• S D Graham, L M Olson, R E Sapien, D Tandberg, and D P Sklar.
• University of New Mexico, Department of Emergency Medicine, UNM School of Medicine, Ambulatory Care Center, Albuquerque 87131-5246, USA.
• Prehosp Emerg Care. 1997 Jan 1; 1 (1): 28-31.

ObjectiveTo compare the initial emergency medical services (EMS) prehospital assessment of medical and traumatic cardiopulmonary arrest in the pediatric patient with that of the Office of the Medical Investigator (OMI) and assess differences and implications for EMS training and prevention.DesignRetrospective review of ambulance run forms with the OMI autopsy confirmations.SettingAn urban EMS system and the state Office of the Medical Investigator.ParticipantsPatients 15 years of age or less who were treated by prehospital personnel from November 1, 1990, to October 31, 1991, for a medical or traumatic arrest.InterventionNone.Measurements And Main ResultsAmbulance runs were reported for 2,586 pediatric patients. Of these, 42 (1.6%) had suffered arrests, with 32 (76%) medical arrests and ten (24%) traumatic arrests. Children 1 year of age or less accounted for 75% of the medical arrests, while children more than 1 year of age accounted for 80% of the traumatic arrests (p = 0.003). Overall mortality was 81%. When EMS prehospital assessments of medical and traumatic arrests were compared with autopsy reports, there was good agreement for sudden infant death syndrome (SIDS) (kappa = 0.70), but poor agreement for child abuse (kappa = 0.37).ConclusionThe authors found good agreement between EMS prehospital assessments and autopsy diagnoses for identifying pediatric SIDS, but child abuse was not well identified prior to autopsy.

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