No difficulties were encountered in children's hospitals regarding equipment and assistance for paediatric emergency surgery. The principal finding of the present survey was that 77.1% of respondents from DGHs and university hospitals encountered difficulties, either related to a lack of specialized personnel (67.7%) or because of a lack of age-appropriate equipment (9.4%), when carrying out emergency surgery for children (Fig. 1). Only 27.1% had a 24 h cover for paediatric emergency surgery. Half of all paediatric emergency procedures are carried out by the general surgeon and the anaesthetist on duty. Only 27.6% responded that they had a dedicated, specialized paediatric team. Two out of every 10 children admitted for emergency surgery would be transferred to a specialist paediatric centre. Local hospital guidelines standardizing paediatric emergency procedures were missing in 77.9% of DGHs and university hospitals. Half of the respondents (46.1%) reported having a lower limit for age or weight, or both in children undergoing elective surgery during the daytime. Regarding basic airway equipment, such as laryngeal masks, tracheal tubes of paediatric and neonatal sizes, Guedel airways, and facemasks, these were available in the majority of hospitals Declaration of interest None declared.
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