Preparedness of practicing pediatricians in Louisiana to manage emergencies

Background. Surveys in recent years show that office emergencies are likely to occur in pediatric offices and that most offices are not equipped to deal with these situations. Methods. To determine the pediatrician's preparedness to manage emergencies, we surveyed a randomly selected sample of 240 office-based pediatricians in Louisiana. We asked for information about basic and advanced cardiac life support training of the physicians and staff, availability of office equipment and medications, prearranged emergency plans, and staff preparedness. Results. Only 73% of pediatricians were trained in pediatric advanced life support (PALS). Of all support staff, only 48% were trained in basic life support, and 30% were trained in PALS. The most common deficiencies in equipment included intraosseous needles (62%), endotracheal tubes (54%), oxygen tanks (39%), intravenous catheters (29%), and nebulizers (22%). Availability of medications ranged from 75% for epinephrine 1:1,000 to 22% for calcium chloride. Although two thirds of the pediatricians had designed emergency plans for their offices, only 20% were conducting mock drills. Conclusions. Deficiencies exist among pediatricians and office staff regarding appropriate levels of preparedness to handle pediatric emergencies. Recommendations are made to attain appropriate levels of preparedness.