Pediatric office emergencies.
OBJECTIVE
An emergency in the office setting can be problematic without adequate staff, support, tools, and protocols. Though many emergencies are not immediately life-threatening, one risks the 'worst case scenario' occurring if not adequately prepared. Pediatric patients are prone to respiratory distress and compromise in many emergencies, and can rapidly decompensate without adequate support. A review of the history of emergency medical services for children and the framework for office emergency preparedness offers insight into current challenges for primary care providers.


RESULTS
Research has demonstrated that many primary care offices and clinics are ill prepared to handle common pediatric emergencies. Reliance on the Emergency Medical Services system is insufficient to assure optimal outcomes, especially given variations in the equipment, training, and experience of Emergency Medical Services providers in the care of children, and in remote areas where access may be delayed. Preparation and practice for office emergencies through 'mock code' exercises can increase practitioner confidence and reduce anxiety to perform life-saving care.


CONCLUSIONS
Better outcomes for office emergencies can result from staff training, availability of appropriate equipment and medications, maintenance of skills via formal and informal practice, and pathways for expeditious transfer to a definitive care facility.
Klig
Jean E
JE
Department of Pediatric Emergency Medicine, Boston Medical Center, 91 East Concord Street, Boston, MA 02118, USA. jean.klig@bmc.org
O'Malley
Patricia J
PJ
D002648:Child; D002959:Civil Defense; D004630:Emergencies; D004632:Emergency Medical Services; D006801:Humans; D009819:Office Visits; D010824:Physicians' Offices