Compliance of child care centers in Pennsylvania with national health and safety performance standards for emergency and disaster preparedness

Pediatric first aid, trauma knowledge, and attitude among parents and general population in Aseer region, Southern Saudi Arabia

Objectives:

Around the world, accidents and injuries are the leading causes of death among children. Because mothers and family members commonly administer first aid at home and at preschools, it’s critical to learn what parents and the public think about children’s mishaps. Our objective was to assess parents’ knowledge and attitude toward pediatric first aid in the Aseer region of Saudi Arabia.

Methods:

A cross-sectional study was conducted in the Aseer region of Saudi Arabia to assess the parents’ level of knowledge and attitude about pediatric first aid and trauma with an electronic- and paper-based multiple-choice self-administered questionnaire covering different medical emergencies. The Arabic and English versions of the questionnaire were made from the information obtained from the first aid educational content of the Saudi Ministry of Health.

Results:

When the participants were asked about their knowledge of pediatric first aid, arranged in descending order from most answers, 37% (n = 135) answered it was good, 30% (n = 111) answered that it was very good, 20% (n = 74) answered that it was not enough, and 13% (n = 47) answered that it was excellent. Results of the multiple linear regression analysis showed the knowledge score to be significantly higher among participants who had higher education levels (t = 2.039, p < 0.001), who had received first aid training before (t = 2.786, p = 0.0001), those who were already healthcare providers (t = 4.336, p < 0.001), those who were from rural districts (t = 2.5, p = 0.355), and younger personnel (t = 0.821, p = 0.345) The difference was not statistically significant.

Conclusion:

Although this study shows that the level of first aid knowledge among personnel who care for children was low, it also shows that they are interested in obtaining proper training.

Implementation and Evaluation of Resuscitation Training for Childcare Workers

BACKGROUND AND OBJECTIVE

Children spend a large amount of time in daycare centers or schools. Therefore, it makes sense to train caregivers well in first-aid measures in children. The aim of this study is to evaluate whether a multimodal resuscitation training for childcare workers can teach adherence to resuscitation guidelines in a sustainable way.

MATERIALS AND METHODS

Caregivers at a daycare center who had previously completed a first-aid course received a newly developed multimodal resuscitation training in small groups of 7-8 participants by 3 AHA certified PALS instructors and providers. The 4-h focused retraining consisted of a theoretical component, expert modeling, resuscitation exercises on pediatric manikins (Laerdal Resusci Baby QCPR), and simulated emergency scenarios. Adherence to resuscitation guidelines was compared before retraining, immediately after training, and after 6 months. This included evaluation of chest compressions per round, chest compression rate, compression depth, full chest recoil, no-flow time, and success of rescue breaths. For better comparability and interpretation of the results, the parameters were evaluated both separately and summarized in a resuscitation score reflecting the overall adherence to the guidelines.

RESULTS

A total of 101 simulated cardiopulmonary resuscitations were evaluated in 39 participants. In comparison to pre-retraining, chest compressions per round (15.0 [10.0-29.0] vs. 30.0 [30.0-30.0], p < 0.001), chest compression rate (100.0 [75.0-120.0] vs. 112.5 [105-120.0], p < 0.001), correct compression depth (6.7% [0.0-100.0] vs. 100.0% [100.0-100.0], p < 0.001), no-flow time (7.0 s. [5.0-9.0] vs. 4.0 s. [3.0-5.0], p < 0.001), success of rescue breaths (0.0% [0.0-0.0] vs. 100.0% [100.0-100.0], p < 0.001), and resuscitation score were significantly improved immediately after training (3.9 [3.2-4.9] vs. 6.3 [5.6-6.7], p < 0.001). At follow-up, there was no significant change in chest compression rate and success of rescue breaths. Chest compressions per round (30.0 [15.0-30.0], p < 0.001), no-flow time (5.0 s. [4.0-8.0], p < 0.001), compression depths (100.0% [96.7-100.0], p < 0.001), and resuscitation score worsened again after 6 months (5.7 [4.7-6.4], p = 0.03). However, the results were still significantly better compared to pre-retraining.

CONCLUSION

Our multimodal cardiopulmonary resuscitation training program for caregivers is effective to increase the resuscitation performance immediately after training. Although the effect diminishes after 6 months, adherence to resuscitation guidelines was significantly better than before retraining.

Assessment of institutional health and safety practices of early years schools in Cape Coast Metropolis, Ghana: a mixed methods approach

Objective

Early years schools by their nature present peculiar challenges for infection control and injuries. This study aimed at assessing the health and safety practices of these institutions and find explanations to challenges faced in meeting the recommended standards.

Design

Sequential explanatory mixed methods design was used in the study.

