Background and aims The incidence and distribution of paediatric out-of-hospital (OOH) emergencies are not known, and the need for paediatric OOH services has not been studied on a population level. We wanted to study the characteristics and epidemiology of paediatric OOH care. We hypothesised this could ameliorate the design of paediatric emergency medical services (EMS) and the education of their personnel.

Methods We studied all (n = 1869) dispatched emergency calls and the connected EMS patient records for paediatric patients (age 0–16 y) in Helsinki, Finland (population 0.6 M, paediatric population 91 000) during a 12-month period (2012). Patient characteristics, diagnoses, time intervals, medical treatments, procedures, vital measurements and outcome of OOH treatment were available for analysis.

Results Paediatric OOH emergencies were relatively rare (1869 calls, or 4.5% of all emergency calls; yearly incidence 20:1000 in the population). Toddlers were frequently involved, as a third of patients were 0–2 y old. Three causes (falls, dyspnoea, seizures) made up nearly half (37%) of all paediatric emergencies, and the majority (80%) concerned previously healthy children. After evaluation by the EMS, only half of the patients (54%) needed ambulance transportation to hospital. Cardiac arrest, or need for advanced life support measures (e.g. intubation), were rarities.

Conclusions Paediatric OOH emergencies are rare and have specific characteristics differing from the adult population. EMS should be designed and their personnel trained for evaluation and management of most frequent situations.