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The aim of this study was to analyze the frequency and urgency of pediatric emergency medical service (EMS) missions and to identify age-specific characteristics in EMS utilization in the rural district of Vorpommern-Greifswald in northeastern Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective observational study, all emergency protocols from ambulance vehicles and emergency physician vehicles from January 1, 2022, to December 31, 2023, in the study region were analyzed using descriptive statistical methods. Patients were categorized into age groups: infants (&lt;\u20091 year), toddlers (1\u20135 years), schoolchildren (6\u201313 years), adolescents (14\u201317 years), adults (18\u201364 years), and seniors (\u2265\u200965 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the study period, 71,446 patients had an EMS contact, thereof 255 infants (0.4%), 976 toddlers (1.4%), 1,437 schoolchildren (2.0%), 1,395 adolescents (2.0%), 25,220 adults (35.3%), and 42,163 seniors (59.0%). The annual emergency rate among adults\u2009\u2265\u200918 years was nearly three times higher than among minors\u2009&lt;\u200918 years (169 vs. 58 patients per 1,000 inhabitants within the respective age groups). Pediatric cases accounted for 5.7% of all missions. Vehicle dispatches for minors followed a bimodal temporal distribution with peaks between 12:00 and 1:00 p.m. and between 6:00 and 7:00 p.m. Seasonal variation was observed, with the highest dispatch volume in June (10.5% of all pediatric dispatches) and the lowest in February (5.3%). Trauma was more common in minors compared to adults (41.8% vs. 23.1%), with the highest proportion among schoolchildren (52.2%). The proportion of critically ill or injured patients (NACA IV\u2013VII) was lower in minors than in adults (10.2% vs. 20.8%). Physician involvement was more frequent in pediatric missions than in adult missions (39.4% vs. 32.9%). Infants showed the highest physician involvement (53.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In pediatric missions, the involvement of physicians is high, however, critically ill children are rare. Low exposure to pediatric cases may contribute to insecurity among paramedics and emergency physicians in pediatric emergencies. Therefore, hands-on training in pediatric emergency care is essential. Given the rising demand for EMS, telemedicine could be a valuable addition in rural settings to reduce the burden on physician resources and ensure comprehensive pediatric care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12873-026-01653-1","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:58:12Z","timestamp":1782712692000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pediatric pre-hospital emergencies in a rural region in northern Germany: frequency, urgency, patterns of utilization, and comparison with adult cases"],"prefix":"10.1186","volume":"26","author":[{"given":"Janina","family":"Dombrowski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Stentzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Krause","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Ebermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Oehlke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold","family":"Henkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timm","family":"Laslo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibiana","family":"Metelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Schoffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeltje","family":"van den Berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"issue":"1","key":"1653_CR1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s10049-021-00956-z","volume":"25","author":"B Gliwitzky","year":"2022","unstructured":"Gliwitzky B, Hoffmann F, Olivieri M, H\u00e4ske D. 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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2022;65(10):987\u201395. https:\/\/doi.org\/10.1007\/s00103-022-03588-x.","journal-title":"Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz"}],"container-title":["BMC Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12873-026-01653-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-026-01653-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-026-01653-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:33:49Z","timestamp":1782783229000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12873-026-01653-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,27]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1653"],"URL":"https:\/\/doi.org\/10.1186\/s12873-026-01653-1","relation":{},"ISSN":["1471-227X"],"issn-type":[{"value":"1471-227X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,27]]},"assertion":[{"value":"10 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for the study was obtained from the Ethics Committee of the University Medicine Greifswald (Internal Reference No.: BB 041\/24a). Ethics Committee of the University Medicine Greifswald waived the need of informed consent. No consent to participate had to be given by the patients, as only anonymized data were analyzed. The study was conducted in accordance with the Declaration of Helsinki and national data protection regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"181"}}