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Toida C, Muguruma T. Prehospital medical equipment for care of pediatric injury patients in Japanese ambulances: a nationwide survey. Acute Med Surg 2020; 7:e605. [PMID: 33364035 PMCID: PMC7753122 DOI: 10.1002/ams2.605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/01/2020] [Indexed: 11/17/2022] Open
Abstract
Aim We evaluated the status of the allocation of medical emergency equipment suitable for pediatric patients of all ages. Methods In 2019, we surveyed the emergency medical officers from 728 fire defense headquarters around Japan. The questionnaire was designed to evaluate the kind and size of equipment available to ambulance crews for prehospital emergency care of injured pediatric patients. A complete pediatric equipment set was defined as a set containing equipment suitable for children aged 0–14 years. Results Overall, 599 (82%) fire defense headquarters responded to our survey. Of these, 596 (99.5%) declared that pediatric equipment was available to ambulance crews. The allocation rates of complete pediatric sets were considerably low: blood pressure cuff, 5%; nasopharyngeal airway, 1%; oropharyngeal airway, 7%; laryngoscope, 6%; supraglottic airway device, 13%; endotracheal tube, 0.2%; and bag‐valve‐mask, 23%. Moreover, none of these fire defense headquarters had complete pediatric equipment sets for all 14 devices assessed in this study. Conclusions Although most Japanese ambulances can provide prehospital emergency care to pediatric patients, this survey revealed the dispersion and deficiencies in the availability of complete pediatric equipment sets.
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Affiliation(s)
- Chiaki Toida
- Department of Disaster Medical Management The University of Tokyo Tokyo Japan.,Department of Emergency Medicine Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Takashi Muguruma
- Department of Emergency Medicine Yokohama City University Graduate School of Medicine Yokohama Japan
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2
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Coleman N, Barry T, Tobin H, Conroy N, Bury G. Paediatric airway management and concerns: a survey of advanced paramedics in Ireland. Ir J Med Sci 2018; 188:683-688. [PMID: 30112623 DOI: 10.1007/s11845-018-1887-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/11/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Paediatric airway management is of fundamental importance in the critically unwell child. Pre-hospital paediatric airway management especially endotracheal intubation is however controversial. AIM To explore Irish Advanced Paramedics (APs) training, experience and clinical practice in paediatric airway management as well as to examine clinician attitudes toward this topic. METHODS An anonymous online survey of all graduates of the University College Dublin AP training program (N = 453). RESULTS With duplicates and failed email deliveries excluded a valid sample of 382 individuals was obtained from whom a response rate of 185/382 (48.4%) was achieved. Three quarters of responding APs worked in urban or mixed practice with the remaining minority operating primarily in rural areas. One quarter of responding APs reported formal training in paediatric intubation. Almost 70% of APs had encountered a child requiring significant airway management in the preceding year. However, this was a rare exposure in terms of overall workload. Basic airway adjuncts were used frequently in such circumstances, with endotracheal intubation having been attempted by only a small minority of APs. Lack of practice was identified by many responding APs as a key issue causing concern in terms of paediatric intubation. CONCLUSION Paediatric airway management has key relevance for pre-hospital care in Ireland. The overall frequency of exposure to children who may benefit from definitive airway management is however likely to represent a significant barrier to the acquisition and maintenance of competency. The ongoing practice of pre-hospital paediatric intubation by APs may not justify its risks.
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Affiliation(s)
- Neil Coleman
- UCD Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Tomas Barry
- UCD Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Helen Tobin
- UCD Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Niall Conroy
- UCD Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Gerard Bury
- UCD Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
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3
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Kaku N, Nitta M, Muguruma T, Hirata Y, Tsukahara K, Knaup E, Nosaka N, Enomoto Y. Medical equipment deployment in pediatric emergency prehospital medical units in Japan. Pediatr Int 2018; 60:93-95. [PMID: 29356286 DOI: 10.1111/ped.13432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/04/2017] [Accepted: 10/10/2017] [Indexed: 11/28/2022]
Abstract
The deployment status of pediatric emergency equipment in ambulances in Japan is unknown. To investigate the status of and issues associated with prehospital emergency medical care for pediatric patients, we conducted a descriptive epidemiological study. We carried out a Web-based survey of 767 fire defense headquarters in Japan, of which 671 responded (valid response rate, 88%). Most of the fire defense headquarters equipped all of their ambulances with oxygen masks (82%), bag-valve masks (for neonates, 83%; for children, 84%), straight laryngoscope blades (for neonates, 47%; for children 68%), blood pressure cuffs for children (91%), oximeter probes (78%), and stiff neck collars (91%); but despite the need for other equipment such as nasopharyngeal and oropharyngeal airways, and Magill forceps, they were insufficiently deployed. In Japan, prehospital emergency medical equipment deployment does not meet the needs of pediatric patients. Minimum equipment standards need to be established for pediatric prehospital care.
