Critical pediatric equipment availability in Canadian hospital emergency departments

Study objective: Of all child visits to emergency departments, 1% to 5% inv olve critically ill children who require cardiopulmonary resuscitation. Num erous versions of pediatric equipment lists for EDs have been published. De spite these efforts, many EDs remain unprepared far pediatric emergencies. The objectives of this study were to assess the availability of pediatric r esuscitation equipment items in Canadian hospital EDs and to identify risk factors for the unavailability of these items. Methods: Using the updated database of the Canadian Association of Emergenc y Physicians (CAEP), a questionnaire survey was sent to 737 Canadian hospit al EDs with a maximum of 3 mailings to nonresponders. On-site Visits to a s elected subset of hospital EDs were completed to validate the results obtai ned by the mailed questionnaire. Results: The response rate was 88.3% (650/737). Results showed the followin g overall equipment unavailability: intraosseous needle, 15.9%; pediatric d rug dose guidelines, 6.6%; infant blood pressure cuff, 14.8%; pediatric def ibrillator pad: dies, 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 vi sits, lack of an on-call pediatrician for the ED, and lack of a pediatric a dvanced life support-trained physician on staff were independently associat ed with equipment unavailability. Conclusion: 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.