Methods

The quantitative data was collected using a questionnaire. The study involved all early years schools in Cape Coast Metropolis totalling 160. Follow-up interview was conducted using eight Heads and Coordinators of these schools.

Results

Early years schools met majority of the health and safety practices. Chi-square analysis revealed that, school auspices was associated with keeping records of doctor's report [χ² (1, N = 160) = 7.27, p = .007, φ = .227, odds ratio = 2.79, 95% CI (1.4, 5.7)] and having immunization records up to date [χ² (1, N = 160) = 4.35, p = .037, φ = .184, odds ratio = 2.88, 95% CI (1.2, 7.7)]. Private early years' schools were almost 3 times likely to meet recommended health and safety practices. Two themes identified as explanations to why most early years schools were not requiring copies of doctor's reports were: “We don't bother to ask” and “Rare cases, they do bring”.

Conclusion

Though early years schools were meeting the recommended standards; they were not previewed to doctor's report of children's previous illnesses. This implies that these institutions may not be readily prepared to assist in meeting certain health care needs of the children in their care.

Funding

None declared

Disaster Preparedness Among Michigan's Licensed Child Care Programs

OBJECTIVE

This study aimed to assess if Michigan child care directors have created disaster management plans, and if local resources were used to develop and implement plans.

METHODS

From December 2013 to March 2014, the Early Childhood Investment Corporation conducted a survey of licensed child care programs in Michigan. An online survey regarding disaster preparedness and training resources was distributed to the directors of a convenience sample of registered child care centers among the Early Childhood Investment Corporation's statewide network of 11 resource centers.

RESULTS

A total of 210 child care programs responded. Most (91%) of respondents had a disaster plan, but 40% did not include accommodations for special needs children, 51% did not have a family/child identification or reunification plan, and 67% did not have car safety devices and a predetermined route for evacuation. Fewer than 9% made disaster plans available online. Few collaborated with local fire (22%), police (27%), or pediatric or emergency medicine organizations (11%). Online modules were the most desirable training format.

CONCLUSIONS

In a state without mandated child care guidelines for disaster preparedness, a substantial proportion of child care programs were missing critical components of disaster planning. Future interventions must focus on increasing partnerships with local organizations and developing guidelines and training to include plans for special needs children, family/child identification and reunification, and evacuation/relocation.

First aid knowledge, attitude, practice, and associated factors among kindergarten teachers of Lideta sub-city Addis Ababa, Ethiopia

Background

Injuries are very common and can occur at any point of time in a day. Unintended injuries in kindergarten children are the most common and need immediate life saving care which is known as first aid. This study aimed to investigate knowledge, attitude, practice, and associated factors of first aid among kindergarten teachers of Lideta sub-city Addis Ababa, Ethiopia.

Method

A cross-sectional study was conducted among kindergarten teachers. Data was collected using pretested, structured and self-administered questionnaire S1 File. The collected data was entered in to Epi Data version 3.1 software and analyzed using SPSS version 20. Logistic regression analysis was used to identify association between kindergarten teachers’ knowledge and attitudes towards first aid and different variables. Odds ratios with 95% CI and p<0.05 were computed to determine the presence of the association.

Result

One hundred and ninety-four teachers participated in the study with a response rate of 95%. Only 40% of the teachers were knowledgeable and 75% of them had positive attitude for first aid. Eighty percent of teachers encountered with children in need of first aid. Kindergarten teachers older than 35 years [AOR = 4.2, 95%CI: (1.02, 16.9)], five years’ experience [AOR = 3.1, 95%CI: (1.2, 7.6)], having previous first aid training [AOR = 3.1, 95%CI: (1.2, 7.7)], source of first aid information and teachers serving in private kindergarten are associated with having knowledge of first aid. Long time experience, type of kindergarten, previous training, and exposure to children in need of first aid were positive association with attitude towards first aid.

Conclusion

Low first aid knowledge and high positive attitude among kindergarten teachers. Having long time experience, being older age, previous first aid training, and serving in private kindergarten were positively associated with first aid knowledge and positive attitude. Creating awareness and including first aid courses in the kindergarten teachers’ curriculum need to be considered.

Creation of a Collaborative Disaster Preparedness Video for Daycare Providers: Use of the Delphi Model for the Creation of a Comprehensive Disaster Preparedness Video for Daycare Providers

OBJECTIVE

Eight million American children under the age of 5 attend daycare and more than another 50 million American children are in school or daycare settings. Emergency planning requirements for daycare licensing vary by state. Expert opinions were used to create a disaster preparedness video designed for daycare providers to cover a broad spectrum of scenarios.

METHODS

Various stakeholders (17) devised the outline for an educational pre-disaster video for child daycare providers using the Delphi technique. Fleiss κ values were obtained for consensus data. A 20-minute video was created, addressing the physical, psychological, and legal needs of children during and after a disaster. Viewers completed an anonymous survey to evaluate topic comprehension.

