Most ERs Not Fully Prepared for Pediatric Patients

Most ERs Not Fully Prepared for Pediatric Patients
MONDAY, Dec. 3 (HealthDay News) -- Parents who find themselvesrushing a child to the nearest emergency room might want to keep a newfinding in mind: Only 6 percent of emergency rooms in the United Stateshave all the equipment they should have on hand to treat youngsters.
Many hospitals declined to respond to the survey, however, so the UCLAresearchers suspect the true number of centers that don't meetrecommendations might be even higher.
Among other deficiencies, hospitals failed to have a variety of devicesgeared toward infants and newborn babies, according to the survey, whichis published in the December issue of Pediatrics.
The survey doesn't address the issue of whether hospitals with lessappropriate equipment provide substandard services to kids, noted Dr.Karen Sheehan, medical director of Injury Prevention and Research atChildren's Memorial Hospital in Chicago. "But if you don't have equipmentsmall enough for a child, it is not a big leap to think this may affect achild's care."
Surveys were sent in 2003 to 5,144 emergency rooms around the UnitedStates, asking about what equipment was geared toward the proper treatmentof children. The researchers wanted to know if the hospitals werefollowing 2001 guidelines regarding pediatric care that were released bythe American Academy of Pediatrics and the American College of EmergencyPhysicians.
According to the study, only 11 percent of emergency room visits bykids occur in hospitals specifically designed to treat children. The restend up in regular emergency rooms.
The emergency rooms contacted by the researchers only returned 1,489surveys, a response rate of 29 percent. Officials at 59 percent of theemergency room departments that responded said they were aware of the 2001guidelines, but many didn't follow them completely.
Just half of the hospitals surveyed had so-called laryngeal maskairways on hand for children. The masks, equipped with tubes, allowpatients to breathe when their airway may be obstructed.
The study authors noted that the survey response rate was low andpointed out that hospitals that did respond tended to deal with highernumbers of pediatric patients. So, the authors wrote, it's possible thatemergency rooms as a whole may be doing a worse job of following theguidelines.
The authors add that "much work is left to be done to improve pediatricpreparedness of [emergency rooms]."
The American College of Emergency Physicians was quick to respond tothe 6 percent statistic, which it called "misleading."
In a statement released Monday, the group cited studies that "show 95percent of children who come to emergency departments are treatedsuccessfully and released. This raises the question of whether the list ofequipment is too extensive, since emergency departments use it as aguideline, and the universal good outcomes seem to indicate thatphysicians are making the necessary adjustments."
Sheehan also noted there are some caveats to the study. "In allfairness, many guidelines come out each year, so it is challenging to keepup with them all," she said.
Also, some hospitals may see comparably few young patients each day,and "it may be hard to devote limited resources to serving relatively fewchildren," she added.
Still, she said, "we need to assure we can provide excellent emergencycare for children in whatever type of emergency department they areseen."
Parents have their own role to play when it comes to emergency care,said Dr. James G. Linakis, a pediatric emergency physician at HasbroChildren's Hospital in Providence, R.I. "They should carefully evaluatewhat kind of emergency services are available to them. The time to do thatis before their child needs an emergency department."
The best choice is typically an emergency room that sees the mostchildren, he said. "If there are pediatric emergency medicine specialistson staff, that can be a real plus. If not, they should look for anemergency department staffed by physicians trained in emergency medicine.Often, a brief discussion with the child's primary-care provider will helpparents determine which emergency department is most suitable foremergency care of their child."