{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:23:05Z","timestamp":1775064185858,"version":"3.50.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The prevalence of children with life-limiting conditions is rising, and since the amendment of the social insurance code in Germany, palliative home care teams have treated an increasing number of children. These teams provide 24\/7 readiness, yet some parents still call the general emergency medical service (EMS) for various reasons. EMS is exposed to complex medical problems in rare diseases. Questions arose about the experiences of EMS and whether they felt prepared for emergencies involving children treated by a palliative care team.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used a mixed methods approach to focus on the interface between palliative care and EMS. First, open interviews were conducted, and a questionnaire was developed based on the results. The variables included demographic items and individual experiences with patients. Second, a case report of a child with respiratory insufficiency was presented to assess the spontaneous treatment intentions of EMS providers. Finally, the need, relevant topics, and duration of specific training in palliative care for EMS providers were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 1,005 EMS providers responded to the questionnaire. The average age was 34.5 years (\u00b110.94SD), 74.6% were male. The average work experience was 11.8 years (\u00b19.7), 21.4% were medical doctors. Experience with a call of a life-threatening emergency involving a child was reported by 61.5% and severe psychological distress during such a call was reported by 60.4%. The equivalent distress frequency for adult patient calls was 38.3%. (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). After review of the case report, the EMS respondents suggested invasive treatment options and rapid transport to the hospital. Most (93.7%) respondents welcomed the consideration of special training in pediatric palliative care. This training should include basic information about palliative care, an analysis of cases involving palliatively treated children, an ethical perspective, practical recommendations, and available (24\/7) local contact for further guidance and support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Emergencies in pediatric palliatively treated patients were more common than expected. EMS providers perceived the situations as stressful, and there is a need for specific training with practical aspects.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1104655","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T18:58:56Z","timestamp":1676401136000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Prehospital emergency medicine for children receiving palliative home care in Germany\u2014a cross-sectional, exploratory study of EMS providers"],"prefix":"10.3389","volume":"11","author":[{"given":"Holger","family":"Hauch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naual","family":"El Mohaui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera","family":"Vaillant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Sander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kriwy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"Rohde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Wolff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Berthold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Schneck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.1177\/0269216320975308","article-title":"Estimating the current and future prevalence of life-limiting conditions in children in England","volume":"35","author":"Fraser","year":"2021","journal-title":"Palliat Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12873-021-00424-4","article-title":"Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical dispatch centre (OFF-RESCUE)","volume":"21","author":"Schehadat","year":"2021","journal-title":"BMC Emerg Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1055\/s-0041-109914","article-title":"Ambulante behandlung im rettungsdienst chancen und risiken der not\u00e4rztlichen versorgung vor ort","volume":"10","author":"Bohn","year":"2015","journal-title":"Notfallmedizin up2date"},{"key":"B4","doi-asserted-by":"publisher","first-page":"734181","DOI":"10.3389\/fped.2021.734181","article-title":"Out-of-hospital emergencies in children under palliative home care","volume":"9","author":"Hauch","year":"2021","journal-title":"Front Pediatr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/S0196-0644(87)80173-7","article-title":"Epidemiology of pediatric prehospital care","volume":"16","author":"Tsai","year":"1987","journal-title":"Ann Emerg Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1542\/peds.73.6.769","article-title":"Emergency medical services and the pediatric patient: are the needs being met?","volume":"73","author":"Seidel","year":"1984","journal-title":"Pediatrics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1016\/j.resuscitation.2009.05.008","article-title":"Characteristics of out-of-hospital paediatric emergencies attended by ambulance- and helicopter-based emergency physicians","volume":"80","author":"Eich","year":"2009","journal-title":"Resuscitation"},{"key":"B8","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1080\/10903127.2018.1551450","article-title":"Emergency medical services provider perspectives on pediatric calls: a qualitative study","volume":"23","author":"Jeruzal","year":"2019","journal-title":"Prehosp Emerg Care"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e014057","DOI":"10.1136\/bmjopen-2016-014057","article-title":"Emergency medical services responders\u2019 perceptions of the effect of stress and anxiety on patient safety in the out-of-hospital emergency care of children: a qualitative study","volume":"7","author":"Guise","year":"2017","journal-title":"BMJ Open"},{"key":"B10","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1055\/s-0042-103327","article-title":"Constitution of a new specialised pediatric home care team - 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