Outpatient Emergency Preparedness

Pendleton, Amber; Stevenson, Michelle D.

doi:10.1097/pec.0000000000000310

Cited by 12 publications

(5 citation statements)

References 10 publications

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“…This study adds to the evidence reported in previous studies that noted poor pediatric office preparedness through self-reported surveys that are prone to bias. Notably, the in-person direct observation survey methods conducted in this study are less prone to biases 7,16,17 .…”

Section: Discussionmentioning

confidence: 99%

“…Despite the AAP recommendation of performing regular mock codes in the office, our findings were aligned with previously published surveys that reported 20%-40% presence of regular mock codes in offices. This highlights major opportunities for future improvement through providing templates for standardized policies 6,8,16 . Surprisingly, we did not find a correlation between office preparedness scores with simulation performance scores.…”

Section: Discussionmentioning

confidence: 99%

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Preparedness for Pediatric Office Emergencies: A Multicenter, Simulation-Based Study

et al. 2021

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OBJECTIVES Pediatric emergencies can occur in pediatric primary care offices. However, few studies have measured emergency preparedness, or the processes of emergency care, provided in the pediatric office setting. In this study, we aimed to measure emergency preparedness and care in a national cohort of pediatric offices. METHODS This was a multicenter study conducted over 15 months. Emergency preparedness scores were calculated as a percentage adherence to 2 checklists on the basis of the American Academy of Pediatrics guidelines (essential equipment and supplies and policies and protocols checklists). To measure the quality of emergency care, we recruited office teams for simulation sessions consisting of 2 patients: a child with respiratory distress and a child with a seizure. An unweighted percentage of adherence to checklists for each case was calculated. RESULTS Forty-eight teams from 42 offices across 9 states participated. The mean emergency preparedness score was 74.7% (SD: 12.9). The mean essential equipment and supplies subscore was 82.2% (SD: 15.1), and the mean policies and protocols subscore was 57.1% (SD: 25.6). Multivariable analyses revealed that independent practices and smaller total staff size were associated with lower preparedness. The median asthma case performance score was 63.6% (interquartile range: 43.2–81.2), whereas the median seizure case score was 69.2% (interquartile range: 46.2–80.8). Offices that had a standardized process of contacting emergency medical services (EMS) had a higher rate of activating EMS during the simulations. CONCLUSIONS Pediatric office preparedness remains suboptimal in a multicenter cohort, especially in smaller, independent practices. Academic and community partnerships using simulation can help address gaps and implement important processes like contacting EMS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preparedness for Pediatric Office Emergencies: A Multicenter, Simulation-Based Study

et al. 2021

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“…2,4 More studies are therefore urgently needed to determine which procedural skills are needed by trainees because these skills may not necessarily align with those recommended by the Accreditation Council for Graduate Medical Education 3 but it is probably more realistic for each training program to tailor this list according to local realities. [5][6][7] Furthermore, a personal list of the needed skills may be determined a priori by each of the graduating general pediatricians depending upon where they will be practicing. Therefore, depending on their individual needs, medical students and residents should rotate through community clinics but preference should be given to rural or other hard-to-reach pediatric practices and/or EDs where pediatricians are likely to be consulted for various procedures.…”

Section: Commentmentioning

confidence: 99%

From Private Practice to Academia: The Experience of a General Academic Pediatrician

Kum-Nji

2023

Journal of Medical Education and Curricular Development

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After pediatric residency, the author worked in a rural community where he was able to immediately practice skills acquired during training such as intubations, bag-mask ventilation, IV placement, ear irrigation, foreign body removal from eyes and ears, abscess incision and drainage, intraosseous placement for rapid hydration of a severely dehydrated infant, EKG, X-ray readings, and ear-irrigations to cite but a few examples. Furthermore, the writer acquired other high-valued procedural skills such as neonatal male circumcision, frenotomy, ligation of supernumerary digits, and manual separation of labial adhesions. The author feels that he could only have acquired and maintained these skills by working in a busy rural pediatric practice. When the writer later became a faculty member, he was able to effectively train medical students and pediatric residents to acquire these same skills. Even though there is a paucity of research information on procedural skills acquisition among general pediatric residents, the writer proposes that the recruitment of full-time general academic pediatricians with real-world experience may be potentially beneficial for the training of medical students and pediatric residents.

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“…2 Medical emergencies may occur between once or more per week and once or more per month in pediatricians' offices. 3,4 Given the scope of pediatric emergency care in the United States and to facilitate consistency in the pharmacotherapy of medical emergencies in children, it is incumbent that all health providers who manage critically ill or injured children be knowledgeable of the medications used to treat pediatric emergencies. Changes in the pattern and scope of practice, changes in the dosages and indications of medications, availability of newer drugs, and the discontinuation of older pharmacotherapeutic agents make it necessary to stay updated.…”

Section: Introductionmentioning

confidence: 99%

Drugs Used to Treat Pediatric Emergencies

Shenoi

Timm

2020

Pediatrics

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This clinical report is a revision of “Preparing for Pediatric Emergencies: Drugs to Consider.” It updates the list, indications, and dosages of medications used to treat pediatric emergencies in the prehospital, pediatric clinic, and emergency department settings. Although it is not an all-inclusive list of medications that may be used in all emergencies, this resource will be helpful when treating a vast majority of pediatric medical emergencies. Dosage recommendations are consistent with current emergency references such as the Advanced Pediatric Life Support and Pediatric Advanced Life Support textbooks and American Heart Association resuscitation guidelines.

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Outpatient Emergency Preparedness

Abstract: Although emergencies occur frequently in general pediatric offices, pediatricians may not have adequate emergency equipment and training. Variable preparedness reflects the need for greater awareness of and compliance with the AAP policy.

Cited by 12 publications

References 10 publications

Preparedness for Pediatric Office Emergencies: A Multicenter, Simulation-Based Study

Preparedness for Pediatric Office Emergencies: A Multicenter, Simulation-Based Study

From Private Practice to Academia: The Experience of a General Academic Pediatrician

Drugs Used to Treat Pediatric Emergencies

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