A Statewide Survey of Strengths, Challenges, and Resources for Emergency Medical Services Responses to the Homes of Children and Youth With Special Health Care Needs

OBJECTIVES: To explore how emergency medical services (EMS) professionals prepare for and experience calls involving children and youth with special health care needs (CYSHCN). METHODS: The research team circulated a needs-assessment survey to EMS professionals in Pennsylvania from February 2020 to April 2020. Survey questions addressed perceived strengths and barriers to prehospital care of CYSHCN and awareness of local organizational supports. Findings were reported as descriptive statistics (closed questions) or as shared themes and illustrative statements (open questions). RESULTS: Responses were received from 401 EMS professionals spanning 66/67 counties (>98%) in Pennsylvania; 301 (75%) affirmed having ever responded to an emergency at a CYSHCN-residing household. Respondents described these calls as involving longer service times, requiring patience and compassion, and being aided by the expertise of family caregivers. Challenges included communication barriers, absence of prearrival health-needs information, insufficient training on diverse CYSHCN conditions, and opposition from caregivers. There was widespread uncertainty regarding the availability of organizational supports, including identification systems, recording of emergency information forms, and fire-safety assistance, with 68% to 86% of respondents answering "I don't know." Most (76% to 99%) affirmed that these systems/resources are/would be helpful. CONCLUSIONS: EMS professionals in Pennsylvania identified family caregivers as assets in EMS calls involving CYSHCN and value anticipatory information about the emergency medical needs of these children and youth. Dedicated training on EMS calls involving CYSHCN and better sharing of information on the registries/identification systems available to a given EMS organization may help providers prepare for emergencies at households with CYSHCN in their response areas.