McGillivray D, Nijssen-Jordan C, Kramer M S, Yang H, Platt R
Departments of Pediatrics, Division of Emergency Medicine, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
Ann Emerg Med. 2001 Apr;37(4):371-6. doi: 10.1067/mem.2001.112253.
Of all child visits to emergency departments, 1% to 5% involve critically ill children who require cardiopulmonary resuscitation. Numerous versions of pediatric equipment lists for EDs have been published. Despite these efforts, many EDs remain unprepared for pediatric emergencies. The objectives of this study were to assess the availability of pediatric resuscitation equipment items in Canadian hospital EDs and to identify risk factors for the unavailability of these items.
Using the updated database of the Canadian Association of Emergency Physicians (CAEP), a questionnaire survey was sent to 737 Canadian hospital EDs with a maximum of 3 mailings to nonresponders. On-site visits to a selected subset of hospital EDs were completed to validate the results obtained by the mailed questionnaire.
The response rate was 88.3% (650/737). Results showed the following overall equipment unavailability: intraosseous needle, 15.9%; pediatric drug dose guidelines, 6.6%; infant blood pressure cuff, 14.8%; pediatric defibrillator paddles, 10.5%; infant warming device, 59.4%; infant bag-valve-mask device, 3.5%; infant laryngoscope blade, 3.5%; 3-mm endotracheal tube, 2.5%; and pediatric pulse oximeter, 18.0%. Low percentage of pediatric visits, lack of an on-call pediatrician for the ED, and lack of a pediatric advanced life support-trained physician on staff were independently associated with equipment unavailability.
This study demonstrated that essential pediatric resuscitation equipment is unavailable in a disturbingly high number of EDs across Canada and has identified several determinants of this unavailability.
在所有儿童前往急诊科就诊的情况中，1%至5%涉及需要心肺复苏的危重症儿童。已经发布了多个版本的急诊科儿科设备清单。尽管做出了这些努力，许多急诊科仍未做好应对儿科紧急情况的准备。本研究的目的是评估加拿大医院急诊科儿科复苏设备的可用性，并确定这些设备不可用的风险因素。
利用加拿大急诊医师协会（CAEP）的更新数据库，向737家加拿大医院急诊科发送了问卷调查，对未回复者最多进行3次邮寄。对选定的一部分医院急诊科进行了实地走访，以验证通过邮寄问卷获得的结果。
回复率为88.3%（650/737）。结果显示以下设备总体不可用情况：骨髓穿刺针，15.9%；儿科药物剂量指南手册，6.6%；婴儿血压袖带，14.8%；儿科除颤电极板，10.5%；婴儿保暖设备，59.4%；婴儿球囊面罩通气装置，3.5%；婴儿喉镜叶片，3.5%；3毫米气管导管，2.5%；以及儿科脉搏血氧仪，18.0%。儿科就诊比例低、急诊科缺乏随叫随到的儿科医生以及工作人员中缺乏接受过儿科高级生命支持培训的医生与设备不可用独立相关。
本研究表明，在加拿大数量惊人的急诊科中，基本的儿科复苏设备不可用，并确定了造成这种不可用情况的几个决定因素。
