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    Office preparedness for childhood emergencies

    Many pediatric practices are not prepared for an in-office emergency. These AAP recommendations will help you make your office code-blue ready.

    When a child experiences a medical emergency, it is not surprising that parents may think first of seeking care from their pediatrician whom they know and trust. Various studies conducted at local and national levels document how often these events occur. In a relatively recent survey including outpatient pediatricians from a single medical center, 39% of 57 respondents reported seeing at least 1 emergency per month.1 An older survey collecting information from 51 practices found that 82% saw at least 1 emergency per month and 25% experienced more than 50 emergencies per year.2 Data from other older surveys showed that about two-thirds of pediatric care providers saw at least 1 child per week with an emergency who required hospitalization or urgent treatment.3,4

    Whereas these studies highlight a need for pediatrician offices to be ready to handle emergencies, available data also demonstrate that many practices, including those that have already needed to treat a critically ill child, are not adequately prepared because they lack the relevant protocols, training, and tools.1,3-7

    Related: Be ready for an in-office 911

    The reasons for the suboptimal preparedness are varied.8 Some practitioners dismiss the need based on beliefs that emergencies are uncommon or can be handled adequately either by calling for emergency medical services (EMS) or because of the practice’s nearness to a hospital. Reviewing their risk-management guidelines, some practitioners wrongly come to the conclusion that having emergency equipment and medications on site increases their liability in emergency situations. Others cite prohibitive costs of maintaining the necessary equipment and medication.

    In 2007, recognizing that pediatric practices may be required to provide urgent or emergent care in their offices and that patient outcomes in these situations can depend on office preparedness to deliver care, the American Academy of Pediatrics (AAP) Committee on Pediatric Emergency Medicine developed a policy statement on “Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers.”8 Findings of a survey conducted about 5 years after its publication, however, showed that only about one-half of pediatricians knew the policy statement existed and only about one-quarter believed their office was in compliance.1

    This article aims to raise awareness of this critically important document. It summarizes the 8 recommendations and highlights the key supporting materials that are provided in the policy statement (Table 1), but readers are urged to read the document in its entirety.

    NEXT: Recommendations

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