Most U.S. hospital emergency rooms aren't prepared to treat children, study finds. Why?
Is your local hospital prepared to treat your child in its emergency room?
A recent study of 4,840 emergency departments in the U.S. found that only 17.4% of ERs had a high level of readiness to treat pediatric patients. It estimated that 2,143 kids' lives could be saved each year if ERs were prepared to treat children.
In Texas, spending $2.44 per child for ERs to meet the readiness standard could save 27 kids' lives a year, said Dr. Katherine Remick, a Dell Medical School associate professor who is the co-director of the National Pediatric Readiness Project.
"There are no universal regulatory requirements," she said of why almost 83% of emergency rooms aren't prepared to treat children.
"That's the misconception most parents and caregivers have: If it says 'Emergency' it is there to treat any and all emergencies regardless of our age," she said.
That doesn't mean that only emergency rooms attached to a children's hospital are equipped to handle a pediatric emergency, she said. Some emergency departments in other hospitals have the training, the procedures and the equipment to handle a child in an emergency, but there's no signage or visible indication of which ERs meet that high level of readiness.
Remick suggests families do their research with their pediatrician to see which local emergency rooms to take their children to in an emergency, and if in a true emergency, "call 911 and hope that the EMS system is able to help navigate your child to the right ER."
"Pediatric readiness is really a system design framework of having policies and protocols in place," Remick said. Yes, it's having pediatric-size equipment, medication and other supplies, but it's also having providers who are trained to handle pediatric emergencies and having safety measures in place to evaluate and give medication based on a child's symptoms, age and weight, not those of an adult.
Emergency rooms do not have to have pediatric specialists or pediatric emergency doctors to be pediatric-ready, she said. Instead, staffers can be trained to handle the immediate need to resuscitate and stabilize a child in an emergency before a transfer to a children's hospital for ongoing care.
Children who die in emergency rooms typically do so in the first few hours of care, and that's why this is so important, Remick said. Those first minutes of care in the most dire situations include establishing an airway, stopping bleeding and keeping the organs functioning. That's where this really matters, Remick said.
Remick remembers being in training in the mid-1980s and working at Brackenridge Hospital, then Austin's main trauma center, when an 11-year-old who had been hit by a car was brought in. At that time, she said, most emergency providers were not trained in working with kids. She said she was lucky her treatment of the patient worked, "but we shouldn't have to rely on luck to ensure the best outcomes."
Texas does have a requirement that by Sept. 1 all designated trauma centers must meet pediatric readiness standards, which include training and having access to equipment and resources at the facility. Children's hospitals also must have the training and resources to treat adults.
In trauma facilities in counties with fewer than 30,000 people, the hospitals can use telehealth to connect experts and the doctors on the ground to treat pediatric patients.
In Central Texas, hospitals with trauma designations are:
Level I (Highest level)
Dell Children's Medical Center
Dell Seton Medical Center
Level II
Ascension Seton Hays
Ascension Seton Williamson
St. David's Round Rock Medical Center
St. David's South Austin Medical Center
Level III
Dell Children's North Campus
Level IV
Ascension Seton Medical Center
Ascension Seton Edgar B. Davis
Ascension Seton Highland Lakes
Ascension Seton Northwest
Ascension Seton Southwest
Baylor Scott & White Lakeway
Baylor Scott & White Marble Falls
Baylor Scott & White Round Rock
Baylor Scott & White Taylor
Cedar Park Regional Medical Center
Christus Santa Rosa Hospital San Marcos
St. David's North Austin Medical Center
St. David's Medical Center
St. David's Georgetown Hospital
This article originally appeared on Austin American-Statesman: Most U.S. hospital ERs are not prepared to treat children, study finds
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