The holiday season is a busy time of year for emergency departments. It’s a common time for slips, falls, and other accidents (see last Thursday’s PediaBlog “Have A Safe Holiday”), injuries, and illnesses. In this region, parainfluenza virus (croup) is finally being nudged aside by respiratory syncytial virus (RSV, bronchiolitis) and influenza virus (the “flu”, aka the worst cold-cough-sore throat-headache-fever-all-at-once you will ever encounter). Your pediatrician’s office has been packed with children suffering from acute infectious illnesses (aside from the illnesses mentioned, there is also a nasty gastrointestinal bug going around right now) and injuries, as well as babies in need of their vaccinations and college students home for the holidays squeezing in their annual checkups. But it’s the local emergency departments that see perhaps the most action. Julie Beck reminds us that not all ER’s are equal, especially when it comes to emergency pediatric care:

There is still no common definition of a pediatric emergency room. This isn’t just about doctors; equipment in any given ER is not necessarily appropriate for small children. According to the R Baby Foundation data, only six percent of ERs in the United States have the necessary supplies to treat pediatric emergencies.


It’s also important to remember that while your pediatrician’s office isn’t an emergency room, neither is your neighborhood “Doc-in-the-Box”-on-every-corner. Where you choose to go can have enormous health and financial benefits… and consequences. (From my long experience, mostly consequences. With prevention always being preferable to being sick or seeking emergency intervention, now would be a good time to reconsider that flu shot you may have refused for your child the last time you were in the office.) If you need to take yourself or a loved-one to an emergency department, go prepared to wait; to give a full and detailed medical history, including what medicine(s) at what dose(s) are being taken; to be subject to one or several tests and interventions that may be painful (and expensive); and to be bombarded with large volumes of information and treatment recommendations. Beck spoke to a mother who also happens to be a pediatric nurse practitioner for some advice:

Her list includes something to occupy the child. “An iPad and a charger can go a long way, especially if the ER is backed up – this will help to keep your child calm and busy,” she said.

She also said it’s important for parents to be prepared with information. “You will be asked a million questions and it’s all in the details,” Chan said. “Write things down or even record with your phone or video.


Beck turns us on to a terrific resource for parents — the RBaby Foundation — for a breakdown of various emergency room services:

There are many options for places that take care of babies. It’s important for you to know what your local options are. These may include:

  • general emergency rooms
  • pediatric emergency rooms within general emergency departments
  • pediatric emergency departments within children’s hospitals


Although routine testing and evaluation of a sick baby is provided in all emergency rooms, experience with newborns and ready availability of services, specialties and even equipment can and do vary between emergency rooms.


Infants and children are not little adults. They have unique medical problems, unique diagnostic and treatment requirements, and unique outcomes. That’s why choosing the right providers to care for your precious offspring is so critical. That’s why care should be taken when heading out for emergency care:

Familiarizing yourself with all of your options for emergency care will help you make the best decision for your baby, should an emergency arise. Pediatric ER’s offer specialized services that may not be available in general emergency rooms.

Pediatric emergency rooms are staffed by physicians, nurses and other health professionals who are specially trained in treating children. In addition to general pediatricians, pediatric ERs often have doctors who have completed a fellowship in pediatric emergency medicine. This type of fellowship is an advanced medical training program, lasting three years, offered to physicians who have completed a residency in pediatrics or emergency medicine.

  • Pediatricians focus on the overall healthcare of babies and children.
  • ER physicians focus on birth to death healthcare for emergencies.
  • Pediatric emergency medicine physicians have specialized training in both pediatrics and emergencies.


Click here for a more detailed look at these other tips for pediatric emergency room care from RBaby Foundation:

  • Investigate and make note of the types of services (pediatric or general care) available at your local hospitals. Make note of the location of the nearest pediatric ER. Not all Doctors practice at all local hospitals.
  • Discuss with your pediatrician which hospitals they are affiliated with, whether this is a pediatric ER, and what their local ER recommendations are in the event of an emergency.
  • Familiarize yourself with the location of the ER that is closest to you.
  • Map your route to the nearest ER and the nearest pediatric ER, in case of emergency.


Finally, know when you can safely drive your baby or child for emergency care yourself versus when you need to call for help by summoning an ambulance for emergency medical services. Calling your pediatrician’s office will help you make that determination if you’re just not sure, however, a good rule of thumb is, “When in doubt, call 911.”

Be careful out there!


(Google Images)