Pediatric prehospital emergency care in Espírito Santo, Brazil (SAMU 192), 2020–2021: a cross-sectional study

Background Brazil’s SAMU 192 is a physician-regulated prehospital system that delivers remote guidance and/or dispatches mobile units according to risk. In pediatrics, improving triage and destination is pivotal to shorten response times and match resources to clinical urgency. We aimed to describe the spatial distribution and the dispatch criticality profile of pediatric attendances regulated by SAMU 192 in Espírito Santo, Brazil, and to test associations with sociodemographic, dispatch, and destination variables. Methods We conducted a cross-sectional observational study using 2020–2021 records from the state Medical Dispatch Center (SAMU 192). We included pediatric attendances aged 1–19 years. Variables comprised age, sex, region, time of day and day of week of the call, call origin (home vs. out-of-home), type of incident, type of dispatched resource (basic vs. advanced life support), and destination. We performed descriptive analyses and chi-square tests (α = 0.05). Spatial distribution was mapped in GIS using the official cartographic base. Results Among 4,860 attendances, 24.4% were triaged as critical at dispatch. The relative proportion of critical cases increased in 2021 versus 2020. Higher criticality proportions were observed during daytime shifts. Spatial patterns were heterogeneous, with concentrations in urban areas. Clinical incidents and responses involving Advanced Life Support units exhibited higher urgency levels. An age gradient was noted, with greater relative severity among children aged 1–4 years. No differences were observed by sex, and call origin (home vs. out-of-home) was similar. Conclusions Findings support tailoring resource allocation by shift and territory, reinforcing pediatric clinical/dispatch protocols, and routinely applying geotechnologies for space–time surveillance. Future multivariable and spatiotemporal analyses could refine prioritization and guide operational planning within pediatric prehospital care.