O1018: EMS Calls for Pediatric Patients Ages 11-18 years with Opioid Exposures using NEMSIS data

Background: The opioid crisis has long been an issue nationwide with the use of prescription opioids and heroin for pain management and recreational use. Poisoning, including drug overdose, is now the 3rd leading cause of death in U.S. children ages 1 to 19 years, after firearm injury and motor vehicle crashes. The purpose of this study is to compare the trend of opioid exposures among children in two age groups: pre-teenage, and teenage.

Methods: This retrospective study uses the National Emergency Medical Services Information System (NEMSIS) data set from the years 2019 to 2023. NEMSIS is a national system used to collect, store and share EMS data. To identify opioid exposures, the NEMSIS database includes ICD-10 codes for chief complaint (subsets of external cause codes F11 and T40) and whether naloxone was administered. Age groups were categorized as middle school (11-13 years) and high school (14–18 years). The two groups were compared for trends over time, sex ratio, and acuity level (lower acuity, emergent, critical, or deceased). Chi-square analysis compared proportions, and linear regression is used for trend analysis.

Results: EMS calls for opioid exposure increased every year among 11–13-year-olds, from 257 in 2019 to 560 in 2023. Among 14–18-year-olds, numbers increased from 2019 (3,904) through 2022 (7,392), then decreased (6,960). In Figure 1, we present the proportion of overall EMS calls for each age group for opioid related complaints based on number of NEMSIS calls increased each year.
The majority of patients in the middle school group were female (61.1%), while in the high school group, females were a minority of patients (40.6%) (p=0.001). Acuity level also varied by age group (p=0.001). In five years, there were acuity data for 1,429 calls in the middle school group and 21,340 in the high school group. A higher proportion of the middle school group presented as critical (24.5%) than the older age group (15.7%) (p=0.001) (Figure 2).

Conclusion: Patterns of EMS calls for middle school and high school children vary significantly. Younger children have a more persistent pattern of increasing calls over time, they are disproportionately female, and they are more likely to present with critical acuity than older children. These differences suggest targeted interventions for prevention and treatment of drug use disorders in children.