P2.174: Characteristics of Emergency Medical Services Encounters for Youth who are Transferred to Law Enforcement

Background: The involvement of law enforcement officers (LEOs) during an emergency encounter with emergency medical services (EMS) can heighten complexity and carry medicolegal complications. The role of law enforcement among youth with an out-of-hospital emergency is poorly described. Our objective was to evaluate characteristics and interventions performed by EMS for youth transferred to the care of law enforcement after an out-of-hospital emergency.

Methods: We performed a retrospective cross-sectional study evaluating scene EMS encounters for youth ( < 25 years old) in the National EMS Information System, a national dataset comprising of encounter level data, from 2018-2023. We included encounters for patients with a disposition of treated and transferred to law enforcement. We evaluated patient characteristics, EMS impressions, and scene-level neighborhood opportunity (measured by the Child Opportunity Index [COI v2.0]).

Results: Among 19,556,229 scene ground encounters for youth, we identified 62,720 encounters transferred to LEOs (0.3%). The median encounter age was 20 years (IQR 16-22 years), with few encounters occurring in younger children The sample had a male predominance (62.8%). Of encounters with available race data (N=39,705, 63.3%), the majority were White (47.9%). Most incidents occurred in the home 25,450 (40.6%), followed by the street/road 19,890 (31.7%). Most encounters occurred in urban settings (85.4%). Of those with available COI data (N=51,295, 81.8%), most were classified as living in Low (12,036 cases; 23.4%) or Very Low COI areas (16,024 cases; 31.2%). A majority of encounters occurred during weekdays (N=42,483, 67.7%), and between the hours of 3-10p (N=27,738, 44.2%; Table 1). The most common dispatch complaints included psychiatric problems, abnormal behavior, or suicide attempts (n=13,736, 21.9%), compared to 4,892 calls (7.8%) related to traumatic injury.  The most common EMS impressions were for psychiatric/behavioral health or substance abuse (N=23,694, 37.8%) followed by trauma (N=12,282, 19.6%). Level of care in encounters included Basic Life Support (N=15,024, 24.0%) and Advanced Life Support (N=47,696, 76.0%). Interventions were infrequently performed, with naloxone used in 141 (0.2%), and restraints in 76 (0.1%) (Table 2).

Conclusion: Among youth, an EMS disposition of transferred to LEOs occurs infrequently. Most encounters are evaluated for a primary EMS impression of psychiatric and behavioral diseases and substance abuse or trauma. A higher proportion of LEO transfers occurred in Low/Very Low COI areas. Our findings highlight a gap in research pertaining to justice involved youth and emphasize the need for future research to investigate the outcomes and experiences of youth after transfer to law enforcement.