With the development of pediatric emergency care as an area of interest, experts and organizations have started to review the care of children in EMS systems. 14 It is estimated that 5 to 10 percent of a system's volume consists of pediatric cases, and the most common pediatric emergencies are trauma, respiratory emergencies, and seizures.15 Cardiac arrest in children is rare (approximately 1 per 10,000 children per year in the United States) usually with a dismal outcome. The ability of paramedics to perform procedures to treat pediatric cardiac arrest, respiratory emergencies, and trauma is extremely variable and age dependent. For most age groups, endotracheal intubation success rates are comparable to those for adults. As would be expected, endotracheal intubation and intravenous access are performed with poor success in infants. In a large regional study of pediatric intubation, Gausche and others have shown no change in patient outcome after field endotracheal intubation.16 The Los Angeles County EMS system has withdrawn the use of pediatric intubation by paramedics, although it has greatly increased clinical education regarding field bag-valve-mask ventilation.
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