Preparedness of selected pediatric offices to respond to critical emergencies in children

Pediatr Emerg Care. 2006 Nov;22(11):694-8. doi: 10.1097/01.pec.0000238744.73735.0e.

Abstract

Objective: To determine the preparedness of pediatric offices that had activated emergency medical services (EMS) for a critically ill child requiring airway management.

Methods: Fifteen patients who initially presented to pediatric or family practice offices but required EMS activation and cardiac and/or respiratory support were identified from a previous prospective study of airway management in children. Two to 4 years after the emergency requiring EMS activation, the offices were contacted to complete a written survey about office preparedness for pediatric emergencies.

Results: Eight of 15 offices (53%) returned a survey. Pediatricians staffed all responding offices, and all offices were within 5 miles of an emergency department. Airway emergencies were the most common emergencies seen in the offices. Availability of emergency equipment and medications varied. All offices stocked albuterol, and most (7/8) had an oxygen source with a flowmeter. However, only half of the offices had a fast-acting anticonvulsant, and a quarter had no anticonvulsant. Three offices lacked bag-mask (manual) resuscitators with all appropriate sized masks, and 3 offices lacked suction. The most common reasons cited for not stocking all emergency equipment and drugs were quick response time of EMS and proximity to an emergency department.

Conclusions: Even after treating a critically ill child who required advanced cardiac and/or pulmonary support, offices were ill prepared to handle another serious pediatric illness or injury.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Airway Obstruction / therapy
  • Albuterol
  • Anticonvulsants
  • California
  • Child
  • Child, Preschool
  • Data Collection
  • Emergencies*
  • Emergency Medical Services / statistics & numerical data*
  • Equipment and Supplies / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Guidelines as Topic
  • Heart Arrest / therapy
  • Humans
  • Infant
  • Life Support Care
  • Male
  • Oxygen
  • Pediatrics* / education
  • Physicians' Offices / standards
  • Physicians' Offices / statistics & numerical data*
  • Resuscitation / instrumentation
  • Seizures / therapy
  • Surveys and Questionnaires
  • Time Factors
  • Tranquilizing Agents
  • Triage

Substances

  • Anticonvulsants
  • Tranquilizing Agents
  • Albuterol
  • Oxygen