Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Oct-Dec;14(4):477-84.
doi: 10.3109/10903127.2010.497901.

Ambulance personnel perceptions of near misses and adverse events in pediatric patients

Affiliations

Ambulance personnel perceptions of near misses and adverse events in pediatric patients

Jeremy T Cushman et al. Prehosp Emerg Care. 2010 Oct-Dec.

Abstract

Objective: To identify emergency medical services (EMS) provider perceptions of factors that may affect the occurrence, identification, reporting, and reduction of near misses and adverse events in the pediatric EMS patient.

Methods: This was a subgroup analysis of a qualitative study examining the nature of near misses and adverse events in EMS as it relates to pediatric prehospital care. Complementary qualitative methods of focus groups, interviews, and anonymous event reporting were used to collect results and emerging themes were identified and assigned to specific analytic domains.

Results: Eleven anonymous event reports, 17 semistructured interviews, and two focus groups identified 61 total events, of which 12 were child-related. Eight of those were characterized by participants as having resulted in no injury, two resulted in potential injury, and two involved an ultimate fatality. Three analytic domains were identified, which included the following five themes: reporting is uncommon, blaming errors on others, provider stress/discomfort, errors of omission, and limited training. Among perceived causes of events, participants noted factors relating to management problems specific to pediatrics, problems with procedural skill performance, medication problems/calculation errors, improper equipment size, parental interference, and omission of treatment related to providers' discomfort with the patient's age. Few participants spoke about errors they had committed themselves; most discussions centered on errors participants had observed being made by others.

Conclusions: It appears that adverse events and near misses in the pediatric EMS environment may go unreported in a large proportion of cases. Participants attributed the occurrence of errors to the stress and anxiety produced by a lack of familiarity with pediatric patients and to a reluctance to cause pain or potential harm, as well as to inadequate practical training and experience in caring for the pediatric population. Errors of omission, rather than those of commission, were perceived to predominate. This study provides a foundation on which to base additional studies of both a qualitative and quantitative nature that will shed further light on the factors contributing to the occurrence, reporting, and mitigation of adverse events and near misses in the pediatric EMS setting.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Institute of Medicine. Washington, D.C: Institution of Medicine of the National Academies; 2006. Jun, Future of Emergency Care Series, Emergency Care for Children: Growing Pains.
    1. Institute of Medicine. Washington, D.C: Institution of Medicine of the National Academies; 2006. Jun, Future of Emergency Care Series, Emergency Medical Services At the Crossroads.
    1. Morey JC, Simon R, Jay GD, et al. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Services Research. 2002;37(6):1553–1581. - PMC - PubMed
    1. Schenkel SM, Khare RK, Rosenthal MM, Sutcliffe KM, Lewton EL. Resident perceptions of medical errors in the emergency department. Acad Emerg Med. 2003;10:1318–1324. - PubMed
    1. Landrigan CP, et al. Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units. N Engl J Med. 2004;351(18):838–1848. - PubMed

Publication types

LinkOut - more resources