Preparedness of selected pediatric offices to respond to critical emergencies in children.
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.
Santillanes
Genevieve
G
Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA 90509, USA. gsantillanes@hotmail.com
Gausche-Hill
Marianne
M
Sosa
Bernardo
B
D000402:Airway Obstruction / Q000628:therapy; D000420:Albuterol; D000927:Anticonvulsants; D002140:California; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D004630:Emergencies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004864:Equipment and Supplies / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007223:Infant; D008020:Life Support Care; D008297:Male; D010100:Oxygen; D010372:Pediatrics / Q000193:education; D010824:Physicians' Offices / Q000592:standards / Q000706:statistics & numerical data*; D012151:Resuscitation / Q000295:instrumentation; D012640:Seizures / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors; D014149:Tranquilizing Agents; D014218:Triage
D000927:Anticonvulsants; D014149:Tranquilizing Agents; D000420:Albuterol; D010100:Oxygen