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Emergency medicine physicians infrequently perform pediatric critical procedures: a national perspective

Shadd N Cabalatungan1, Henry C Thode1, Adam J Singer1

  • 1Department of Emergency Medicine, Stony Brook University School of Medicine, Stony Brook, NY, USA.

Clinical and Experimental Emergency Medicine
|April 7, 2020
PubMed

Insights

Critical procedures like intubation and CPR are performed significantly less often in children than adults. This study highlights the need for pediatric-specific training for emergency physicians to maintain skills.

Area of Science:

  • Emergency Medicine
  • Pediatric Critical Care
  • Health Services Research

Background:

  • Critical procedures are essential in emergency medicine.
  • Estimating the frequency of these procedures in diverse patient populations is crucial for resource allocation and training.
  • Previous studies on procedure frequency have been limited in scope.

Purpose of the Study:

  • To comprehensively estimate the frequency of critical procedures in adults and children using a national database.
  • To compare the incidence of endotracheal tube intubation (ETI), cardiopulmonary resuscitation (CPR), and central line insertion (CLI) between pediatric and adult patients.
  • To inform training strategies for emergency physicians.

Main Methods:

  • Secondary analysis of the 2010-2014 National Hospital Ambulatory Medical Care Survey.
  • Inclusion of adult and pediatric patients undergoing critical procedures in the emergency department.
  • Calculation of annual procedures per emergency physician and average intervals for infrequent procedures.

Main Results:

  • An estimated 668 million total emergency department visits occurred during the study period.
  • Adults underwent significantly more critical procedures per emergency physician annually compared to children.
  • Specific rates: Adults received 8.6 CLIs, 3.7 CPRs, and 6.3 ETIs per EP/year; pediatric rates were substantially lower.

Conclusions:

  • Critical procedures are performed with significantly lower frequency in children compared to adults.
  • Findings confirm previous smaller studies on pediatric vs. adult procedure rates.
  • Development of pediatric-specific critical procedure training for general emergency physicians is recommended to ensure comprehensive care.
Abstract

Keywords:
Cardiopulmonary resuscitationCatheterizationIntubationProcedures

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