Table 1 Emergency characteristics of children receiving medical analgesia during HEMS operations
|  | Injured, not mechanically ventilated children (< 15 yrs.) receiving medical analgesia (n = 2885) n (%) or median (IQR) | p | ||
|---|---|---|---|---|
Age [yrs] | 0–5 n = 443 (15.4) | 6–10 n = 902 (31.3) | 11–14 n = 1540 (53.4) | |
Sex [male/female] | 280/163 (63.2/36.8) | 558/343 (61.9/38.1) | 1048/492 (68.1/31.9) | Â |
NA | 0 | 1 (0.1) | 0 | Â |
NACA score | 3 (3–4) | 3 (3–4) | 3 (3–4) | < 0.001 |
NA | 0 | 0 | 0 | Â |
Number of injured regions | Â | Â | Â | Â |
1 | 306 (69.1) | 659 (73.1) | 1085 (70.5) | 0.237 |
2–3 | 125 (28.2) | 221 (24.5) | 420 (27.3) | 0.225 |
≥ 4 | 12 (2.7) | 22 (2.4) | 35 (2.3) | 0.864 |
NA | 0 | 0 | 0 | Â |
Injury localization | Â | Â | Â | Â |
Head | 144 (32.5) | 193 (21.4) | 290 (18.8) | < 0.001 |
Spine | 16 (3.6) | 116 (12.9) | 252 (16.4) | < 0.001 |
Chest | 81 (18.3) | 74 (8.2) | 153 (9.9) | < 0.001 |
Abdomen | 50 (11.3) | 109 (12.1) | 165 (10.7) | 0.585 |
Pelvis | 10 (2.3) | 22 (2.4) | 55 (3.6) | 0.172 |
Upper extremity | 163 (36.8) | 290 (32.2) | 525 (34.1) | 0.233 |
Lower extremity | 186 (42.0) | 451 (50.0) | 755 (49.0) | 0.015 |
Initial level of pain | Â | Â | Â | Â |
No pain | 18 (4.1) | 15 (1.7) | 22 (1.4) | 0.001 |
Mild pain | 76 (17.4) | 110 (12.4) | 157 (10.3) | < 0.001 |
Moderate to severe pain | 331 (75.7) | 750 (84.4) | 1338 (87.8) | < 0.001 |
NA | 6 (1.4) | 13 (1.4) | 16 (1.0) | Â |
Analgesics administered | Â | Â | Â | Â |
Opioids | 165 (37.2) | 490 (54.3) | 977 (63.4) | < 0.001 |
Esketamine | 293 (66.1) | 487 (54.0) | 744 (48.3) | < 0.001 |
Metamizole | 5 (1.1) | 18 (2.0) | 38 (2.5) | 0.216 |
NSAIDs | 1 (0.2) | 7 (0.8) | 8 (0.5) | 0.426 |
Acetaminophen | 15 (3.4) | 4 (0.4) | 1 (0.1) | < 0.001 |
Analgesic regimen | Â | Â | Â | Â |
Mono therapy | 408 (92.1) | 798 (88.5) | 1312 (85.2) | < 0.001 |
Dual therapy | 34 (7.7) | 104 (11.5) | 226 (14.7) | < 0.001 |
Triple therapy | 1 (0.2) | 0 (0) | 2 (0.1) | 0.434 |
Medical combinations | Â | Â | Â | Â |
Opioids only | 135 (30.5) | 386 (42.8) | 756 (49.1) | < 0.001 |
Esketamine only | 259 (58.5) | 392 (43.5) | 536 (34.8) | < 0.001 |
Opioids with Esketamine | 29 (6.5) | 95 (10.5) | 200 (13.0) | < 0.001 |
Metamizole only | 2 (0.5) | 13 (1.4) | 18 (1.2) | 0.274 |
Opioids with Metamizole | 0 (0) | 5 (0.6) | 15 (1.0) | 0.078 |
Acetaminophen only | 12 (2.7) | 2 (0.2) | 0 (1.0) | < 0.001 |
Route of administration | Â | Â | Â | Â |
I.V. access | 329 (74.3) | 818 (90.7) | 1399 (90.8) | < 0.001 |
I.O. access | 4 (0.9) | 0 (0.0) | 1 (0.1) | < 0.001 |
Mucosal atomization device | 8 (1.8) | 13 (1.4) | 6 (0.4) | 0.004 |
NA | 14 (3.2) | 14 (1.6) | 29 (1.9) | Â |
Technical monitoring applied | Â | Â | Â | Â |
None | 54 (12.2) | 111 (12.3) | 231 (15.0) | 0.104 |
Blood pressure | 168 (37.9) | 432 (47.9) | 823 (53.4) | < 0.001 |
Pulse oximetry | 362 (81.7) | 743 (81.2) | 1165 (75.6) | 0.001 |
3-channel-ECG | 101 (22.8) | 188 (20.8) | 339 (22.0) | 0.676 |
NA | 0 | 0 | 0 | Â |