessed the relationship between pediatric-focused continuing education and EMTs’ knowledge of and comfort with pediatric cases, adjusting for relevant covariates. EMTs’ participation in continuing education focusing on pediatrics and special health care needs was significantly associated with an increase in perceived comfort and knowledge. Among EMTs who did not receive continuing education focused on either pediatrics or special health care needs, the most frequently reported barrier to education was a perceived lack of availability. The impact of continuing education on perceived comfort and knowledge was more pronounced than the effect of prior experience, especially considering the limited prevalence of provider exposure to pediatric and childhood special health care needs cases compared to adult cases. Expanding educational opportunities is a promising approach to increasing the comfort and knowledge of EMTs who transport and care for pediatric cases.
AbramsonT. M.RoseE.CrowE.LaneC. J.KearlY.Loza-GomezA. (2020). Paramedic identification of pediatric seizures: A prospective cohort study. Prehospital Emergency Care. Advance online publication. https://doi.org/10.1080/10903127.2020.1831667
2.
Al-JabirA.KerwanA.NicolaM.AlsafiZ.KhanM.SohrabiC.O’NeillN.IosifidisC.GriffinM.MathewG. (2020). Impact of the coronavirus (COVID-19) pandemic on surgical practice-Part 2 (surgical prioritisation). International Journal of Surgery, 79, 233–248.
3.
AltmanB.BernsteinA. (2008). Disability and health in the United States, 2001–2005. National Center for Health Statistics. 2008-1035.
4.
American Academy of Pediatrics, American College of Emergency Physicians, DolanM. A.MaceS. E. (2006). Pediatric mental health emergencies in the emergency medical services system. American College of Emergency Physicians. Annals of Emergency Medicine, 48(4), 484–486. https://doi.org/10.1016/j.annemergmed.2006.08.015
5.
BentleyM. A.ShobenA.LevineR. (2016). The demographics and education of emergency medical services (EMS) professionals: A national longitudinal investigation. Prehospital and Disaster Medicine, 31(S1), S18–S29.
BoyleC. A.BouletS.SchieveL. A.CohenR. A.BlumbergS. J.Yeargin-AllsoppM.VisserS.KoganM. D. (2011). Trends in the prevalence of developmental disabilities in US children, 1997–2008. Pediatrics, 127(6), 1034–1042. https://doi.org/10.1542/peds.2010-2989
8.
BradleyE.LofchyJ. (2005). Learning disability in the accident and emergency department. Advances in Psychiatric Treatment, 11(1), 45–57. https://doi.org/10.1192/apt.11.1.45
ChaiyachatiB. H.AgawuA.ZorcJ. J.BalamuthF. (2020). Trends in pediatric emergency department utilization after institution of coronavirus disease-19 mandatory social distancing. The Journal of pediatrics, 226, 274–277. e271.
11.
DalkeyN.HelmerO. (1963). An experimental application of the Delphi method to the use of experts. Management science, 9(3), 458–467.
DiazM. C. G.DawsonK. (2020). Use of simulation to develop a COVID-19 resuscitation process in a pediatric emergency department. American Journal of Infection Control, 48(10), 1244–1247.
15.
EinfeldS. L.EllisL. A.EmersonE. (2011). Comorbidity of intellectual disability and mental disorder in children and adolescents: A systematic review. Journal of Intellectual and Developmental Disability, 36(2), 137–143. https://doi.org/10.1080/13668250.2011.572548
16.
EngelmanA.IveyS. L.TsengW.DahrougeD.BruneJ.NeuhauserL. (2013). Responding to the deaf in disasters: Establishing the need for systematic training for state-level emergency management agencies and community organizations. BMC Health Services Research, 13(1), 84. https://doi.org/10.1186/1472-6963-13-84
17.
FidacaroG. A.Jr.JonesC. W.DragoL. A. (2020). Pediatric transport practices among prehospital providers. Pediatric Emergency Care, 36(11), e632–e635.
18.
FowlerJ.BeovichB.WilliamsB. (2018). Improving paramedic confidence with paediatric patients: A scoping review. Australasian Journal of Paramedicine, 15(1).
19.
FrattaK. A.FisheJ. N. (2019). EMS, pediatric transport safety and secondary transport. In StatPearls [Internet]. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/30020606/
20.
FredricksonJ. M.BauerW.ArellanoD.DavidsonM. (1994). Emergency nurses’ perceived knowledge and comfort levels regarding pediatric patients. Journal of Emergency Nursing, 20(1), 13–17.
21.
GauscheM.HendersonD. P.SeidelJ. S. (1990). Vital signs as part of the prehospital assessment of the pediatric patient: A survey of paramedics. Annals of Emergency Medicine, 19(2), 173–178. https://doi.org/10.1016/S0196-0644(05)81804-9
22.
