• A 2-week-old infant stops breathing in your waiting room.

• A frantic mother comes to the office carrying her 2-year-old son, who has just aspirated a balloon.

• A 6-year-old is brought to the office with a partial thickness burn of the right arm.

• A mother calls the office and states that her 15-month-old child bit into an electrical cord.

• A 5-year-old boy falls from a tree at school and is brought into the office.

• A 9-year-old girl has an anaphylactic reaction to a penicillin injection.

• A 5-year-old boy cuts his foot on a piece of rusty metal in a barnyard and has only had two tetanus immunizations.

These scenarios all can occur in the office. The literature, as well as a periodic survey done by the American Academy of Pediatrics, suggests that many offices are not prepared to manage these and other emergencies. In some practices, the staff have not received formal training in cardiopulmonary resuscitation (CPR), even though ill patients are seen regularly and injectable medications are dispensed.

Staff and Office Preparation

The issues that are important in preparing for an emergency involve: staff education; equipment and supplies; management guidelines, protocols, and procedures; and resuscitation practice sessions.

STAFF EDUCATION

All office staff should be trained in basic life support, including foreign body removal, rescue breathing, and chest compressions.

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