Emergency Medical Care for Children

"Children are not small adults," states Dr. Mary Christine Bailey, Medical Director of Newton Wellesley Hospital's new Pediatric Emergency Department. "Children have a unique physiology", explains Dr. Bailey. "They respond differently to trauma, medications and clinical interventions." Bailey, who is also a Board Certified Pediatrician, has undergone fellowship training to become Sub-boarded in Pediatric Emergency Medicine. She is one of three such specialists staffing this new and unique community hospital emergency department specifically designed for infants, children and adolescents.

Any parent, who has rushed their child to an emergency room, can testify that children's needs go far beyond the physical in their experience of an acute illness or traumatic injury. A child's age, size and stage of physical, emotional and intellectual development plays a major role in their responses to every experience, especially a crisis. Surprisingly, widespread recognition of the unique emergency medical needs of children is relatively new. In the early 1980s, the American Academy of Pediatrics (AAP) among other professional groups and organizations, began to actively address both the emergency health care needs of children and ways to create services which would better meet these needs. In 1981, the AAP founded a special section of its organization on Emergency Medicine with the purpose of "… providing a forum for the discussion of problems relating to the treatment and care of pediatric cases in the emergency department" and a mission "to sustain, develop and promote the delivery of optimal emergency care for acutely ill and injured children and adolescents."

Optimal Emergency Care for Children
Newton-Wellesley's Pediatric Emergency Department serves as a good example of recommendations for optimal pediatric emergency care put forth by the American Academy of Pediatrics. The Pediatric Emergency Department, a division of the Hospital's general Emergency Department, is open from noon to midnight, the peak hours for children's medical emergencies. Pediatric Emergency Medicine specialists, who understand and are trained in the unique physiologic and psychosocial needs of children, staff the department.

The typical bright lights, décor and activity of a hospital emergency room can often be disturbing for children. Because of this, Newton-Wellesley's Pediatric Emergency Department maintains a separate waiting room, specially designed to be "child friendly". The department also includes a separate suite of four private treatment rooms, again with an emphasis on reducing fear and anxiety as much as possible. Newton-Wellesley's pediatric emergency suite also enables comprehensive, ongoing monitoring of pediatric patients.

Community hospitals such as Newton-Wellesley offer exceptional convenience for suburban patients, a majority of whom are families with children. However, as a "Summary of Findings in Emergency Medicine", published by the AAP reports, it is typical for Pediatric Emergency Medicine Physicians to practice at urban, medical school sites. In an effort to advance the sophistication of services generally offered by community hospitals, Newton-Wellesley is unique in its creation of a Pediatric Emergency Department staffed by Emergency Medicine Physicians. Newton-Wellesley Hospital also excels in its comprehensive pediatric care by providing other on-site pediatric sub specialists such as pediatric cardiologists, radiologists, gastroenterologists and others available for follow-up care. Pediatric Surgeons are available on-call 24 hours a day, 7 days a week for surgical emergencies.

Newton-Wellesley's Pediatric Emergency Department brings advanced, urban teaching hospital expertise to a community hospital setting in other significant ways. The Department features a telemedicine link to the Pediatric Intensive Care Unit at the MassGeneral Hospital for Children in Boston. This link enables that site's Pediatric Intensive Care Physicians to observe Newton-Wellesley's critically ill pediatric emergency patients in real-time. This valuable telemedicine link also provides Newton-Wellesley's Emergency Department physicians with access to immediate, intensive care specialist consultations and assistance.

Emergency Equipment and Medications for Children
As lay people, much of what we know about emergency medical care we've learned by watching television programs such as "ER". We have seen the defibrillator paddles placed on a patient's chest and used to revive a heartbeat. We have witnessed intubations when an emergency room patient needs assistance breathing and an endotracheal tube is placed in a patient's airway. We have watched as splints are attached to broken bones. We have seen the program's physicians reacting without a moment's hesitation to shout-out orders for the exact amount and type of medication needed by a severely injured patient.

The emergency room equipment we see on television is, in fact, identical to the equipment used in real emergency rooms. But, if we replaced that television program's adult patients with children, it would become immediately apparent that much of that equipment is inappropriate for use with children. The defibrillator paddles, endotracheal tubes, oxygen masks, splints, catheters, blood pressure cuffs and much more, are not sized for children. The availability of proper equipment is a major benefit of a pediatric emergency facility.

Similarly, most medications are developed specifically for adults. Because the number of children who may use particular medications and the duration of their use are limited, most drug manufacturers do not conduct clinical trials using children. Consequently, these medications do not come with manufacturers' recommendations for use by and dosages for children. However, within the professional pediatric community, studies are done regarding medications and their use with children. Pediatric specialists know this information, and are capable of shouting-out those orders with the same speed as "ER's" actors. This is another major benefit of access to specialized pediatric emergency care.

According to the federal government's Child and Adolescent Emergency Department Visit Data Book, published by Emergency Medical Services for Children, "There are more than 31 million child and adolescent visits to emergency departments every year, corresponding to a rate of nearly 42 children per every 100 emergency patients". Nearly 18% of these visits are injury related.

Children represent the largest population of hospital emergency department patients. Improvements in providing appropriate emergency medical treatment for children are being made nationwide. And yet, according to the Consumer Product Safety Commission, "Less than 10% [of the nations' hospitals] have pediatric emergency departments". Clearly families living in the suburban communities west of Boston are fortunate to have access to the new, state-of-the-art Pediatric Emergency Department at Newton-Wellesley Hospital.


This material is intended to provide general educational information and to help users arrange more easily for health care services. This site is not an attempt to practice medicine or provide specific medical advice and should not be used to make a diagnosis or to replace or overrule a qualified health care provider's judgment. Nor should users rely upon this information if they need emergency medical treatment. We strongly encourage users to consult with a qualified health care professional for answers to personal questions.






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