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Affiliation(s)
- Noriyuki Kaku
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.,Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiko Nitta
- Department of Emergency Medicine, Osaka Medical College, Osaka, Japan.,Department of Pediatrics, Osaka Medical College, Osaka, Japan
| | - Takashi Muguruma
- Department of Emergency Medicine, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yuichiro Hirata
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.,Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Tsukahara
- Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Okayama, Japan
| | - Emily Knaup
- Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Okayama, Japan
| | - Nobuyuki Nosaka
- Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yuki Enomoto
- Department of Emergency and Critical Care Medicine, University of Tsukuba Hospital, Tsukuba, Japan
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Kaku N, Nitta M, Muguruma T, Tsukahara K, Knaup E, Nosaka N, Enomoto Y. Targeted age, device deployment, and problems associated with pediatric defibrillation in pediatric prehospital emergency medical care settings in Japan. Acute Med Surg 2016; 3:356-359. [PMID: 29123812 DOI: 10.1002/ams2.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/06/2016] [Indexed: 11/10/2022] Open
Abstract
Aim The use of automated external defibrillators was expanded to include infants according to the 2010 cardiopulmonary resuscitation guidelines in Japan. However, deployment has been slower for pediatric patients in Japan, because there are fewer appropriate pediatric patients for automated external defibrillators than adults. This study aimed to investigate the targeted age range for pediatric defibrillation and device deployment of defibrillators for pediatric patients in prehospital emergency medical care settings in Japan, and present the issues associated with automated external defibrillators. Methods We administered a web-based survey to the fire defense headquarters in Japan regarding prehospital emergency medical care for pediatric patients in June 2013. We extracted and analyzed some parts of the data related to pediatric defibrillation. Results Eighty-eight percent of the fire defense headquarters responded to the survey. Sixty-two percent of the fire defense headquarters applied the expanded indication protocol for pediatric defibrillation, which included infants. Forty-three percent of the fire defense headquarters replied that their emergency medical service personnel were using semi-automatic defibrillators without a pediatric mode, whereas 21% of them were using automated external defibrillators that were not equipped with pediatric attenuators. Moreover, many of the semi-automatic defibrillators are not designed for pediatric defibrillation in patients aged <8 years. Conclusions Pediatric prehospital emergency medical care in Japan is inadequately equipped for pediatric defibrillation. It will be necessary to use age-appropriate defibrillators as the targeted age range for automated external defibrillators rapidly expands to include infants.
