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Biomedical subjects

B W Wayland

Publications and source records attributed to B W Wayland.

4 recordsLinked to original sources
PubMed1991

Pediatric prehospital care in urban and rural areas.

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10,493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P less than .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

California↗
PubMed1989

Violent death in the pediatric age group: rural and urban differences.

Violent death (homicide and suicide) in the pediatric age group is a major public health problem. A descriptive study was undertaken to review retrospectively the 1077 pediatric coroner's cases in 11 California counties for differences between urban and rural violent death rates. Pediatric violent death was more prevalent in the urban region than in the rural region (P less than 0.0007). High urban homicide rates accounted for most of this difference. Suicide rates were not significantly different (P = 0.18). Seventy-four percent of the violent deaths were in the 15- to 18-year age group, and most of these deaths were caused by firearms (81%). Blacks had the highest homicide and suicide rates. Child abuse was an important cause of death for young children in the urban area only. Socioeconomic factors, cultural differences, high population density, and the availability of firearms were proposed as factors affecting violent death in the pediatric age group.

Adolescent↗
PubMed1989

Pediatric deaths and emergency medical services (EMS) in urban and rural areas.

A total of 1078 pediatric coroners' cases in 11 rural and urban California counties were reviewed as they relate to emergency medical services (EMS). Pediatric coroners' death rates per 100,000 population varied from an average of 2.17 in the rural region to 30.4 in the urban region. Vehicular accidents caused the majority (66%) of the accidental deaths, and firearms caused 61% of the violent deaths. Violent deaths (homicide and suicide) were significantly more common in the urban region (P less than 0.001), and vehicular deaths (excluding auto versus pedestrian) were more common in the rural region (P less than 0.001). EMS provider usage was greater in the urban areas (84 vs 66%, P less than 0.001), as was the number of cases receiving advanced life support (97 vs 66%, P less than 0.001). Urban and rural differences in place of death were significant for two places of death; street and highway, and inhospital deaths. A significantly greater number of children died on the street/highway in rural areas (P less than 0.05). Hospital deaths were more likely to occur on the ward in the rural region, versus the intensive care unit in the urban region (P less than 0.001). Proposed factors which may explain these findings include differences in medical resources and in local transfer policies. The study demonstrates that EMS providers are involved in the care of children who have had a fatal emergency. Further evaluation of rural and urban differences in prehospital care of the pediatric patient is indicated.

Adolescent↗