Download 10 things parents should know before heading to the ER

To
the
H ospital,
Stat!
10 things parents should know
before heading to the ER
By Janine DeFao
Sooner or later, it is bound to happen. Your child
will spike a fever in the middle of the night, have
a holiday-weekend ear infection, bump his head,
break a bone or – God forbid – something worse.
Then you’re off to the emergency room, trying
to control the crying and hysterics (his and yours),
hoping your child will be OK and that you won’t
be there for hours.
Nearly 24 million children visit an emergency
room each year in the United States, according to
the American Academy of Pediatrics. That’s a big
number for a trip no one wants to take, much less
plan for. But these tips, compiled with the help of
some Bay Area ER experts, will help you get ready
if – or, let’s face it, when – the time comes.
1 Plan Ahead
LUCILLE PACKARD CHILDREN’S HOSPITAL
What are your nearest emergency rooms? Do
you know which hospital your pediatrician is affiliated with? The time to ask these questions is now,
not when you have a crisis on your hands. While
your insurance should pay for a visit to any hospital
in the case of a true emergency, you can save yourself hassle and haggling over bills down the line if
you talk to your doctor and read your medical plan
or call your insurer with any questions about which
hospitals are considered within or outside your
network.
2 Consider a Pediatric
Emergency Room
SUSAN MERRELL, UCSF
Above, Dr. Gary Dahl,
a pediatric oncologist
at Lucille Packard
Children’s Hospital,
knows how to put his
young patient at ease.
At right, a pediatric
specialist treats an
infant in the NeuroIntensive Care Nursery
at the UCSF Children’s
Hospital.
20 Bay Area Parent | October 2009
The Bay Area is extremely lucky to have three
emergency rooms just for kids at Children’s Hospital & Research Center Oakland, Lucille Packard
Children’s Hospital at Stanford University and the
newest pediatric ER, which opened in November
at California Pacific Medical Center’s California
campus in San Francisco.
“What’s different in a pediatric ER than an adult
ER are the recognition skills we have for what’s
going on with a child,” says Dr. Mary Rutherford,
director of emergency medicine at Children’s Hospital Oakland. “From the moment you step into the
hospital to see a triage nurse, your child is going to
be evaluated by a specialty-trained pediatric nurse
and a sub-specialty trained physician,” adds Dr.
Karim Mansour, an emergency medicine attending
physician at the hospital.
That expertise also brings skill and a comfort level dealing with often upset children
and parents. In addition, the atmosphere is more geared to children, whether it’s waiting
room TVs tuned to kids’ shows, pint-sized furniture, colorful murals or bedside television.
“Children are the highest priority, and their welfare comes first,” says Dr. Thomas
Peitz, chairman of the Department of Emergency Medicine at CPMC. “In the main ER,
a child may have to wait because of strokes and heart attacks.”
But in a serious emergency, doctors stress that you don’t want to travel long distances
just to get to a pediatric ER. Go to the closest ER, period. Children often are transferred
if they need specialty care once they’re stabilized at their nearest hospital.
3 Call Your Pediatrician First
If you can reach your pediatrician’s office or advice nurse, do so. They may be able to
stitch up that head wound in the office or may suggest you go to a pediatric urgent care,
which charge less than emergency rooms.
They can give advice on the phone and, if you do need to head to the ER, can call
ahead and brief ER staff on what to expect. “It makes it a lot easier, knowing that they
have sent you in, and it’s much easier to coordinate after-care,” Rutherford says.
However, Rutherford and Mansour stress that parents should not hesitate to call
911 in a serious emergency, from a potential back or head injury to seizures to breathing
difficulty.
“We’ve over-stigmatized the use of ambulances for children,” says Rutherford. “What
EMS (emergency medical services) has that very few families have in sudden emergencies is oxygen.”
4 Treat Your Child at Home
Peitz suggests parents treat fever or pain with over-the-counter medicines before
heading to the hospital. “Tylenol and Motrin are you best friends. They’re the safest
medicines on the planet and will make a huge difference to your child,” he says. “Don’t
worry that you will mask the symptoms. That’s the first thing we do. We’ll treat the pain
and treat the fever.”
5 Stay Calm
“When a mother or father panics, a child’s anxiety level goes up as well,” Peitz says. He
recommends taking a deep breath and trying to clear your head to make the best decision. “People need to be reassured that their instincts are almost always correct,” he says.
6 Leave Siblings at Home
“The emergency room is the wrong place to be sewing up brother and having two
others jumping off the chairs,” says Peitz, who has stitched up a couple of his own four
children, ages 2 to 9. If possible, see if a neighbor or friend can watch the other kids
while you head to the ER with the patient. “Parents need to focus and hear what you
say” without the added stress of tending to additional children. He adds, however, that
CPMC’s pediatric ER always has child-life specialists on staff who not only help parents
and patients prepare for their treatments but also can assist with other siblings if need be.
