The Epidemiology of Pediatric Ambulance Transport in Ontario, Canada

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dc.contributor.advisorMacpherson, Alison
dc.contributor.authorCouperthwaite, Amy Bonnie Gale
dc.date.accessioned2023-08-04T15:09:04Z
dc.date.available2023-08-04T15:09:04Z
dc.date.issued2023-08-04
dc.date.updated2023-08-04T15:09:04Z
dc.degree.disciplineKinesiology & Health Science
dc.degree.levelDoctoral
dc.degree.namePhD - Doctor of Philosophy
dc.description.abstractBackground: Trauma is one of the most frequent requests for ambulance services. However, little is known about the mechanism of injury sustained by pediatric patients seen by a paramedic. There are few studies comparing ambulance transport to private transport in pediatric patients and none within the Canadian context. Methods: This dissertation consists of three studies that describe the epidemiology of pediatric ambulance transport in Ontario, Canada. Study 1 focuses on creating a profile of children <19 years who were seen by Toronto Paramedic Services. Study 2 examines the difference in all-cause-mortality, hospitalization, ICU admission, and severe injury between ambulance transport and private transport to the emergency department [ED] in children in the province of Ontario. Study 3 examines differences in all-cause-mortality, hospitalization, ICU admission, and severe injury between ambulance transport and private transport in motor vehicle collisions for children in Ontario. Results: In Manuscript 1, the most common mechanism of injuries were falls, transport related injuries, assault/gunshot injuries, injuries involving choking or foreign bodies, and burn/scald injuries. In Manuscript 2, there were 1,872,519 patients who sustained an injury in Ontario with 129,577 (6.9%) transported to the ED via ambulance. The adjusted OR for all cause mortality was 154.88 (95% CI: 101.11-237.23), the adjusted OR for ICU admission was 19.17 (95% CI: 18.01-20.41), the adjusted OR for hospitalization was 13.27 (95% CI: 12.97-13.57) and the adjusted OR for severe injury was 1.88 (95% CI: 1.78-1.98). In Manuscript 3, There were 32,025 patients who sustained an injury in an MVC with 13,995 (43.7%) transported to the ED via ambulance. The adjusted OR for mortality in an MVC was 33.05 (95% CI: 8.05-135.79), the adjusted OR for ICU admission was 17.14 (95% CI: 11.57-25.39), the adjusted OR for hospitalization was 13.30 (95% CI: 11.05-16.01), and the adjusted OR for severe injury was 2.22 (95% CI: 1.45-3.39). Conclusions: The majority of injuries seen by TPS were fall related, transport-related, gunshots/assaults, choking/foreign body, and burn/scald injuries. Ambulance transport amongst pediatric patients who sustained an injury and patients who were injured in an MVC in Ontario is associated with increased odds of mortality and morbidity outcomes.
dc.identifier.urihttps://hdl.handle.net/10315/41318
dc.languageen
dc.rightsAuthor owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.
dc.subjectEpidemiology
dc.subjectHealth sciences
dc.subjectHealth care management
dc.subject.keywordsEpidemiology of ambulance transport
dc.subject.keywordsPediatric ambulance transport
dc.subject.keywordsPediatric paramedic medicine
dc.subject.keywordsParamedic medicine
dc.subject.keywordsPediatric transport to ED
dc.subject.keywordsPediatric emergency medicine
dc.subject.keywordsPediatric prehospital care
dc.subject.keywordsPrehospital care
dc.subject.keywordsTrauma prehospital care
dc.subject.keywordsPediatric trauma prehospital care
dc.subject.keywordsTrauma
dc.subject.keywordsInjury
dc.subject.keywordsPediatric injury
dc.subject.keywordsPediatric trauma
dc.subject.keywordsPediatric trauma in Ontario
dc.subject.keywordsPediatric trauma in Toronto
dc.subject.keywordsPediatric prehospital care in Ontario
dc.subject.keywordsPediatric prehospital care in Toronto
dc.subject.keywordsPediatric ambulance care in Ontario
dc.subject.keywordsPediatric ambulance care in Toronto
dc.subject.keywordsPediatric prehospital service in Canada
dc.subject.keywordsPediatric ambulance service in Canada
dc.titleThe Epidemiology of Pediatric Ambulance Transport in Ontario, Canada
dc.typeElectronic Thesis or Dissertation

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