Vital sign parameters are components of emergency medical services (EMS) protocols, guide treatment and interventions, and activate hospital processes such as trauma teams or other expedited care. The appropriate interpretation of vital sign parameters is recognised as an important prehospital paediatric priority.1

We recently developed two sets of age-based vital sign parameters based on an outcome of prehospital life-saving interventions 2 3, one with higher sensitivity and another with higher specificity. If demonstrated to have clinical utility, particularly when combined with other clinical variables, these parameters will be useful in the improved risk stratification of children in the prehospital setting. As an extension of our earlier work, we evaluated the association of different parameters for vital sign abnormalities with in-hospital outcomes in children.

We performed a retrospective cohort study using prehospital patient care records from the 2018–2022 ESO Data Collaborative, a United States EMS prehospital electronic health record. We included encounters for children (<18 years) transported by EMS from the scene with linked hospital data. We followed processes described in prior work for determining abnormal vital signs using the ESO database.3 4 We abstracted first-documented vital signs and classified these according …