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Affiliation(s)
- Noriyuki Kaku
- Emergency and Critical Care Center Kyushu University Hospital Fukuoka Japan.,Department of Pediatrics Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Masahiko Nitta
- Department of Emergency Medicine Osaka Medical College Osaka Japan.,Department of Pediatrics Osaka Medical College Osaka Japan
| | - Takashi Muguruma
- Department of Emergency MedicineSchool of Medicine Yokohama City University Yokohama Japan
| | - Kohei Tsukahara
- Advanced Emergency and Critical Care Medical Center Okayama University Hospital Okayama Japan
| | - Emily Knaup
- Advanced Emergency and Critical Care Medical Center Okayama University Hospital Okayama Japan
| | - Nobuyuki Nosaka
- Department of Pediatrics Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan
| | - Yuki Enomoto
- Department of Emergency and Critical Care Medicine University of Tsukuba Hospital Tsukuba Japan
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Gellerfors M, Larsson A, Svensén CH, Gryth D. Use of the Airtraq® device for airway management in the prehospital setting--a retrospective study. Scand J Trauma Resusc Emerg Med 2014; 22:10. [PMID: 24484856 PMCID: PMC3922107 DOI: 10.1186/1757-7241-22-10] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 01/31/2014] [Indexed: 11/30/2022] Open
Abstract
Background Difficulties with prehospital intubations have encouraged the development of indirect laryngoscopy techniques, facilitating laryngeal visualization. Airtraq® is a relatively new single-use indirect laryngoscope. The Airtraq® has been evaluated in several prehospital mannequin intubation trials. However, prehospital clinical experience with the device is limited. Methods A retrospective medical chart review was performed for patients who underwent prehospital endotracheal intubation in the Stockholm County between January 2008 and December 2012. Both anaesthesiologists and nurse anaesthetists performed prehospital intubations during the study period. All Airtraq® intubations during this period were included in the analysis. The objective was to estimate the success rate of Airtraq® used in a prehospital setting. Results During the 5-year period (January 2008- December 2012), 2453 tracheal intubations were performed. Airtraq® was used in 28 cases (1%). The overall Airtraq® intubation success rate was 68%. Among patients with anticipated or unexpected difficult airway (23/28) the Airtraq® success rate was 61% (14/23). Among patients who underwent drug facilitated or rapid-sequence intubation protocols 4/5 (80%) were successfully intubated with Airtraq®. Conclusion In conclusion, this retrospective study showed a higher Airtraq® success rate than previous prospective prehospital trials. However, compared to other prehospital direct and indirect intubation methods the Airtraq success rate is low. Further clinical trials are necessary to evaluate the role of Airtraq® in the prehospital airway management.
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Affiliation(s)
- Mikael Gellerfors
- Department of Clinical Science and Education, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm South General Hospital, 118 83 Stockholm, Sweden.
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Parker MJ, Manan A. Translating resuscitation guidelines into practice: health care provider attitudes, preferences and beliefs regarding pediatric fluid resuscitation performance. PLoS One 2013; 8:e58282. [PMID: 23554882 PMCID: PMC3595280 DOI: 10.1371/journal.pone.0058282] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/01/2013] [Indexed: 11/18/2022] Open
Abstract
Introduction Children who require fluid resuscitation for the treatment of shock present to tertiary and non-tertiary medical settings. While timely fluid therapy improves survival odds, guidelines are poorly translated into clinical practice. The objective of this study was to characterize the attitudes, preferences and beliefs of health care providers working in acute care settings regarding pediatric fluid resuscitation performance. Methods A single-centre survey study was conducted at McMaster Children's Hospital from January to May, 2012. The sampling frame (n = 115) included nursing staff, physician staff and subspecialty trainees working in Pediatric Emergency Medicine (PEM) or Pediatric Critical Care Medicine (PCCM). A self-administered questionnaire was developed and assessed for face validity prior to distribution. Eligible participants were invited at 0, 2, and 4 weeks to complete a web-based version of the survey. A follow-up survey administration phase was conducted to improve the response rate. Results Response rate was 72.2% (83/115), with 83% (68/82) self-identifying as nursing staff and 61% (50/82) as PCCM providers. Resuscitation experience, frequency of shock management, and years in specialty, were similar between PCCM and PEM responders. Physicians and nurses had differing opinions regarding the most effective method to achieve rapid fluid resuscitation in young children presenting in shock (p<0.001). Disagreement also existed regarding the age and size of patients in whom rapid infuser devices, such as the Level-1 Rapid Infuser, should be used (p<0.001). Providers endorsed a number of potential concerns related to the use of rapid infuser devices in children, and only 14% of physicians and 55% of nursing staff felt that they had received adequate training in the use of such devices (p = 0.005). Conclusions There is a lack of consensus among health care providers regarding how pediatric fluid resuscitation guidelines should be operationalized, supporting a need for further work to define best practices.
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Affiliation(s)
- Melissa J Parker
- Department of Pediatrics, McMaster Children's Hospital and McMaster, University, Hamilton, Ontario, Canada.