Gausche-HillM.SchmitzC.LewisR. J. (2007). Pediatric preparedness of US emergency departments: A 2003 survey. Pediatrics, 120(6), 1229–1237.
23.
GlaeserP. W.LinzerJ.TunikM. G.HendersonD. P.BallJ. (2000). Survey of nationally registered emergency medical services providers: Pediatric education. Annals of Emergency Medicine, 36(1), 33–38. https://doi.org/10.1067/mem.2000.107662
24.
GulliB.CiatollaJ. A.BarnesL. (2011). Emergency care and transportation of the sick and injured. Jones & Bartlett Learning.
25.
GurneyJ. G.McPheetersM. L.DavisM. M. (2006). Parental report of health conditions and health care use among children with and without autism: National Survey of Children’s Health. Archives of Pediatrics & Adolescent Medicine, 160(8), 825–830. https://doi.org/10.1001/archpedi.160.8.825
26.
HansenM.MecklerG.O’BrienK.EngleP.DickinsonC.DickinsonK.JuiJ.LambertW.CottrellE.GuiseJ.-M. (2016). Pediatric airway management and prehospital patient safety: Results of a national Delphi survey by the children’s safety Initiative-emergency medical services for children. Pediatric Emergency Care, 32(9), 603.
27.
HartkaT.VacaF. E. (2020). Factors associated with EMS transport decisions for pediatric patients after motor vehicle collisions. Traffic Injury Prevention. Advance online publication. https://doi.org/10.1080/15389588.2020.1830382
IBM Corp. (2016). IBM SPSS Statistics for Windows Version 24.0. IBM Corp.
30.
JerinJ. M.ReaT. D. (2005). Web-based training for EMT continuing education. Prehospital Emergency Care, 9(3), 333–337.
31.
Jo SuE.MannN. C.McCallM.HedgesJ. R. (1997). Use of resuscitation skills by paramedics caring for critically injured children in Oregon. Prehospital Emergency Care, 1(3), 123–127. https://doi.org/10.1080/10903129708958803
32.
KrahnG. L.WalkerD. K.Correa-De-AraujoR. (2015). Persons with disabilities as an unrecognized health disparity population. American Journal of Public Health, 105(S2), S198–S206. https://doi.org/10.2105/AJPH.2014.302182
33.
KumarV. R.BachmanD. T.KiskaddonR. T. (1997). Children and adults in cardiopulmonary arrest: Are advanced life support guidelines followed in the prehospital setting?Annals of Emergency Medicine, 29(6), 743–747. https://doi.org/10.1016/S0196-0644(97)70195-1
34.
LeeT. J.FagianaA. M.WellsR. J.HeimanH. S.HurdW. W.BorgmanM. A. (2019). Overview of pediatric and neonatal transport. In HurdW. W.BeninatiW. (Eds.), Aeromedical evacuation (pp. 363–390). Springer.
35.
LeszczyńskiP.CharutaA.ŁaziukB.GałązkowskiR.WejnarskiA.RoszakM.KołodziejczakB. (2018). Multimedia and interactivity in distance learning of resuscitation guidelines: A randomised controlled trial. Interactive Learning Environments, 26(2), 151–162.
LindquistB. D.KovalK. W.AckerP. C.BillsC. B.KhanA.ZachariahS.NewberryJ. A.RaoG. R.MahadevanS. V.StrehlowM. C. (2020). Continuing education for prehospital healthcare providers in India—A novel course and concept. Open Access Emergency Medicine: OAEM, 12, 201.
38.
MecklerG.LeonardJ.HoyleJ. (2014). Pediatric patient safety in emergency medical services. Clinical Pediatric Emergency Medicine, 15(1), 18–27. https://doi.org/10.1016/j.cpem.2014.01.003
39.
National Center for Health Statistics. (2017). Health, United States, 2016: With chartbook on long-term trends in health. National Center for Health Statistics.
40.
NewschafferC. J.FalbM. D.GurneyJ. G. (2005). National autism prevalence trends from United States special education data. Pediatrics, 115(3), e277–e282. https://doi.org/10.1542/peds.2004-1958
41.
OwleyT. B. (2004). Treatment of individuals with autism spectrum disorders in the emergency department: Special considerations. Clinical Pediatric Emergency Medicine, 5(3), 187–192.
42.
Owusu-AnsahS.MooreB.ShahM. I.GrossT.BrownK.Gausche-HillM.RemickK.AdelgaisK.RappaportL.SnowS. (2020). Pediatric readiness in emergency medical services systems. Pediatrics, 145(1).
43.
PasicJ.RussoJ.Roy-ByrneP. (2005). High utilizers of psychiatric emergency services. Psychiatric Services, 56(6), 678–684. https://doi.org/10.1176/appi.ps.56.6.678
44.