RESULTS

A consensus was attempted on all topics, ranging from elements for inclusion to presentation format. The Fleiss κ value of 0.07 was obtained. Fifty-seven of the total 168 video viewers completed the 10-question survey, with comprehension scores ranging from 72% to 100%.

CONCLUSION

Evaluation of caregivers that viewed our video supports understanding of video contents. Ultimately, the technique used to create and disseminate the resources may serve as a template for others providing pre-disaster planning education. (Disaster Med Public Health Preparedness. 2019;13:123-127).

EMS Activations for School-Aged Children From Public Buildings, Places of Recreation or Sport, and Health Care Facilities in Pennsylvania

OBJECTIVES

To determine the etiology of emergency medical services (EMS) activations in 2011 to public buildings, places of recreation or sport, and health care facilities involving children aged 5 to 18 years in Pennsylvania.

METHODS

Electronic records documenting 2011 EMS activations as provided by the Pennsylvania Department of Health's Bureau of EMS were reviewed. Data elements (demographics, dispatch complaint, mechanism of injury, primary assessment) from patients aged 5 to 18 years involved in an EMS response call originating from either a public building, a place of recreation and sport, or health care facility were analyzed.

RESULTS

A total of 12,289 records were available for analysis. The most common primary assessments from public buildings were traumatic injury, behavioral/psychiatric disorder, syncope/fainting, seizure, and poisoning. The most common primary assessments from places of recreation or sport were traumatic injury, syncope/fainting, altered level of consciousness, respiratory distress, and abdominal pain. The most common primary assessments from health care facilities were behavioral/psychiatric disorder, traumatic injury, abdominal pain, respiratory distress, and syncope/fainting. When examining the mechanism of injury for trauma-related primary assessments, falls were the most common mechanism at all 3 locations, followed by being struck by an object. Of the 1335 serious-incident calls (11% of the total EMS activations meeting inclusion criteria), 61.2% were from public buildings, 14.1% from places of recreation or sport, and 24.7% from health care facilities.

CONCLUSIONS

Our identification of common EMS dispatch complaints, mechanisms of injury, and primary assessments can be used in the education of staff and preparation of facilities for medical emergencies and injuries where children spend time.

Low Compliance of Urgent Care Centers in the United States With Recommendations for Office-Based Disaster Preparedness

OBJECTIVES

The aim of the study was to determine the compliance of urgent care centers in the United States with published recommendations for office-based disaster preparedness.

METHODS

An electronic questionnaire was distributed to urgent care center administrators as identified by the American Academy of Urgent Care Medicine directory.

RESULTS

One hundred twenty-two questionnaires of the 872 distributed were available for analysis (14% usable response rate). Twenty-seven percent of centers have an established disaster plan for events that involve their establishment and surrounding community; 49% practice the plan at least once a year, 19% less frequent than once a year, and 32% never practice. Forty-seven percent of centers are familiar with designated emergency shelters and community evacuation plans. Seventeen percent of centers function as part of a surveillance system to provide early detection of any biologic/chemical/nuclear agents. Twenty-two percent of centers take part in local community and hospital disaster planning, exercises, and drills through emergency medical services and public health systems. Five percent of centers aid schools, child care centers, camps, and other child congregate facilities in disaster planning. Twenty-eight percent of centers have an assembled emergency/disaster kit, containing such items as water, first aid supplies, radios, flashlights, batteries, heavy-duty gloves, food, and sanitation supplies.

CONCLUSIONS

Areas for improvement in urgent care center disaster preparedness were identified, such as developing an office disaster plan that is practiced at least yearly, becoming familiar with designated emergency shelters and community evacuation plans, providing surveillance to detect potential acts of terrorism, assisting community organizations (hospitals, schools, child care centers, etc) in disaster planning, and assembling office emergency/disaster kits.

Compliance of camps in the United States with guidelines for health and safety practices

OBJECTIVE

To determine the compliance of US camps with guidelines for health and safety practices as set forth by the American Academy of Pediatrics and the US Department of Homeland Security.

METHODS

An electronic questionnaire was distributed to US camps during the summer of 2012 as identified by 3 online summer camp directories.