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Al-Anazi AF. Pediatric emergency medical services and their drawbacks. J Emerg Trauma Shock 2012; 5:220-7. [PMID: 22988399 PMCID: PMC3440887 DOI: 10.4103/0974-2700.99687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 03/10/2012] [Indexed: 12/04/2022] Open
Abstract
Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS) with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo) were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established.
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Affiliation(s)
- Abdullah Foraih Al-Anazi
- Department of Pediatric Emergency, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
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8
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Breon A, Yarris L, Law J, Meckler G. Determining the paediatric educational needs of prehospital providers: part 2. ACTA ACUST UNITED AC 2011. [DOI: 10.12968/jpar.2011.3.9.510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alia Breon
- Resident in Emergency Medicine, Oregon Health & Science University, Department of Emergency Medicine, US
| | - Lalena Yarris
- Emergency Medicine, Oregon Health & Science University, Department of Emergency Medicine, US
| | - Junwen Law
- Oregon Health & Science University, Department of Emergency Medicine, US
| | - Garth Meckler
- Emergency Medicine and Paediatrics, Oregon Health & Science University, Department of Emergency Medicine, US
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9
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Breon A, Yarris L, Law J, Meckler G. Determining the paediatric educational needs of prehospital providers: part 1. ACTA ACUST UNITED AC 2011. [DOI: 10.12968/jpar.2011.3.8.450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alia Breon
- Oregon Health & Science University, Department of Emergency Medicine, US
| | - Lalena Yarris
- Oregon Health & Science University, Department of Emergency Medicine, US
| | - Junwen Law
- Oregon Health & Science University, Department of Emergency Medicine, US
| | - Garth Meckler
- Oregon Health & Science University, Department of Emergency Medicine, US
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10
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Préparation des services d’accueil d’urgences (SAU) français à la prise en charge des urgences vitales de l’enfant. ANNALES FRANCAISES DE MEDECINE D URGENCE 2011. [DOI: 10.1007/s13341-010-0005-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Schmid MC, Mang H, Ey K, Braun J, Schüttler J. [Airway management in the German air rescue service]. Anaesthesist 2009; 58:884-90. [PMID: 19603145 DOI: 10.1007/s00101-009-1584-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The equipment carried in rescue helicopters concerning airway management is not standardized in Germany. The current DIN/EN equipment regulations are not detailed for every single item resulting in differences between the various rescue bases. The aim of this survey was to show existing differences in airway management equipment. METHODS All 72 German air rescue helicopters listed in the ADAC air rescue stations atlas 2006/2007 received a questionnaire. RESULTS A total of 64 bases returned the questionnaire (88.9%). The most frequent types of supraglottic airway equipment were laryngeal masks (67.2%), Combitubes (32.8%) and laryngeal tubes (29.7%). Cricothyrotomy sets were more frequent (68.8%) than tracheostomy sets (35.9%). Of the bases 18.8% had masks suitable for non-invasive ventilation (NIV). All helicopters were equipped to carry out capnometry. CONCLUSIONS The rescue helicopters were found to have differences with respect to the equipment carried for airway management. Medical treatment according to current guidelines is possible on almost all bases.
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Affiliation(s)
- M C Schmid
- Anästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
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12
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Schmid M, Mang H, Ey K, Schüttler J. Prehospital airway management on rescue helicopters in the United Kingdom. Anaesthesia 2009; 64:625-31. [PMID: 19453316 DOI: 10.1111/j.1365-2044.2008.05859.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Adequate equipment is one prerequisite for advanced, out of hospital, airway management. There are no data on current availability of airway equipment on UK rescue helicopters. An internet search revealed all UK rescue helicopters, and a questionnaire was sent to the bases asking for available airway management items. We identified 27 helicopter bases and 26 (96%) sent the questionnaire back. Twenty-four bases (92%) had at least one supraglottic airway device; 16 (62%) helicopters had material for establishing a surgical airway (e.g. a cricothyroidotomy set); 88% of the helicopters had CO(2) detection; 25 (96%) helicopters carried automatic ventilators; among these, four (15%) had sophisticated ventilators and seven (27%) helicopters carried special face masks suitable for non-invasive ventilation. We found a wide variation in the advanced airway management equipment that was carried routinely on air ambulances. Current guidelines for airway management are not met by all UK air ambulances.
