Preparing an office practice for pediatric emergencies
- Maya A Jones, MD, MPH
Maya A Jones, MD, MPH
- Assistant Clinical Professor of Emergency Medicine
- Seattle Children's Hospital
- Section Editors
- Richard D Zane, MD
Richard D Zane, MD
- Section Editor — Emergency Medical Services/Disaster Medicine
- Professor and Chair of Emergency Medicine
- University of Colorado School of Medicine
- George A Woodward, MD
George A Woodward, MD
- Section Editor — Pediatric Signs and Symptoms
- Professor of Pediatrics
- University of Washington School of Medicine
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Pediatric providers deliver a variety of services to children and their families, including, on occasion, triage and treatment of childhood emergencies. Infants and children with potentially life-threatening illnesses and injuries are sometimes taken to primary care offices by parents or caregivers who are seeking help from healthcare professionals they know and trust. When this occurs, the office and staff need to be prepared to provide initial stabilization and when necessary, life-saving care .
Studies have shown that office visits by children requiring emergency care are common [2,3]. Thus, it is essential that pediatric primary care offices are equipped with devices, medications, communication systems, and trained personnel to manage the most frequent types of pediatric office emergencies . The consequences of being unprepared are serious; initial treatment provided in the office may mean the difference between life and death. Appropriate stabilization of pediatric emergencies and timely transfer to an appropriate facility for definitive care are important responsibilities of every medical provider who cares for children.
Emergency conditions in infants and children coming to medical office settings are relatively frequent, but the actual number varies significantly depending upon practice characteristics . As an example, more than 2400 life-threatening pediatric emergencies per year were reported in a telephone survey of 51 pediatric offices in one suburban county of Connecticut (an average of 24 emergencies per office per year) . In a survey of pediatricians and family medicine providers who practice in an urban setting, almost two-thirds of those who responded reported that they cared for at least one child who required hospitalization or urgent care each week, and 80 percent had cared for at least one severely ill patient in the past three months  In a separate survey of pediatricians, 73 percent reported one or more emergencies per week .
Several studies have been conducted to identify the types of pediatric emergencies that are most often encountered in the office setting [2,3,5,6]. Respiratory emergencies, seizures, infections (especially in young infants), and shock/dehydration are reported most often, and serious traumatic injuries have also been noted [2,5,6]. In a nationwide survey of 1000 randomly selected, nonhospital based pediatricians, the percentage of pediatricians who had encountered children with the following conditions in the office setting in the previous year was as follows :
●Meningitis: 71 percent
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