ABSTRACT
The purposes of this study were to (1) document whether or not responding emergency departments (EDs) have a process and/or team to interact with parents of children dead on arrival (DOA); (2) conduct a needs assessment to determine what information is essential to convey to a family of a child DOA; and (3) determine what EDs are doing to their residents/fellows in crisis counseling. A survey instrument was developed using input from key health care professionals at Children's Hospital who are involved in the acute care of children and their families. This survey was sent to directors of EDs in all children's hospitals and those general hospitals with more than 400 beds. Respondents identified themselves as ED directors at children's hospitals or general hospitals throughout the United States. The survey documented the lack of a process or team approach to counseling the family of a child who presents DOA. Often, the most inexperienced physicians are expected to provide this information and to counsel parents. Few EDs reported offering communication skills training in this area. Many respondents expressed dissatisfaction about the lack of a process or team regarding patients who present DOA and recognize the need for improvement.
Subject(s)
Counseling/methods , Death, Sudden , Emergency Service, Hospital , Parents/psychology , Professional-Family Relations , Child , Communication , Counseling/education , Emergency Service, Hospital/statistics & numerical data , HumansABSTRACT
Although there has been an emphasis on career satisfaction in pediatrics and on motivators that impact on resident career selection, little attention has been directed toward the career development process in pediatric residency training. This report summarizes the results of a survey conducted of 155 pediatric residency program directors about their counseling practices. Implications of the results and recommendations are discussed to improve this process.
Subject(s)
Career Choice , Counseling , Internship and Residency , Pediatrics/education , Counseling/standards , Follow-Up Studies , Humans , Program Evaluation , Surveys and Questionnaires , United StatesSubject(s)
Academic Medical Centers , Career Choice , Learning , Personality , Private Practice , Research , Humans , Pediatrics , United States , WorkforceSubject(s)
Informed Consent , Jurisprudence , Mentally Ill Persons , Psychiatry , Comprehension , Disclosure , United StatesABSTRACT
Postsplenectomy sepsis, although infrequent, is real and hazardous. We have taken a nonoperative approach to the child with a ruptured spleen who is in stable condition. Six consecutive patients with a diagnosis confirmed by angiography or scan were treated without surgery. The results suggest the usefulness of this approach in the child who is not bleeding massively.
