Impact of a Pediatric Prehospital Destination Decision Support Tool (PDTree) on Emergency Medical Services Transport Patterns and Destination Choice

Implementation of the PDTree pediatric direct transport decision support tool increased the bypass rate and, subsequently, direct transport to more pediatric capable facilities. Despite this increase in the bypass of the nearest facility, the proportion transporting to large tertiary specialty children's centers decreased, while there was a significant increase in transport to intermediate pediatric facilities. Regional and national EMS governing bodies should balance benefits of pediatric direct transport protocols with operational costs to better meet the needs of pediatric populations.