Parental presence during pediatric emergency procedures: finding answers in an Asian context

Objective

The practice of allowing parental presence during invasive procedures in children varies depending on setting and individual provider preference. We aim to understand the attitudes, preferences, and practices of physicians and nurses with regard to parental presence during invasive pediatric emergency procedures in an Asian cultural context.

Methods

We surveyed physicians and nurses in the pediatric emergency department of a large tertiary hospital using separate self-administered questionnaires over three months. The data collected included the demographics and clinical experience of interview respondents. Each provider was asked about their attitude and preference regarding parental presence during specific invasive procedures.

Results

We surveyed 90 physicians and 107 nurses. Most physicians in our context preferred to perform pediatric emergency procedures without parental presence (82, 91.1%). Forty physicians (44.4%) reported that parental presence slowed down procedures, while 75 (83.3%) felt it increased provider stress. Most physicians made the decision to allow parents into the procedure room based on parental attitude (69, 76.7%) and the child’s level of cooperation (64, 71.1%). Most nurses concurred that parental presence would add to provider stress during procedures (69, 64.5%). We did not find a significant relationship between provider experience (P=0.26) or age (P=0.50) and preference for parental presence.

Conclusion

In our cultural context, most physicians and nurses prefer to perform procedures for children in the absence of parents. We propose that this can be changed by health professional training with role play and simulation, adequate supervision by experienced physicians, and clear communication with parents.

Point-of-care ultrasound identification of pneumatosis intestinalis in pediatric abdominal pain: a case report

We describe a case report of an infant with intussusception who presented to a pediatric emergency department with diarrhea and increased irritability. Pneumatosis intestinalis (intra-mural air) detected on point-of-care ultrasonography (but not apparent on plain abdominal radiographs) alerted the emergency physicians towards the severity of disease process.

Age-wise exposure rates to hepatitis e virus in a southern Indian patient population without liver disease

To determine the age-stratified exposure to hepatitis E virus (HEV) in patients attending a tertiary care hospital in southern India, serum samples from 600 individuals were tested using a commercial HEV IgG enzyme-linked immunosorbent assay. Subjects were composed of blood donors, antenatal women, and pre-operative individuals who were negative for hepatitis B surface antigen and antibody to hepatitis C virus with no evidence of liver disease; 200 each were 1-5 and 6-15 years old and 100 each were 16-40 and > or = 41 years old. One (0.5%) sample was positive in those 1-5 years old, two (1.0%) in those 6-15 years old, eight (8%) in those 16-40 years old, and 13 (13%) in those > or = 41 years old. The overall seropositivity rate was 4%. However, there was an age-related increase in exposure to HEV that was statistically significant (P < 0.001), with a higher HEV seropositivity in urban individuals.