RamgopalS.ElmerJ.EscajedaJ.Martin-GillC. (2018). Differences in prehospital patient assessments for pediatric versus adult patients. The Journal of pediatrics, 199, 200–205. e206.
45.
RzońcaE.ŚwieżewskiS. P.GałązkowskiR.BieńA.KosowskiA.LeszczyńskiP.RzońcaP. (2020). Neonatal transport in the practice of the crews of the polish medical air rescue: A retrospective analysis. International Journal of Environmental Research and Public Health, 17(3), 705.
46.
SchroterS.ThomasD.NimmerM.VisotckyA.FraserR.ColellaM. R.BrowneL. R. (2020). Multimedia evaluation of EMT-paramedic assessment and management of pediatric respiratory distress. Prehospital Emergency Care, 1–11.
47.
SeidelJ. S.HornbeinM.YoshiyamaK.KuznetsD.FinklesteinJ. Z.St GemeJ. W. (1984). Emergency medical services and the pediatric patient: Are the needs being met?Pediatrics, 73(6), 769–772.
48.
ShahM. N.CushmanJ. T.DavisC. O.BazarianJ. J.AuingerP.FriedmanB. (2008). The epidemiology of emergency medical services use by children: An analysis of the national hospital ambulatory medical care survey. Prehospital Emergency Care, 12(3), 269–276. https://doi.org/10.1080/10903120802100167
49.
SholokhovaD.SviatoslavM. (2019). The paediatric trauma patient profile from the perspective of the emergency medical team. Critical Care Innovations, 2(2), 1–8.
50.
SimonH. K.SullivanF. (1996). Confidence in performance of pediatric emergency medicine procedures by community emergency practitioners. Pediatric Emergency Care, 12(5), 336–339. https://doi.org/10.1097/00006565-199610000-00003
51.
SmithG. A.ThompsonJ. D.ShieldsB. J.ManleyL. K.HaleyK. J. (1997). Evaluation of a model for improving emergency medical and trauma services for children in rural areas. Annals of Emergency Medicine, 29(4), 504–510. https://doi.org/10.1016/S0196-0644(97)70224-5
52.
SobolewskaP.Pinet PeraltaL. M. (2019). Use of the educational mobile applications by emergency medical services personnel. Critical Care Innovations, 2(2), 25–31.
53.
SpaiteD. W.KarrikerK. J.ConroyC.SengM.BattagliaN.SalikR. M. (2001). Emergency medical services assessment and treatment of children with special health care needs before and after specialized paramedic training. Prehospital and Disaster Medicine, 16(2), 96–101. https://doi.org/10.1017/S1049023X00025760
54.
SpaiteD. W.KarrikerK. J.SengM.ConroyC.BattagliaN.TibbittsM.MeislinH. W.SalikR. M.ValenzuelaT. D. (2000). Increasing paramedics’ comfort and knowledge about children with special health care needs. The American Journal of Emergency Medicine, 18(7), 747–752. https://doi.org/10.1053/ajem.2000.16300
55.
StevensS. L.AlexanderJ. L. (2005). The Impact of training and experience on EMS providers’ feelings toward pediatric emergencies in a rural state. Pediatric Emergency Care, 21(1), 12–17.
56.
U.S. Department of Health and Human Services. (2013). The National survey of children with special health care needs chartbook 2009–2010. Health Resources and Services Administration, Maternal and Child Health Bureau. https://mchb.hrsa.gov/cshcn0910/population/pages/pc/pcih.html
57.
Van Naarden BraunK.ChristensenD.DoernbergN.SchieveL.RiceC.WigginsL.SchendelD.Yeargin-AllsoppM. (2015). Trends in the prevalence of autism spectrum disorder, cerebral palsy, hearing loss, intellectual disability, and vision impairment, metropolitan Atlanta, 1991-2010. PloS One, 10(4), e0124120. https://doi.org/10.1371/journal.pone.0124120
58.
WarrenL.SapienR.Fullerton-GleasonL. (2008). Is Online pediatric continuing education effective in a rural state?Prehospital Emergency Care, 12(4), 498–502.
59.
WertzE.WertzE. M. (2002). Emergency care for children. Delmar Thomson Learning.
60.
Wolf-FordhamS. B.TwymanJ. S.HamadC. D. (2014). Educating first responders to provide emergency services to individuals with disabilities. Disaster Medicine and Public Health Preparedness, 8(06), 533–540. https://doi.org/10.1017/dmp.2014.129
61.
ZablotskyB.BlackL. I.MaennerM. J.SchieveL. A.DanielsonM. L.BitskoR. H.BlumbergS. J.KoganM. D.BoyleC. A. (2019). Prevalence and trends of developmental disabilities among children in the United States: 2009–2017. Pediatrics, 144(4), e20190811.
