FAMILY MEMBER PRESENCE DURING PEDIATRIC EMERGENCY DEPARTMENT PROCEDURES

Objective: Exclusion of family members (FM) during pediatric procedure s in the emergency department (ED) is an accepted practice. This study questions the validity of such a practice. Subjects: FM of ED pediatr ic patients undergoing procedures and ED staff performing procedures. Sites: ED of a tertiary care university-affiliated community hospital and the pediatric ED of a university hospital. Methods: Post-procedure surveys were obtained from FM remaining with their child during an ED procedure and from the ED personnel performing the procedures. FM act ivity during the procedure was also recorded. Results: Ninety-six chil dren (average age 20 months) underwent a total of 127 procedures. ED p rocedures included: vascular access 91, lumbar puncture 23, urethral c atheterization 9, nasogastric tube placement 1, rapid sequence intubat ion 1, fluid resuscitation from shock 1, and removal of foreign body f rom eye 1. Three children were critically ill during performance of pr ocedures. ED staff answered 98 surveys concerning the performance of t he 127 procedures. FM activities included: Stood at bedside 35 (31%), soothed child 21 (19%), and helped restrain child 55 (55%), In 55 (57% ) cases the FM was the only adult present with the ED staff member per forming the procedure(s). FM member opinions of presence during proced ures were: Good idea 101 (91%), bad idea 6 (5%), and did not care 4 (4 %), ED staff opinions were: good idea 92 (93%), bad idea 2 (2%), and d id not care 4 (5%), FM presence made four (5%) members of the ED staff nervous. Conclusion: FM presence during ED procedures is a practice f avored by both parents and ED staff at our institutions. This practice should not be limited to minimally invasive procedures in stable pati ents but should be considered for procedures such as lumbar punctures and intubations even in critically ill patients.