Abstract
<title>Abstract</title> <p>Introduction: Prehospital pediatric emergencies are rare, time-critical events requiring specialized expertise, yet limited exposure among emergency teams may affect care. Although telemedicine is established in adult emergency care, its role in pediatric prehospital emergencies remains unclear. This study evaluated the applicability of telemedical consultation in this setting. Methods This prospective observational survey included children aged 0–18 years treated by the Munich pediatric prehospital emergency physician service between October 2024 and March 2026. Questionnaires were returned for 627 of 2733 eligible deployments (capture rate 22.9%). After each deployment, pediatric emergency physicians, ambulance crews, and regular emergency physicians assessed whether comparable care could have been provided through telemedical consultation. The primary outcome was the proportion of cases considered suitable for telemedicine. Results Neurological (35.6%), trauma (21.9%), and respiratory (21.2%) emergencies accounted for approximately 78% of cases. Pediatric emergency physicians deemed on-site presence necessary in 81.9% of cases but considered telemedicine feasible in 79.8%, including 82.4% of transports. Feasibility ratings were lower among ambulance crews (63.4%) and regular emergency physicians (65.8%). Critical interventions were uncommon, including advanced airway management in 5.9%, intubation in 2.2%, intraosseous access in 1.3%, anesthesia induction in 0.8% and resuscitation in 1.6%; intravenous access was required in 17.1%. Discussion Prehospital pediatric emergency care shows substantial potential for telemedicine to extend specialist expertise and reduce on-site physician deployment and physician-accompanied transports. It may be particularly suitable for neurological, trauma, and respiratory emergencies. Further studies should assess feasibility, safety, implementation, and outcomes.</p>