ABSTRACTS
Documentation of weight in pediatric 9-1-1 responses with administration of weight-based medicationsAuthor: Susan Burnett PhD, MS, EMT-P | Researcher, Paramedic | University at Buffalo Department of Emergency Medicine Associate Authors: Schwartz, Baruch, BA, EMT Eisenhauer, Amy, M., BA, EMT Moore Gruver, Sara, M.Ed., EMT-P, FP-C Leslie Salewon, Macall, MPH Clemency, Brian, M., DO, MBA
Background: Determining a child’s weight is a critical first step in administering the appropriate dose of a medication in an emergency. The National EMS Quality Alliance (NEMSQA) patient safety process measure, “Pediatrics-03b," calls for the documentation of weight in kilograms or length-based weight estimate for pediatric patients who receive weight-based medications in the settings of 9-1-1 requests. To date, no publication has identified documentation compliance for this measure at a national level. The goal of this study was to describe documentation of weight in pediatric 9-1-1 responses and factors associated with compliance for this quality measure. Methods: We used the ImageTrend Collaborate 2024 national dataset to analyze 9-1-1 responses for pediatric patients (<18 years of age) who received medication by EMS clinicians. Patients were excluded if they only received medications via topical or inhalation routes, consistent with the NEMSQA measure definition. Weight documentation was obtained from eExam01 and eExam02 NEMSIS fields. Differences in weight documentation compliance were assessed by patient demographics, as well as unit and scene characteristics. Furthermore, medication type and administration routes were examined. Statistical analyses included chi-square tests for comparison of proportions and multivariable logistic regression for the binary outcome of documentation of weight. Results Overall, 49,079 responses met inclusion criteria, and 36,369 (74.1%) had a documented weight. Weights were less likely to be documented in cases involving adolescent (age 13-17) patients (Odds Ratio [OR]: 0.81, 95% Confidence Interval [95% CI]: 0.71-0.91), patients described as Black (OR: 0.73, 95% CI: 0.63-0.85), or those with lower patient acuity (OR: 0.64, 95% CI: 0.49-0.82). Weights were more likely to be documented in cases managed by advanced life support units (OR: 1.88, 95% CI: 1.27-2.77) and patients described as male (OR: 1.06, 95%: 1.01-1.12). Conclusion Three quarters of all 9-1-1 responses that met the Pediatrics-03b case definition were compliant with the measure. Establishing a benchmark and understanding barriers to optimal implementation are critical to improving the care and documentation of pediatric care by EMS clinicians. Future studies should be focused on evaluating the case definition for the measure to determine how to best evaluate and improve care in this domain.
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