This abstract was presented at the American Academy of Pediatrics conference in 2008.

Effect of Geographic Location on Paramedic Student Pediatric Encounters

Ashley D. Young, NREMTP; Ron Lawler, NREMTP; Sandi S. Wewerka, MPH; Sara Krohn, MS; Joshua G. Salzman MA.

Introduction: Paramedic student pediatric patient encounters during their internship phase are elieved to be infrequent. This study examines the impact of geographic location on pediatric encounters and the types of skills students perform during these encounters.

Methods: A retrospective review of prospectively collected pediatric (e8 years old) field data from 2001-2007 was conducted using FISDAP, a national administrative database used to track paramedic student field internship data. The total number of pediatric encounters per student, and the number of ALSBLS, and overall number of skills performed were descriptively reported. The Kruskal-Wallis nonparametric test was used to determine if these variables differed based on geographic location (rural G10,000; suburban = 10,000Y99,999; urban Q100,000). Mann-Whitney U tests with a Bonferroni correction were used for all follow-up analyses between groups.

Results: Pediatric runs account for 4.5% of all runs completed by paramedic students, with BLS skills performed most frequently. Students in urban areas encounter significantly more pediatric patients than students in rural areas (4 vs. 2 encounters per student; P G 0.001). Urban paramedic students performed more ALS (3 vs. 1; P G 0.001), more BLS (14 vs. 7; P G 0.001) and roughly twice as many skills overall compared to rural students (17 vs. 9; P G 0.001). Suburban students had significantly more pediatric encounters (3 vs. 2 encounters per student; P G 0.001) and more BLS (9 vs. 7, P G 0.001) and total skills performed (11 vs. 9, P G 0.001) than rural students. Suburban students had fewer total skills (11 vs. 17; P G 0.001) and fewer BLS skills (9 vs. 14; P G 0.001) performed than urban students.

Conclusion: Exposure to pediatric patients for paramedic students is extremely low, with BLS skills performed most often. Geographic location appears to play a role in the frequency of pediatric encounters and number of skills performed. Increasing paramedic student access to urban environments may assist in increasing their overall exposure to this important subset of patients.