Version May 2024
| As you answer these questions, you may be better able to identify those areas where your office preparedness can be enhanced. |
| 1. Have you ever experienced emergencies in your office setting? What were they, and how often have they occurred? |
| 2. What is your office setting (freestanding office, clinic-based, health center-based, hospital-based, other)? Are there resources on site but outside of your office that you could call on during an office emergency (security, other medical or dental professionals in the same building, hospital code team)? |
| 3. What are the high and low staffing points during the times when your office is open? Include nights and weekends if applicable. |
4. What is the emergency readiness of the staff present during those times? Include any training in:
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| 5. Have non-clinical staff been trained to recognize a potential or actual emergency? |
| 6. What anticipatory guidance and education do you provide parents regarding injury prevention, first aid and CPR training, recognizing and responding to emergencies, and accessing emergency medical services (EMS)? |
| 7. Is your waiting room under direct observation or screened frequently by a clinical staff member? What child-proofing measures have you implemented? |
| 8. Do all staff know how to access the EMS system? Are staff able to give location of and directions to the office, level of clinical staff present, age and condition of the child (including vital signs if appropriate), desired transport location, and the level of emergency response required (eg, First Responder [ie, police or fire department], BLS [basic life support, emergency medical technician] or ALS [advanced life support, paramedic]). |
| 9. Do you have specific telephone triage protocols for non-clinical and clinical staff? Are all staff currently trained in them? |
| 10. How do you ensure getting the closest available ambulance? Is it 911? a private ambulance? How long does it take for EMS to respond to a call from your office? |
| 11. What is the transport time from your office to a site of definitive care, such as the nearest emergency department or the nearest pediatric center? |
| 12. Have your local EMS providers ever been to visit your office for a non-emergency call, or to receive experience in evaluating pediatric patients? |
| 13. What level of provider comes when you call 911? First Responder (ie, police or fire department), BLS (Basic-Level EMTs), ALS (paramedics)? Does your local EMS have the necessary equipment and expertise to manage children? |
| 14. Do you know the point of entry (hospital of initial destination) for your local 911 response team? (EMS is required by regulation to transport to the closest appropriate hospital, unless they have a state-approved point-of-entry plan to allow a bypass.) |
| 15. If EMS does not go directly to a pediatric center on a 911 call, how do you emergently transport a child to the desired pediatric center when necessary? |
| 16. Does your office use oxygen? If so, how is it supplied? Do all clinical staff know how to operate the oxygen canister? Where is the key kept? |
| 17. What dosage strategy do you use in the office (code card, length-based tape, dosage book, no strategy)? |
| 18. What airway equipment do you stock? Do all clinical staff know how to locate, choose and use the appropriate size equipment for any given child? |
| 19. What equipment and supplies do you have on site to provide you and your staff with universal precautions? |
| 20. Does your practice care for any children who are technology-dependent or have special health care needs? Do you have need for any additional equipment or expertise, should a technology-dependent child have an emergency in your office? |
| 21. Do you have written office protocols for the common office emergencies, such as respiratory distress, anaphylaxis, sepsis, dehydration, supraventricular tachycardia? Are all clinical staff appropriately and currently trained in them? |
| 22. How do you document events during an office emergency (assigned role, tape recorder, retrospective, other)? |
| 23. How do you and your clinical staff maintain skills and readiness? Examples include attending nursery deliveries, moonlighting in the urgent care or pediatric emergency departments, being a PALS or APLS instructor, holding regular "mock" office codes and scavenger hunts for infrequently used equipment, and providing expert review of pediatric runs for your local EMS. |
| 24. How do you document parent education, staff training, protocols, and stocking for emergencies? |
| 25. What is your risk management company's policy regarding emergency preparedness of your office? |
| 26. Are there other aspects of your office practice that you think could be improved in order to achieve fewer office emergencies and better outcomes? |
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