When your child has an emergency condition and needs treatment right now, you don’t have time to research the local emergency rooms to find those which are experienced with and ready to handle pediatric emergencies. Even if you know that there is a children’s hospital in town, it may be too far away. But wait you say, aren’t all emergency rooms ready and able to successfully treat my child? Sadly, the answer is that they are not and there is almost no way for you to figure this out in advance.
Children are not miniature adults. They have different anatomy than adults. They have different diseases and medical conditions than adults. They often need different medical equipment than adults. They may need different medications than adults and, even when the medication is the same, the appropriate dosage will be quite different and may be hard to determine quickly. Even in a busy emergency department, a well-trained emergency medicine doctor may not have that much experience with children and their unique illnesses. Study after study has shown that the more experience a physician has with any task, the better they perform it. It is very easy for even a well-trained doctor to fail to recognize the difference between a routine childhood illness and a life-threatening one.
Almost no states require emergency departments to be ready and trained to deal with pediatric emergencies. The few that do do not uniformly enforce their requirements. The federal government has created an assessment tool to identify which hospitals are ready for children and over 70% of the hospitals in the United States have completed the assessment. Unfortunately, the results for individual hospitals are confidential so you cannot find out which hospitals in your area are ready to treat children and which are not. And the readiness of the hospital has real life consequences.
Children are four times more likely to die in an emergency department that is not set up and trained to deal with them. According to a study published in the on line medical journal JAMA Network Open, between 2012 and 2017, about 1,440 children died because the emergency department to which they were taken was not equipped and trained to treat them. Even more children have survived, but have been left with serious, long-term health issues related to care given in an unprepared ER.
In the absence of state mandates, hospitals have little incentive to spend money on training and special equipment to beef up the ability of their emergency departments to treat children successfully. It is always about the money. We need to insist that the states mandate certain minimum levels of training and equipment for pediatric patients. We need to insist that those standards be enforced. Finally, we need to insist that hospitals or the state publish a list of hospitals and their degree of preparedness for pediatric emergencies. No hospital wants its name on a list that shows it is unprepared for pediatric emergencies. On the other hand, if we do nothing, nothing is likely to change and children will continue to die or be injured because emergency departments are not ready for them.