7 Bring Your Child’s Medical History
and List of Medications
A medication list, covering everything from prescription medications to over-thecounter painkillers to homeopathic medicines, vitamins and supplements “is extremely
valuable” to ER doctors, Rutherford says. Which immunizations a child has had can also
affect their treatment. “Families assume we can get this information from other locations
Not Your Parents’
Hospitals
If you’ve never set foot in a children’s hospital, you may be surprised by
how inviting – and how unlike regular
hospitals – they can be. From colorful
murals on the walls to pint-sized furniture and play areas to teen lounges,
hospitals specializing in the care of children know how to put sick or injured
children, and their parents, at ease.
Whether it’s private rooms where
parents can stay the night or off-site
housing for families of children with
long-term illnesses who live at a distance, such hospitals realize that caring
for children also means close involvement with the entire family. Child-life
specialists help patients and families
understand and prepare for medical
procedures and can provide longerterm support, from school programs to
therapy through play, art or music. The
goal is to provide a bridge between
hospital and home and keep children’s
lives as normal as possible, even if
they need to be hospitalized for an
extended period of time.
Of course, the doctors and other
staff at children’s hospitals also are
experts at diagnosing and treating children with problems from everyday conditions such as asthma to rare diseases,
and they conduct critical research on
pediatric illnesses and treatments.
“We strike a balance between
high-tech and high-touch,” says Kate
Schoen, spokeswoman for the University of California Children’s Hospital in
San Francisco.
These Bay Area hospitals make the
littlest patients their biggest concern.
California Pacific
Medical Center:
■ Has a new six-bed pediatric ER,
the only one in San Francisco, at its
California Street campus (Women &
Children’s Center), which houses all
pediatric and obstetric services.
■ Delivers more than half the babies in
San Francisco, 6,888 last year or nearly
one per hour.
■ Admits 8,500 children each year to
its well-baby nursery, pediatrics unit >>
650.655.7600 | BayAreaParent.com 21
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Many pediatric hospital rooms, such as this one at California Pacific Medical Center, maintain a cheery atmosphere.
more easily than we can. Within a hospital, it’s difficult. Between hospitals, it’s almost impossible,” she adds.
8 Bring a Comfort Item for Your Child
A favorite stuffed animal, blanket or book can help take
your child’s mind off the pain. “You want to give them some
sense of control. They feel they’ve lost control,” Peitz says.
9 Understand There May Be a Good
Reason for the Wait
“One thing I wish patients would understand more is
that we triage patients, and we will see the sickest patients
first,” Mansour says. “We do the best we can to see patients
as quickly as possible.” If your pediatrician calls the hospital
before your arrival, it can also help speed the triage, or sorting, process.
10 Speak Up and Ask Questions
“Parents can count on the fact that we want them to advocate and speak up for their children. They’re the best interpreters of their own children’s needs. We accept that role. Children
often can’t speak up for themselves,” says Rutherford. “Speak
up if they need more pain control, if you don’t think they’re
ready to go home, what you think the crying means. That is
what sometimes makes the difference.”
It also can help to takes notes if you’re feeling overwhelmed, says Peitz. “Don’t be afraid to ask repeated questions. It’s a traumatic situation. They’re completely entitled to
be annoying. It’s their child, we understand that, and we don’t
take offense.”
The bad news, says Rutherford, is that with the likelihood
of ER visits among children, “eventually, you’ll get here.” But
“the good news,” she adds, “is that children are very resilient
and recover extremely well.” ■
Janine DeFao, an associate editor at Bay Area Parent, has had one
emergency room visit, so far, between her two children.
22 Bay Area Parent | October 2009
<< and neonatal and pediatric intensive-care
units as a regional referral center that draws
children from all over Northern California.
Children’s Hospital
& Research Center Oakland:
■ Is the only independent children’s hospital
in Northern California, with 190 beds, a
40-bed emergency room and urgent care,
and 30 specialties including cardiology,
oncology and surgery.
■ Is one of only 49 freestanding children’s
hospitals in the nation.
■ Treats nearly 53,000 children annually in
its emergency room and urgent care clinic,
admits more than 10,000 and has more than
220,000 outpatient visits.
Asthma is one of the leading causes of admission at Children’s Hospital &
■ Has specialty care facilities in Pleasanton,
Research Center in Oakland during the winter.
Walnut Creek, Modesto, Larkspur and
Brentwood.
■ Has one of the nation’s top 10 pediatric research
University of California
institutes, in terms of external award funding from the
San Francisco Children’s Hospital:
National Institutes of Health. Research areas include
pediatric cancer, sickle cell disease and prenatal diag■ Has a 150-bed “children’s hospital within a hospital,”
nostic tests.
with more than 150 experts in more than 40 specialties who treat patients and conduct research. Has more
747 52nd St., Oakland. 510-428-3000,
than 100,000 outpatient and emergency room visits
childrenshospitaloakland.org.
and admits 5,000 children each year.
■ Opened one of the world’s first intensive-care nurserLucille Packard
ies for critically ill newborns and, last year, a neuroChildren’s Hospital at Stanford:
intensive care nursery to prevent and treat neurological
damage in newborns.
■ Has 312 beds, including a seven-bed pediatric emer■ Conducted the world’s first fetal surgery.
gency room.
