Is your practice emergency ready?

August 1, 2007

An excerpt from AAP's recommendations on preparing the pediatric office for different types of emergencies.

As you answer these questions, you may be better able to identify those areas in which your office preparedness can be enhanced.

1 What emergencies have you experienced in the office setting? How often have office emergencies occurred in your practice?

2 What is your office setting (freestanding office, clinic-based, health center-based, hospital-based, other)? Are there resources outside your office on which you could call during an office emergency (eg, security, other medical or dental professionals in the same building, hospital code team)?

4 What is the emergency readiness of the staff present during those times? (Include first aid, CPR, BLS, ALS, PALS, APLS, Emergency Nurse Pediatric Course, other continuing medical education, etc.)

5 Have nonclinical staff been trained to recognize a potential or actual emergency?

6 What anticipatory guidance and education do you provide parents regarding injury prevention, first aid and CPR training, recognizing and responding to emergencies, and accessing EMS?

7 Is your waiting room under direct observation or screened frequently by a clinical staff member? Is it childproofed?

8 Does your practice have a written protocol for response in an office emergency? Does that protocol cover times of low staffing?

9 Do all staff members know how to access the EMS system? Staff members should be able to give the location and directions to the office, level of clinical staff present, age and condition of child (including vital signs if appropriate), desired transport location, and the level of emergency response (ALS or BLS) required.

10 Do you have specific telephone triage protocols for nonclinical and clinical staff?

11 How far is your office from a site of definitive care, such as the nearest ED, or the nearest pediatric center?

12 How long does it take for EMS to respond to a 9-1-1 call from your office?

13 Has EMS ever been to visit your office for a nonemergency call or to receive experience in evaluating pediatric patients?

14 What level of provider comes when you call 9-1-1: first responder, BLS, or ALS? Does your local EMS have the necessary equipment and expertise to manage children?

15 What is the point of entry for your local 9-1-1 response team (ie, the facility to which they are required by field protocol to bring a pediatric patient)?

16 If EMS does not go directly to a pediatric center on a 9-1-1 call, how do you emergently transport a child to the desired pediatric center when necessary?

17 Does your office use oxygen? If so, how is it supplied? Do all clinical staff members know how to operate the oxygen canister and know where the key is kept?

18 What emergency dosage strategy do you use in the office (code card, length-based tape, dosage book, no strategy)?

19 What airway equipment do you stock? Do all staff members know how to locate, choose, and use the appropriate size of equipment for any given child?