Sacchetti A, Carraccio C, Leva E, Harris R H, Lichenstein R
Department of Emergency Medicine, Our Lady of Lourdes Medical Center, Camden, New Jersey 08103, USA.
Pediatr Emerg Care. 2000 Apr;16(2):85-7. doi: 10.1097/00006565-200004000-00004.
Opinions remain polarized on allowing family member presence during pediatric resuscitations (FMP). Reluctance to adopt FMP may stem from preconceived notions on this practice. This study evaluates the effect of prior experience with FMP and on its acceptance by emergency department personnel (EDP).
EDP from three different EDs were surveyed concerning FMP. Study facilities included an urban teaching community ED with routine FMP (R-ED), a suburban community ED with occasional FMP (O-ED) and an urban university pediatric ED with virtually no FMP (N-ED) during pediatric resuscitations. Survey information included hospital of practice, position in ED, years in practice, opinions on FMP and personal experience with FMP for five clinical scenarios: laceration repair (LAC), intravenous access (IV), lumbar puncture (LP), endotracheal intubation (ETI), cardiopulmonary resuscitation (CPR), and critical resuscitation (CR). Statistical analysis was through chi square and regression analysis.
Eighty-five emergency department personnel participated in the survey, 57 (67%) nurses, 22 (25%) physicians, 4 technicians (5%), and 2 nurses aids (2%). There was a significant correlation between a favorable opinion concerning family member presence during LP, ETI, CPR and CR and the type of Emergency Department in which the individual practiced (P<0.002). Regression analysis demonstrated a similar relation between personal experience with LAC, IV, ETI, CR, and CPR and a favorable opinion on FMP during that activity (P<0.03).
Opinions on FMP are strongly influenced by experience with this practice. Emergency department personnel with prior exposure to family member presence during resuscitations favor this activity. Biases by EDP lacking experience with FMP may limit its introduction into unfamiliar institutions.
对于在儿科复苏过程中允许家庭成员在场（FMP）这一做法，各方观点仍存在两极分化。不愿采用FMP可能源于对此做法的先入之见。本研究评估了FMP的既往经验及其对急诊科人员（EDP）接受度的影响。
对来自三个不同急诊科的EDP就FMP进行了调查。研究机构包括一家在儿科复苏期间有常规FMP的城市教学社区急诊科（R - ED）、一家偶尔有FMP的郊区社区急诊科（O - ED）以及一家在儿科复苏期间几乎没有FMP的城市大学儿科急诊科（N - ED）。调查信息包括执业医院、在急诊科的职位、执业年限、对FMP的看法以及在五种临床场景下FMP的个人经历：伤口缝合（LAC）、静脉穿刺（IV）、腰椎穿刺（LP）、气管插管（ETI）、心肺复苏（CPR）和重症复苏（CR）。通过卡方检验和回归分析进行统计分析。
85名急诊科人员参与了调查，其中护士57名（67%）、医生22名（25%）、技术人员4名（5%）、护士助理2名（2%）。对于LP、ETI、CPR和CR期间家庭成员在场持赞成意见与个人所在的急诊科类型之间存在显著相关性（P<0.002）。回归分析表明，LAC、IV、ETI、CR和CPR的个人经历与在该活动期间对FMP持赞成意见之间存在类似关系（P<0.03）。
对FMP的看法受此做法的经验影响很大。有复苏期间家庭成员在场既往经历的急诊科人员赞成这一做法。缺乏FMP经验的EDP的偏见可能会限制FMP在不熟悉的机构中的引入。