■ Has the nation’s largest pediatric brain tumor treat■ Admits more than 10,000 children and expectant
ment program and most comprehensive pediatric
mothers each year, delivers more than 5,000 babies and
stroke and cerebrovascular disease center.
treats more than 130,000 patients in clinic visits.
■ Opened a newly renovated, state-of-the art pediatric cancer center in fall 2008, specializing in stem-cell
transplants.
■ Pioneered minimally invasive, “scarless” pediatric
surgery.
■ Specializes in high-risk obstetrics.
■ Has a special Web site for children ages 5-12 with
games, videos and information to help them prepare
for a hospital visit or stay at lpch.org/kids. Cartoons
include getting an x-ray, MRI and IV.
725 Welch Ave., Palo Alto. 650-497-8000, lpch.org.
■ Started a collaboration in 2007 with ValleyCare
Medical Center in Pleasanton that includes a pediatric specialty clinic, prenatal diagnostic center and
UCSF doctors and neonatologists on staff at the
hospital.
■ Is slated to break ground within a year on a new
children’s hospital at Mission Bay, to open in 2014, part
of a three-hospital campus for children, women and
cancer patients.
505 Parnassus Ave., San Francisco. 888-689-UCSF,
ucsfhealth.org/childrens.
650.655.7600 | BayAreaParent.com 23
CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND
3700 California St., San Francisco. 415-6006000, cmpc.org.
SPECIAL ADVERTISING SECTION
Family-Friendly East Bay Hospitals
ALTA BATES SUMMIT
MEDICAL CENTER
Solano County
Alta Bates Campus:
510-204-4444
2450 Ashby Ave.
Berkeley
altabatessummit.org
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Bay Area Parent welcomes you to our Hospital Locator Map. Find the
hospital you want in our listings and match its number on the map for
its location. Please note that locations on the map are not exact and it is
suggested to call the hospital for specific directions.
1
We offer 21 private birthing
suites, 24-hour obstetric anesthesiology service, breastfeeding support program, prenatal
classes, and highly successful
In Vitro Fertilization Program.
Comprehensive services include:
Level III Intensive Care Nursery,
Regional Perinatal Center,
24-hour coverage by perinatologists, neonatalogists and obstetricians, Genetic counseling
and Sweet Success (gestational
diabetes) Program.
Tours available, also in
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include Childbirth Preparation,
Sibling Education, Baby Care,
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Parent and Breast Feeding
Support Groups, Prenatal and
Postpartum Yoga, Outpatient
Lactation Services and Infant
CPR. For information call (510)
204-1334.
Alta Bates Summit offers a
respected team of obstetricians,
pediatricians, anesthesiologists,
midwives and nurses. For a
physician referral, call (510)
869-6777. The team balances
technical skill with care that is
warm and supportive of parents’
choices and needs. Alta Bates
Summit delivers more babies
than any hospital in Northern
California. Visit our website at
altabatessummit.org.
CHILDREN’S HOSPITAL
& RESEARCH CENTER
OAKLAND
2
510-428-3000
747 52nd St.
Oakland
childrenshospitaloakland.org
An independent, freestanding
24 Bay Area Parent | October 2009
SPECIAL ADVERTISING SECTION
pediatric medical center that has
served Northern California since
1912. Children’s devotes 100%
of its resources to kids.
Comprehensive services include
hematology/oncology, cardiology and cardiothoracic surgery,
orthopedics and sports medicine
for young athletes, general surgery
and neurosurgery, neurology and
top asthma management in our
pulmonary medicine department.
We house a national sickle cell
center and have the only inpatient
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Northern California.
Our emergency department and level 1 trauma center
operate the busiest pediatric
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California. We also offer the
expertise that comes from being
a teaching hospital, with 80 residents, and having a world-class
research center with a $50-million-a-year budget. With Child
Life services and a fully accredited hospital school, Children’s
is the best place for kids in
Northern California. Please call
us for more information.
EDEN MEDICAL CENTER
Eden Campus:
510-537-1234
20103 Lake Chabot Rd.
Castro Valley
edenmedcenter.org
3
San Leandro Campus:
510-357-6500
13855 East 14th St.
San Leandro
sanleandrohospital.org
4
An entire floor dedicated
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C-section room, completely
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To schedule a tour call
(510)889-5078.
Monthly Pregnancy Forums,
Childbirth Preparation, Baby
Care, Sibling Celebration (for
the
brothers and sisters to be),
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5
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3901 Lone Tree Way
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sutterdelta.org; 800-4SUTTER
A brand new, state-of-the-art
Women’s Health Center was
opened in 2005, offering a
comfortable home-like setting
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Patients cared for in the Center
include women who are receiving either obstetrical or gynecological services.
These patients include such
things as normal delivery, high
risk pregnancy, operative deliveries (C-sections), hysterectomy
D&C, laparoscopy and tubal
ligations. In addition, a Level II
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6
925-847-3000
5555 W. Las Positas
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valleycare.com
Family-centered birthcenter,
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Childbirth classes, infant CPR,
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during pregnancy classes. For
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tour, call (800) 719-9111 or visit
our website at valleycare.com.
(925) 299-2660
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