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West J Emerg Med. 2018 Nov;19(6):970-976. doi: 10.5811/westjem.2018.9.38379. Epub 2018 Oct 18.

Factors Affecting Family Presence During Fracture Reduction in the Pediatric Emergency Department.

Author information

University of Minnesota, Department of Pediatrics, Minneapolis, Minnesota.
American Family Children's Hospital, Department of Child Life Services, Madison, Wisconsin.
University of Wisconsin, Madison, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.
University of Wisconsin, Madison, Department of Radiology, Madison, Wisconsin.
University of Wisconsin, Madison, Department of Biostatistics and Medical Informatics, Madison, Wisconsin.
University of Wisconsin, Madison, Department of Pediatrics, Madison, Wisconsin.



Asking family members to leave during invasive procedures has historically been common practice; however, evidence-based recommendations have altered the trend of family presence during pediatric procedures. The aim of this study was to determine factors related to family members' choice to be present or absent during fracture reductions in a pediatric emergency department (ED), and their satisfaction with that choice.


We administered role-specific, anonymous surveys to a convenience sample of patients' family members in the ED of a Level I pediatric trauma center. All family members were given a choice of where to be during the procedure.


Twenty-five family members of 18 patients completed surveys. Seventeen family members chose to stay in the room. Family member satisfaction with their decision to be inside or outside the room during the procedure (median = very satisfied) was almost uniformly high and not associated with any of the following variables: previous presence during a medical procedure; provider-reported procedure difficulty, or anxiety levels. Family member perception of procedure success (median = extremely well) was also high and not associated with other variables. Location during the procedure was associated with a desire to be in the same location in the future (Fisher's exact test, p=0.001). Common themes found among family members' reasons for their location decisions and satisfaction levels were a desire to support the patient, high staff competence, and their right as parents to choose their location.


Family members self-select their location during their child's fracture reduction to high levels of satisfaction, and they considered the ability to choose their location as important.

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Conflicts of Interest: By the West JEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The project was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR002373 as well as the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant K08 DK111234. Additional funding was provided by the University of Wisconsin School of Medicine and Public Health through the Shapiro Summer Research Program and the BerbeeWalsh Department of Emergency Medicine. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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