Is your child at risk for medical errors in your local emergency room?

If your child was seriously injured or ill, you’d most likely take him or her to the closest emergency room. But not all emergency departments (EDs) are adequately staffed and equipped to provide safe, appropriate care to children. According to the American Academy of Pediatrics, 20 percent of ED visits are for children, but only six percent of U.S. hospitals have the equipment, medications, supplies and training to properly care for children. What should you look for when choosing an emergency department for your children?

The best plan is to be prepared

Although you may not always have a choice of where your child receives emergency care, it’s wise to find out what EDs near your home, your child’s school and any camps or sports venues your child spends time at have the necessary specialists and equipment to provide appropriate emergency care to children. A health advisor can help you research the resources available in your area so that you have a list of vetted EDs on hand if your child ever needs emergency care. An advisor can also quickly connect you with the most appropriate physicians and hospitals if your child becomes ill or is injured when you’re away from home.

What questions should you ask?

There are several questions you can ask to find out if an ED is adequately prepared to treat your child:

• Do you have board-certified pediatric emergency medical specialists on staff or on call in the ED? A survey recently completed by the National Pediatric Readiness Project found that only 15 percent of doctors treating pediatric patients in U.S. EDs were trained in pediatric emergency medicine. Pediatric emergency specialists have six years of post-medical school residency and sub-specialty training in both pediatrics and pediatric emergency medicine.
• How many children does the ED treat per day? Studies have found that the greater the number of children an ED treats, the more experienced the staff is in recognizing common pediatric illnesses and treating complex and rare pediatric conditions and the more aware they are of the differences between treating adult and pediatric patients. For example, for an adult, respiratory syncytial virus (RSV) is usually not serious, but in young children, it can be life-threatening. It’s also important that lab and X-ray technicians are experienced interpreting results in pediatric patients because growing children’s bodies are not the same as adults’. Growth plates can make children’s X-rays harder to read, for example, and children’s vital signs, such as blood pressure, are different than adults’.
• Does the ED have pediatric equipment and drug dosing protocols? Because the appropriate dose of drugs for children is dependent on the child’s weight, it’s important that ED staff be trained in how to calculate the right dose of medication. Many adult medical technologies and supplies, such as CT scanners and IV needles, can pose an unnecessary risk to children. Ask if the ED has pediatric-specific equipment and supplies.

It can be beneficial for an ED to have a separate waiting area for children to avoid increasing their anxiety and fear by encountering seriously ill or injured adults. Many EDs with pediatric emergency medicine specialists also allow parents to remain with their children during exams and treatment, another approach that can make both you and your child more comfortable.