Safe Pediatric Ground Ambulance Transport

Background: Ambulance crashes that result in child injury or death are preventable with the use of proper restraints. This systematic review assesses aspects relevant to the proper use of pediatric restraints: EMS professionals’ resources and training, knowledge, attitudes, and behaviors. It also identifies barriers to using restraints. Methods: PubMed and Web of Science were searched using free-text search terms between the years 2000 and 2020. Inclusion criteria included human research, pediatric population, ambulance as the mode of transportation, peer-reviewed journals, and English full-texts. After initial screening and inclusion, a snowball methodology was used to further identify potentially relevant articles. The methodology was carried out by two independent reviewers.  Results: The original search yielded 80 publications after de-duplication between databases, and two additional articles were identified independently of the search through snowball sampling. Four publications met inclusion criteria for final analysis. Two studies were survey-based among EMS personnel aiming to identify knowledge, behaviors, and barriers to child transport. One study used qualitative data collection by interviews of ambulance personnel. The final study was a combination of survey and observational data. Of note, there were no studies that evaluated an intervention. Conclusion: Based on this review, there is a lack of research in the realm of safe pediatric ambulance transport. There is a need for quality improvement studies to address the barriers that were identified by previous literature and to improve the overall safety and compliance of pediatric safety restraints during transportation to the hospital.