Article Text

Could lack of necessary equipment and training to manage common paediatric emergencies within primary healthcare centres impact on secondary healthcare services?
  1. M G Gnanalingham,
  2. G Harris,
  3. E Didcock
  1. Department of Community Paediatrics, Strelley Health Centre, Nottingham NG8 6LN, UK
  1. Correspondence to:
 Dr M G Gnanalingham
 Academic Division of Child Health, School of Human Development, University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH, UK; molingham{at}

Statistics from

Front line paramedics in the UK lack emergency paediatric equipment and skills.1 However, comparative assessments within primary healthcare centres have not been forthcoming, despite their potential propensity for paediatric emergencies and need for resuscitation drugs.2 Indeed, within our locality, East Midlands ambulances were summoned to 27 paediatric emergencies in the same centres surveyed in the preceding year. Moreover, in over 90% of cases paramedics needed to instigate further treatment, primarily for paediatric airway and breathing emergencies, including suspected anaphylaxis, asthma, croup, and pneumonia.

We ascertained the availability and accessibility of basic equipment for managing the paediatric airway and breathing, circulation, and potential drugs for common paediatric emergencies, using an e-mail questionnaire to all 27 primary health care centres within the Nottingham city region. Within practices, children aged 0–16 years comprised a median 25.5% of the total patient number (median 4600, range 1560 to 12 093). No practice had all 21 basic resuscitation items, with 59% of practices having ⩽10 of these items. Indeed, 52% of practices had ⩽4 basic airway and breathing items, 82% of practices had ⩽4 basic circulatory items, and 85% of practices had ⩽4 basic drug items. Only two practices had external defibrillators with paediatric paddles, and only one practice had a pulse oximeter. Only 30% of practices had algorithms for basic life support and common emergencies, and kept their equipment together. Only 17.5% of GPs had been trained in paediatric resuscitation in the past 5 years.

In conclusion, we have shown that primary healthcare centres lack the basic resuscitation equipment and skills to manage common paediatric emergencies. In order to improve the preparedness of these centres, we need to: (a) standardise locally available basic resuscitation equipment, (b) assess and train all necessary personnel, and (c) ascertain the occurrence of critical incidents through a local and national database.


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  • Competing interests: there are no competing interests

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