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Pediatric Prehospital Refusal of Medical Assistance: Association with Suspected Abuse or Neglect

机译：儿科预热拒绝医疗援助：与疑似虐待或忽视的联系

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Introduction: Unlike adult refusal of medical assistance (RMA), pediatric refusal is not initiated by the patient. This lack of autonomy may permit neglect by the guardian through denial of necessary treatment. The purpose of the current study was to determine whether pediatric RMA was associated with suspected abuse or neglect (SAN). Methods: This was a retrospective single EMS agency cross-sectional analysis of calls between January 1, 2011 and December 31, 2015 for patients <18years of age resulting in RMA. Age- and complaint-matched control groups were generated from transported patients during the same time period. Recidivism was defined as 2 or more episodes of RMA involving a single patient during the study period. Results: A total of 241 calls for service resulted in RMA during the study period, representing 12.7% of all pediatric calls. Information regarding SAN was available for 202 calls. Recidivism was noted in 8 patients (17 calls for service), resulting in 185 unique patients. Twenty-one RMA patients (11.4%) were identified as SAN. No difference in SAN status was noted between RMA patients and age-matched controls (21 vs. 24, p = 0.75) and complaint-matched controls (21 vs. 26, p = 0.53). No SAN was identified in the 8 recidivist patients when compared with the 177 non-recidivist patients (0 vs. 21, p = 0.60). Conclusions: Pediatric SAN patients are not uncommon users of EMS in our service area. Neither RMA nor recidivist RMA was associated with the presence of SAN within our patient population.
机译：简介：与成人拒绝的医疗援助（RMA）不同，患者未启动儿科拒绝。这种缺乏自主权可以通过否定必要的治疗来允许监护人忽视。目前研究的目的是确定儿科RMA是否与疑似滥用或忽视（SAN）有关。方法：这是2011年1月1日和2015年12月31日期间的呼叫呼叫的回顾性的单一EMS代理横断面分析<18年代患者导致RMA。在同一时间段内，从运输的患者产生年龄和投诉匹配的对照组。在研究期间，累犯定义为涉及单身患者的2或更多次RMA发作。结果：在研究期间，共有241次呼吁服务导致RMA，占所有儿科呼叫的12.7％。有关SAN的信息可用于202个电话。 8名患者中注意到累犯（17例服务），导致185名独特的患者。二十一位RMA患者（11.4％）被确定为SAN。 RMA患者和年龄匹配的对照（21 vs.24，P = 0.75）和投诉匹配的对照（21对26，P = 0.53）之间没有差异。与177名非累犯患者（0 vs.21，P = 0.60）相比，在8名累官患者中没有发现SAN。结论：儿科SAN患者在我们的服务区内的EMS罕见。 RMA和累犯RMA都没有与我们患者人口中的SAN的存在相关联。

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