9 Pediatric Emergency Essentials
Of the nation's more than 5,700 hospitals, only about 250 are children's hospitals, and these tend to be clustered in major cities or towns with large universities. Translation? Just 7 percent of ER visits by children are to these specialized medical centers. A big reason: In most states, one quarter to one third of the population lives in rural areas. And unlike city kids, who often have easy access to multiple hospitals, children in the countryside face longer trips to get help, and once there, they're less likely to be treated by a pediatric specialist.
Ted Humphry, M.D., has been a pediatrician in rural Humboldt County, CA, for more than 30 years, and knows the challenges all too well. "We have three hospitals in the county, and none has a pediatric trauma center. But we do pediatric trauma because we have to," says Dr. Humphry. "We just have the bare essentials for stabilizing and arranging for transport." It's often a minimum delay of five or six hours before a child gets to one of the bigger hospitals, he says.
Urban hospitals have their own set of unique challenges when it comes to caring for their youngest (and actually, all) patients. A full two thirds of urban ERs operate over capacity, according to the American Hospital Association, and more than half of those practice "diversion," where they close their ERs to ambulances for periods of time. "ERs are hopelessly overcrowded, and the world's best triage nurse isn't going to be doing his job as well as he can if there are fifty people waiting," says Dr. Krug.
Brandy Nannini, who lives just outside Washington, DC, experienced the harrowing fear of diversion last year when her then 1-year-old daughter, who has a chromosomal disorder, had a seizure. She requested to go to the city hospital where her daughter's doctor was based but discovered its ER was closed. "My daughter was blue and looked like she was dying," she says. "We ultimately had to go to the little community hospital down the street. The doctors were able to stabilize her, but it was obvious we made them nervous. Besides her being so young, she's got a complicated medical condition, and you could tell she wasn't the type of patient they see every day," she says.
Still, Nannini is grateful they were able to get in when they did -- half an hour after they arrived, that emergency room closed down as well. "I wasn't able to stop being upset about the diversion until hours later, when Isabella was finally transferred to the medical center. I'd never seen anything like it: There were gurneys everywhere, people with major trauma, horrible flu. They really didn't have any room for us earlier."