Should Parents Be Present during Emergency Department Procedures on Children, and Who Should Make That Decision? A Survey of Emergency Physician and Nurse Attitudes

Abstract

Abstract. Objective: To survey physician and nurse attitudes regarding parental presence during painful procedures on children performed in the emergency department (ED) and who should make that decision. Methods: The design was an anonymous written survey consisting of six clinical scenarios distributed to all staff and resident physicians and nurses in ten EDs at institutions in the United States routinely caring for children. Participants were asked whether parents should remain with children undergoing intravenous (IV) placement, laceration repair, lumbar puncture, conscious sedation, major resuscitation, and major resuscitation with death. They also were asked who should make the decision. Results: The percentage of physicians who responded that parents should be present was 91.3% for peripheral IV start, 93.3% for laceration repair, 65.7% for lumbar puncture, 83.1% for conscious sedation, 31.9% for major resuscitation, and 35.6% for major resuscitation where death was likely. The percentage of nurses who responded that parents should be present was 86.8% for peripheral IV start, 89.6% for laceration repair, 55.0% for lumbar puncture, 74.9% for conscious sedation, 41.4% for major resuscitation, and 54.3% for major resuscitation where death was likely. In 64.8% of the completed surveys, the physicians indicated that they alone or in conjunction with a parent should make the decision. In 61.5% of the completed surveys, the nurses indicated that they should be involved in the decision. Conclusions: A majority of emergency physicians and nurses indicated parents should be present for some invasive pediatric procedures. However, as the invasiveness of the pediatric procedures increased, fewer physicians and nurses believed that parents should be present.

Resuscitation Team Perceptions of Family Presence During CPR

“…These findings were supported by research from Mian et al (2007), Sacchetti et al (2000), and Beckman et al (2002), and, more recently, Feagan and Fisher (2011). These findings were supported by research from Mian et al (2007), Sacchetti et al (2000), and Beckman et al (2002), and, more recently, Feagan and Fisher (2011).…”

Should parents accompany critically ill children during inter-hospital transport?

“…1 It is debatable however, whether parents should be present throughout every phase of their child's treatment, particularly during episodes that may involve risk. [2][3][4][5] Two situations often cited are the induction of anaesthesia, 6 7 or when cardiopulmonary resuscitation is required. 8 A third example, namely inter-hospital transportation of the critically ill child, has become increasingly relevant in the United Kingdom over the last decade.…”

Observational Study of Family Member Presence for Pediatric Emergency Department Procedures

“…2,16 The literature, however, has not supported family member presence impacting procedure success rate or health care worker anxiety. 2,16 The literature, however, has not supported family member presence impacting procedure success rate or health care worker anxiety.…”