Saturday, February 13, 2010

What happens in the emergency depatment?

Ok so now you've gotten your child to the ED. What now? What are they doing to do to him?

The ED can be a scary place, especially if you've never been there before. Most pediatric EDs have toys and entertainment to make the experience less scary for kids but it doesn't always make the parents less scared!

When you come into the ED with your child, the first person you will encounter is usually a secretary or a greeter. They will ask you your child's name and why you are bringing her in. If your child comes in by ambulance, the ambulance personel will give the greeter this information.

The next person you will encounter is the triage nurse. This nurse will ask you about your child's symptoms. medical history, allergies and medications your child takes. It is very important to know your child's medical history. The ED personnel may not have access to your child's medical records and if your child takes medications everyday or has allergies this information can be crucial to your child's treatment.

It is always very important to tell the triage nurse everything. Don't think you will "save it for the doctor" because the triage nurse is the person who decides how serious your child's problem is. If you do not tell the triage nurse everything about your child's problem then they may be put farther back in line than they should be. Don't lie to make the problem sound worse than it is, just be honest and share all the information with the nurse.

The next thing that will happen is you may be sent back to the waiting room or put into a room. Most emergency departments are very overcrowded and a room may not be always available for your child. Please be patient- the staff is moving as fast as they can and the sickest kids are seen first.  Some EDs are very crowded and the wait time can be several hours. We try to avoid this, but it does happen.

Once you are in a room, you will be assigned a nurse. This is the person who will give your child medications, start an IV if necessary and monitor your child's condition while she is in the ED. If her condition changes, be sure to tell your child's nurse.

Your child will be seen be a provider next. This may be a physician, a nurse practitioner or a physician assistant. Most teaching hospitals have residents working in the ED. These are physicians who are undergoing further training in a specialty such as emergency medicine or pediatrics. They are doctors who work under the supervision of an attending physician. Nurse practitioners (NP)  and physician assistants (PA) may or may not see your child. If your child is seen by a NP or PA, they may or may not also be seen by an attending. There is always an attending available in the emergency department so if you have any concerns, you always have the right to ask to see the attending.

You may feel like the same questions are asked over and over again. This is probably true. However, it's important to make sure we have all the information so please bear with us..

Once your child is seen and examined, you should be given an idea of what will happen next. If you child needs a test, blood work, medication, feel free to ask any questions. It is very important that you understand what is being told to you. If you do not understand it is perfectly ok to ask questions. We would much rather spend 15 minutes explaining something to you than you not know what is going on with your child.

Stay tuned.. tomorrow I will talk about the people you might see in the emergency department.


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