Drug therapy for children in emergency hospital
                    service

A cross-sectional study that included the participation of 37 nursing professionals by using a structured and assessed instrument with four scenarios involving drug therapy.

Results:

The participants showed uniform knowledge about the drug therapy in all scenarios. However, in the third scenario, a statistically significant difference (p = 0.003) was observed among the professionals working in the research institution and studying at the same time, regarding the change of route for medication administration in cardiac arrest situations.

Conclusion:

The surveyed nursing professionals have knowledge about the drug therapy directed to the pediatric population in situations of emergency.

Keywords
Nursing assessment; Quality of health care; Medication systems; Emergence service, hospital; Child

Scenarios	Yes n(%)	No n(%)	I have doubts n(%)
1) A preschool child aged 4 years, having a seizure, with the prescription of a loading dose of 30mg of intravenous sodium phenytoin. When preparing the prescribed medication, the nursing assistant has knowledge that the particular drug should not be administered in pure form, hence requiring a diluent. As a diluent of phenytoin sodium, the assistant uses 5% dextrose. Is the described conduct correct?	11(29.7)	19(51.4)	7(18.9)
2) An infant aged 1 year and 6 months is taken to the children's emergency in maternal company presenting a condition of vomiting for a day. The medical team prescribed 0.6ml of dimenhydrinate/ pyridoxine hydrochloride intramuscularly. The nursing technician prepares the prescribed medication and opts for the dorsal-gluteal region (gluteus maximus muscle) to administer the injection. Do you agree with the employee's conduct?	18(48.6)	11(29.7)	8(21.6)
3) A 9 year-old child is admitted to the emergency room after the multidisciplinary team starts performing the procedures of Cardiopulmonary Arrest (CPR). There were signs of infiltration in the peripheral venous catheter insertion, opting for its removal. In the absence of available venous network, the medical team prescribes 30 mg of epinephrine via orotracheal cannula. Noting the change in route of administration, the nursing assistant finds no trouble with administering other prescribed medications in the tracheal tube. Is the nursing employee's line of reasoning correct?	2(5.4)	32(86.5)	3(8.1)
4) A preschool child aged 3 years, under intense respiratory discomfort is forwarded to the emergency room, to start rapid sequence intubation. The medical team prescribes the necessary medications for the procedure. During the administration of fentanyl citrate, the nursing assistant performs an IV push of the drug in the peripheral venous access of the patient. In your opinion, was there a failure during the drug administration?	14(37.8)	15(40.5)	8(21.6)

	Work scheme
Scenarios	Only Works (n=22) n(%)	Works and studies (n=7) n(%)	Works in two places (n=7) n(%)	Works in two places and studies (n=1) n(%)	p-value
1	14(63,6)	3(42,9)	2(28,6)	0(0,0)	0,257
2	7(31,8)	2(28,6)	1(14,3)	1(100,0)	0,360
3	21(95,5)	3(42,9)	7(100,0)	1(100,0)	0,003^* * Fisher p<0.05
4	10(45,5)	3(42,9)	1(14,3)	0(0,0)	0,411

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author Giselle Pinto de Oliveira Sá Macedo Napoleão de Barros street, 754, São Paulo, SP, Brazil. Zip Code: 04024-002 gigimacedo@yahoo.com.br