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Affiliation(s)
- M Schmid
- Department of Anesthesiology, University Erlangen-Nuernberg, Erlangen, Germany.
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Abstract
OBJECTIVE The nasopharyngeal airway is a simple airway adjunct used by various healthcare professionals. It is the least invasive method of safely managing upper airway obstruction. The objective of this report was to describe a rapid and very simple method of securing a nasopharyngeal airway in an agitated patient. METHOD We describe a simple method of securing a nasopharyngeal airway, using safety pins and tapes. RESULT This technique has been used by the authors in several emergency situations and has been found to be quick and effective. CONCLUSION The nasopharyngeal airway is a simple piece of equipment that is cheap and easy to use. The technique described in this article is a simple, practical and effective method of securing a nasopharyngeal airway in an emergency situation.
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A model protocol for emergency medical services management of asthma exacerbations. PREHOSP EMERG CARE 2007; 10:418-29. [PMID: 16997769 DOI: 10.1080/10903120600884814] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Emergency medical services (EMS) is an important part of the continuum of asthma management. The magnitude of the EMS responsibility is very large, with millions of patients with asthma treated each year by EMS personnel. In response to inconsistencies between the 1997 National Asthma Education and Prevention Program asthma guidelines and a variety of existing EMS protocols on the management of asthma exacerbations, the Centers for Disease Control and Prevention convened a workgroup in 2004 to discuss the various opportunities and challenges ahead. At the meeting, and over the ensuing year, the workgroup created a model protocol that was derived from the National Asthma Education and Prevention Program guidelines. The model protocol is available in both text and algorithm format and offers guidance for EMS systems to develop and implement treatment protocols in their local areas. The workgroup recommendations emphasize flexibility, simplicity, and low-risk practices. By integrating these recommendations into existing protocols, we believe that EMS systems could improve prehospital care for patients with asthma. Demonstration projects are needed to carefully examine the implementation process and the actual impact of the model protocol on various outcomes. The workgroup also encourages more research on EMS management of asthma exacerbations. In the meantime, improved collaboration between EMS and national asthma organizations is an immediate priority and will continue to advance future discussions on how to improve asthma management in the prehospital setting. The workgroup hopes that state and local EMS systems will see the value of the model protocol and encourage its use.
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Gnanalingham MG, Harris G, Didcock E. The availability and accessibility of basic paediatric resuscitation equipment in primary healthcare centres: cause for concern? Acta Paediatr 2006; 95:1677-9. [PMID: 17129983 DOI: 10.1080/08035250600763034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Paediatric emergencies in primary healthcare centres are serious events that occur more commonly than envisaged. However, at present, these centres appear to lack the training and equipment to manage common paediatric emergencies. AIM To determine the availability and accessibility of basic resuscitation equipment in primary healthcare centres. METHODS A questionnaire survey of 27 primary healthcare centres within the Nottingham City region determined the availability and accessibility of basic paediatric resuscitation equipment and algorithms. RESULTS No practice had all 21 basic resuscitation items, with 59% of practices having < or =10 of these items. Only 11% of practices had all seven basic airway and breathing resuscitation items, with 52% of practices having < or =4 items. No practice had all eight basic items for circulation management, with 82% of practices having < or =4 of these items. Only two practices had all six basic drug items, with 85% of practices having < or =3 of these items. Only 26% of practices had algorithms for paediatric basic life support and common emergencies, and only 30% of practices kept their resuscitation equipment together. In the last 5 y, less than a fifth of general practitioners were trained in paediatric resuscitation. CONCLUSION Primary healthcare centres appear to lack the training and equipment to manage common paediatric emergencies. We recommend standardization of equipment and algorithms, training and assessment of key personnel, and critical incident reporting within primary healthcare centres.
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Abstract
The face of primary care is changing fast
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Affiliation(s)
- F Jewkes
- Wiltshire Ambulance Service NHS Trust, Dorman House, Malmesbury Rd, Chippenham, Wilts SN15 5LN, UK.
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