What is a Children’s ER? Choosing the Best Care for your Child

Board Certified Pediatric Emergency Physician Dr. Ronnie Waldrop and Erin Rovelli, RN serve patients at the Children’s Emergency Room at Inova Loudoun Hospital – Loudoun County’s only emergency facility solely dedicated to caring for children and adolescents.  The facility was one of 11 ERs nationwide to receive the prestigious Lantern Award for exceptional practice and innovative performance in the core areas of leadership, practice, education, advocacy, and research.

No one wants to experience a medical emergency – especially when it comes to kids! But, the truth is, they do happen.

In fact, children account for an estimated 22 million ER visits in the United States each year. Unfortunately, the Institute of Medicine estimates that less than 50% of emergency departments are adequately prepared for pediatric emergencies.

So, in the rare event that you do experience an emergency, where do you go and what should you look for to ensure your child is receiving the best possible care?

Location. If you have a life-threatening emergency such as severe respiratory distress, you should take your child to the nearest facility for stabilization and seek specialty care afterwards. If time permits and a pediatric-specific emergency room is nearby, you should proceed there immediately

Environment. You will know a pediatric-prepared facility when you see one because it looks prepared for children! This will include appropriate decoration, play equipment, uniforms, pediatric-sized medical equipment, and noise control. It is not the stark, sterile environment of most general or adult emergency rooms. A visit ahead of time will confirm your impression and is highly recommended!

Experienced Staff. Physicians and nurses in a pediatric-prepared facility are specifically trained and experienced in the acute management of all pediatric trauma and illnesses – both lifesaving and minor.

The facility should be staffed with pediatric emergency physicians who are well versed in a variety of children’s issues including trauma, infectious disease, pain management, airway management, special needs accommodations (including Autism spectrum disorders), adolescent medicine, and mental health issues.

In addition, child life specialists should be available to help ease anxiety, make your child feel safe and secure, and ensure that your family is as comfortable as possible during your hospital stay.

Equipment. Specialized age- and size-appropriate medical equipment for children – from infancy to adolescence – must be readily available. And, the staff should be experienced in using such equipment.

Medications & Pain Management. Medications and prescriptions must be safely prescribed for pediatric appropriateness. All medications for children should be double-checked by individual experts and electronic means for your child’s safety.

Additionally, it’s important to remember that children are often unable to express their level of pain. Therefore, they require an expert to determine safe medication dosing to relieve their pain.

Affiliations and Associations. There is no hospital that has all sub-specialties available on site. Therefore, you should look for a facility that is well-connected with regional pediatric resources. These relationships should be diligently maintained by affiliation, transfer agreements, and cooperative education programs.

Communication. Communication with patients and family members is a priority in a children’s emergency room. This is achieved through child life specialists, cultural competence with interpretative services, and access to electronic medical records that incorporate patient portals. Likewise, constant communication with a patient’s primary care provider, specialists, and referring physicians should be maintained.

Consider these criteria when selecting the best place for your child to receive care. Remember, a children’s ER is much more than just a kid-friendly waiting area and exam room. We encourage you to learn more by touring your local ERs.