RESULTS

Analysis was performed on 433 completed questionnaires. Fourteen percent of camps were considered medically related. Ninety-three percent of camps have established relationships with community emergency medical services, 34% with local orthodontists, and 37% with local mental health professionals. Camps reported the immediate availability of the following: automated external defibrillators (75%), respiratory rescue inhalers (44%), epinephrine autoinjectors (64%), cervical spine collars (62%), and backboard with restraints (76%). Camps reported the presence of the following written health policies: dehydration (91%), asthma and anaphylaxis (88%), head injuries (90%), seizures (78%), cardiac arrest (76%), and drowning (73%). Although 93% of camps have a disaster response plan, 15% never practice the plan. Sixty-eight percent of camps are familiar with community evacuation plans, and 67% have access to vehicles for transport. Camps reported the presence of the following written disaster policies: fire (96%), tornadoes (68%), arrival of suspicious individuals (84%), hostage situations (18%).

CONCLUSIONS

Areas for improvement in the compliance of US camps with specific recommendations for health and safety practices were identified, such as medically preparing campers before their attendance, developing relationships with community health providers, increasing the immediate availability of several emergency medications and equipment, and developing policies and protocols for medical and disaster emergencies.

Pediatric first aid knowledge and attitudes among staff in the preschools of Shanghai, China

Background

Unintentional injury remains the leading cause of morbidity and mortality among children worldwide. The aims of this study were to assess a baseline level of first aid knowledge and overall attitudes regarding first aid among staff members in Shanghai preschools.

Methods

A cross-sectional study was carried out among the staff members at selected preschools. A stratified random sampling method was first used to identify suitable subjects. Data were obtained using a multiple-choice questionnaire. A standardized collection of demographics was performed and participants were given the aforementioned questionnaire to indicate knowledge of and attitudes toward first aid.

Results

1067 subjects completed the questionnaire. None of the surveyed employees answered all questions correctly; only 39 individuals (3.7%) achieved passing scores. The relative number of correct answers to specific questions ranged from 16.5% to 90.2%. In particular, subjects lacked knowledge regarding first aid for convulsive seizures (only 16.5% answered correctly), chemical injuries to the eye (23%), inhaled poison (27.6%), and choking and coughing (30.1%). A multiple linear regression analysis showed scores were significantly higher among staff members with more education, those who had received first aid training before or were already healthcare providers, younger employees, and staff members from rural districts. Most employees agreed that giving first aid was helpful; the vast majority felt that it was important and useful for them to learn pediatric first aid.

Conclusions

The level of first-aid knowledge among preschool staffs in Shanghai was low. There is an urgent need to educate staff members regarding first aid practices and the various risk factors relating to specific injuries.

Compliance of middle school-aged babysitters in central Pennsylvania with national recommendations for emergency preparedness and safety practices

OBJECTIVE

To determine the compliance of middle school-aged babysitters with national recommendations for emergency preparedness and safety practices.

PATIENTS AND METHODS

A prospective, self-administered questionnaire-based study was conducted at 3 middle schools in central Pennsylvania.

RESULTS

A total of 1364 questionnaires were available for analysis. Responding babysitters (n = 890) reported previous training that included babysitter (21%), first aid (64%), and cardiopulmonary resuscitation (59%) training. Reported unsafe babysitter practices were leaving a child unattended (36%) and opening the door to a stranger (24%). The most common emergency experience encountered by responding babysitters included cut or scrape (83%), burns (28%), and choking (14%). Ten percent of responding babysitters have activated the 911 system.

CONCLUSIONS

Middle school-aged babysitters will likely encounter common household emergencies and therefore benefit from first aid training; however, very little difference in safety knowledge was found between trained and untrained babysitters, suggesting modifications in babysitter training programs may be required.

[Are we prepared for a disaster? Spanish multicentre study]

INTRODUCTION

Paediatric Emergency Departments (PED) should have written disaster plans, to ensure a rapid and efficient response.

OBJECTIVES

1) to determine if Spanish PED have written disaster plans, 2) to describe the characteristics of these plans, and 3) if paediatric victims were included in them.

MATERIAL AND METHODS

Descriptive multicentre study based on questionnaires sent to physicians in charge of different Spanish PED. The structured survey included questions about external emergency plans (EEP) and internal emergency plans (IEP).

RESULTS

Twenty-five out of 44 surveys were replied. Eighteen PED had an EEP, most of them had been written 10 years ago and were reviewed every 3 years or more. In 11/18 PED, the EEP was well-known by health care providers. Drills were never performed in 13/18 PED. Twenty-one PED had an IEP, most of them had been written 8 years ago and were reviewed every 3 years or more. In 13/21 PED, IEP was well-known by health care providers but drills were never performed in 12/21 PED. IEP included evacuation plans (22), fire emergency plans (19), bomb threat plan (13) and flood plans (9). Nine PED have paediatric-specific disaster plans and in 7 PED, disaster plans included adult and paediatric victims. Children were not included In 1 EEP and in 5 IEP.

CONCLUSIONS

Most of PED have written disaster plans, but these plans are old, unknown by health care providers and almost half of them do not include paediatric victims. It is necessary to improve disaster planning in Spanish PED.