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Do family members interfere in the delivery of care when present during invasive paediatric procedures in the emergency department?
Author(s) -
Ryan Glenn,
Treston Greg
Publication year - 2007
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2007.00962.x
Subject(s) - medicine , incision and drainage , sedation , confidence interval , emergency department , observational study , foreign body , abscess , telephone call , pediatrics , surgery , nursing , electrical engineering , engineering , pathology
Objective: To determine whether family members interfere with patient care when present during invasive procedures performed on their children in the ED. Methods: A prospective observational study of consecutive cases of procedural sedation of children aged between 12 months and 16 years was conducted between March 2002 and March 2006 in the ED of a secondary‐level regional hospital in south‐east Queensland. Procedures performed included laceration repair, fracture reduction, foreign body removal and abscess incision and drainage. Parents/primary caregivers were encouraged to stay with their child. A stepwise explanation of the procedure and sedation to be used was undertaken, informed consent obtained and telephone follow up attempted 5–14 days post procedure. Results: Six hundred and fifty‐two patient encounters with parents or primary caregivers present for the procedure were included for a total of 656 procedures: 234 laceration repairs, 250 fracture reductions, 85 foreign body removals, 33 abscess incision and drainages, 14 dislocation reductions and 40 other procedures. Telephone follow up was successful in 65% (424) of cases. The mean age was 6.5 years. Family member interference occurred in one case (0.15%, 95% confidence interval 0–0.73%). In 17 cases (2.68%, 95% confidence interval 2.1–5.9%) family members present expressed concerns about the procedure during the telephone follow up but had not interfered at the time of the procedure. There were no significant differences between the concerned parents at follow up and the study group across key patient variables such as child’s age ( P = 0.369), weight ( P = 0.379), respiratory rate ( P = 0.477), sex ( P = 0.308), procedure indication ( P = 0.308) and airway manoeuvres ( P = 0.153). Conclusion: When family members are encouraged to stay for invasive procedures performed on their child, and careful explanation of the procedure, sedation, possible complications, choice of medication for sedation and possible side‐effects is undertaken, family member interference is extremely rare.