Abstract:
The purpose of this study was twofold: First, to identify essential pediatric resuscitative
equipment gaps in the nation’s emergency departments; second, to identify associations
among and between the domains of community and health care organizational structure
as they related to hospital emergency departments’ (EDs) adoption of the 2001 “Care of
the Child in the Emergency Department: Guidelines for Preparedness” (Guidelines for
Preparedness) published by the American Academy of Pediatrics (AAP) and the
American College of Emergency Physicians (ACEP). Diffusion of Innovation (DOI) is
the theoretical concept by which multiple characteristics within the domains of health
care structure and community were examined. The study was conducted using extant data
from the Center for Disease Control and Prevention (CDC) branch of the National Center
for Health Statistics (CDC/NCHS). This descriptive study examined the relationships
regarding the organizational and community characteristics of emergency departments
with the adoption of the Guidelines for Preparedness. Characteristics of pediatric
patient volume, pediatric subspecialty services, per capita income, urbanicity, and region
were associated with the availability of pediatric emergency care essential equipment and
services. Logistic regression was used to further explore variable relationships. The study
identified hospital and community characteristics associated with pediatric emergency
readiness and emergency medical care services essential for the care of critically ill or
injured children. The study’s community variables of per capita income and metropolitan
status were significant, as were the structure variables of pediatric ED volume (size),
pediatric trauma service, the presence of pediatric emergency medicine, and being a
pediatric hospital. The DOI concepts of complexity and interconnectedness were drivers
in both the adoption of the Guidelines for Preparedness and the compliance with
pediatric essential emergency equipment. This study affirms that pediatric emergency
equipment availability is a problem. Pediatrics continues to be an afterthought in
emergency and disaster management, and as a nation we are not prepared for pediatric
emergencies or pediatric disaster care.
