P3.S364: Prehospital time in rural and urban Emergency Medical Services’ Response to pediatric poisoning events

Background: Barriers to healthcare in rural areas can delay treatment in pediatric patients who experienced poisoning. We compared emergency medical services (EMS) response times and EMS-reported delays in responding to pediatric poisoning incidents between rural and urban settings using the 2021 National Emergency Medical Services Information System (NEMSIS).

Methods: Rural areas were defined as locations with a population of < 50,00, not part of metropolitan areas, while all other locations were classified as urban (metropolitan) areas. Patients under 18 years of age transported by EMS with a provider primary impression of poisoning were included (N=11,911, 12% rural). Study variables were compared using rank-sum tests and Chi-square tests. Multivariable analysis of outcomes included quantile regression and logistic regression for continuous data and categorical data, respectively.

Results: The median total prehospital time by EMS was 40 minutes (interquartile range: 29, 57), and the most common type of delay was scene delay (6%). Patients transported by rural EMS agencies experienced 7 minutes (95% confidence interval: 5, 8) longer prehospital time than those transported by urban agencies. There were no differences between rural and urban EMS agencies in the occurrence of dispatch, response, scene, and transportation delays.

Conclusion: These results elucidate the need for equitable allocation of resources and training to enhance rural EMS responders. By integrating targeted interventions to rural pediatric populations, better care can be achieved across all geographic regions. Further research must be conducted to ascertain the specific factors, outside of delays, resulting in the disparity between rural and urban prehospital time.