Prehospital Considerations

Standards of care in the prehospital environment have been slow in developing. Many pediatric patients are being treated in systems which lack the experience and standards of care that are needed to manage children appropriately. IV access is the prehospital advanced life-support intervention that is most often performed, 6 although the beneficial effects may be rare.11 IV success rates are as high as 93 percent.6 Airway management, however, is often more difficult, with many studies showing success rates from 57 to 79 percent, far lower than the success rates with adult patients. Minimizing scene times is an important issue in pediatric trauma management. Placing IV lines en route to the hospital unless a prolonged extrication is required can shorten field times. 6

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