ABSTRACTS
Quantifying and Describing Pediatric Patients who received Emergency Care from North Dakota EMS for Suicide or Self-HarmAuthor: Antonio Fernandez PhD, NRP | Principal Research Scientist | ESO Associate Authors: Greer, Chettie, RN | Price, Christopher, T.E., MPA, NRP | Waldo, Mary, RN, MSN, TCRN, CEN, CPEN, CCEMT-P | Treichel, Alison, MPH | Crowe, Remle, PhD, NREMT | Wilson, Jennifer, K, MBA, EMT | Montera, Christopher, MHL, BS, NRP | Myers, J. Brent, MD, MPH
Introduction The World Health Organization has indicated that mental health disorders are a leading cause of suicide and self-harm. Pediatric suicide or self-harm 9-1-1 responses have not been described In North Dakota (ND). Objective The objective of this study was to quantify and describe pediatric 9-1-1 responses for suicide or self-harm in ND. Methods This retrospective analysis evaluated all 9-1-1 responses in ND for patients less than 18 with a provider impression and/or cause of injury consistent with suicide or self-harm (S/SH) from 1/1 2022 to 12/312024. Descriptive statistics were calculated and multivariable logistic regression was performed. Results There were 11,245 pediatric 9-1-1 emergency responses, 4% (n=488) were for S/SH. Of those, 63% (n=306) were for a suicide attempt, 35% (n=170) suicidal ideation, and 2% (n=12) self-harm. There was a 42% increase in pediatric 9-1-1 responses for S/SH over the study period while total 9-1-1 pediatric responses increased 14%. Females had almost a two-fold increase in the odds of requiring EMS for pediatric S/SH when compared to male patients (aOR: 1.92, 95% CI: 1.57-2.35). Patient age ranged from 8 to 17 years old (median=15, Interquartile range: 13-16). There was a 27% increase in the odds of requiring EMS for S/SH for every one-year increase in age (aOR = 1.27, 95% CI = 1.24-1.31). When compared to non-institutional homes or residences, the odds of requiring EMS for pediatric S/SH were increased almost three-fold when the incident location was an institutional residence (aOR = 2.74, 95% CI = 1.88-3.98). Among all pediatric 9-1-1 responses for S/SH, 7% (n=36) had bandaging and/or hemorrhage control performed, 7% (n=36) had resuscitation procedures documented, and 1% (n=5) had restraints use documented. In total, 87% (n=420) were transported (3 patients required involuntary patient transfer to psychiatric hospital). Among those not transported (n=64), 14% (8/64) were due to the patient refusals. Conclusion One in every 25 pediatric 9-1-1 calls in ND were for S/SH and the overwhelming majority of patients were female. Most occurred in the home and EMS interventions were rare. Strategies to prepare EMS clinicians to care for this patient population should be investigated.
|
