EMS Research with Professor Bram: Moving Toward Safer Pediatric Transport Care in EMS

Moving Toward Safer Pediatric Transport Care in EMS
Insights from Dr. Nick Cochran-Caggiano’s Research on Pediatric Transport and Resuscitation
By Bram Duffee, PhD, EMT-P

Transporting children in ambulances presents unique challenges that EMS providers face every
day. Issues like the correct use of safety equipment, performance of life-saving procedures like
CPR, and the absence of universal standards can make pediatric care in emergency settings more
difficult than necessary.
Dr. Nick Cochran-Caggiano, an emergency physician and researcher, has taken a deep look into
these challenges through two pivotal studies that every EMS worker should know about. Both
studies were discussed on the latest podcast episode of “EMS Research with Professor Bram.”
The Unsafe Reality of Pediatric Transport in Ambulances
One of Dr. Cochran-Caggiano’s studies, published in Pediatric Emergency Care (2023),
examined how children are secured during ambulance transport. The study reviewed over 3,000
cases by observing video footage of ambulances arriving at a pediatric emergency department.
The findings reveal a troubling reality:
 Just 53.5% of children were transported using the correct safety device for their weight.
 A staggering 77.1% of transport restraints were not used properly, putting children at
significant risk.
 Commercially made pediatric restraints were found to be the best option, yet these
were still improperly used half the time.
 For many patients, ambulance cots were the default method of transport, but this was
only the correct choice in 18.2% of cases.
Dr. Cochran-Caggiano shared his thoughts on this alarming data during a recent interview,
emphasizing that the absence of consistent safety standards puts children at unnecessary risk.
"Having some sort of ability to transport children safely is a must," he said. He also pointed out
the pitfalls of the current patchwork approach to pediatric safety in EMS. "There’s no appropriate
way to secure [a child’s car seat] to an ambulance stretcher. You can make a good faith effort, but
that’s really all it is."
Why This Matters
Improper restraint practices don't just violate safety protocols—they create scenarios where
otherwise preventable injuries become inevitable. Reflecting on the need for systemic change,
Dr. Cochran-Caggiano pushed for a proactive approach, stating, "Let’s make a difference before