The Emergency Department: Children and Emergency

July 29, 2019| Health and Wellbeing /

Being ill can be quite a distressing time for children, but our Richmond Emergency Department is open and here to reassure you 24/7.

We spoke with Jen, an Emergency Physician at Epworth Richmond to talk us through all things Emergency Department (ED) and children.

When should you take a child to the emergency department instead of the GP?

You should take your child to the emergency department if you’re worried about your child. We know that parents are usually the best judge about whether their child is sick or well or hurt or just not quite right, or just not acting like their usual self. If you can get in and see your GP pretty quickly and be assured by that, that’s great. But if you can’t get in and see your GP then we’re here 24/7, open for business and always happy to see children and provide reassurance or treatment or investigations or tests; whatever is necessary.

What would you find are the most common reasons that children end up in the emergency department?

It sort of depends a little bit on the age group of the child. Certainly in the smaller group, so babies into toddlers, we see a lot of children with fevers, and sometimes it can be a bit of a hassle trying to figure out what’s wrong with them and figuring out whether it’s just a simple cold or virus affecting their upper respiratory tract, or something more serious. So fevers are common, gastro is common, coughs and colds and bronchitis are common. Infections that have been picked up from daycare or school, we see a lot of those. We also see a lot of the accident side, so broken bones, trips, twists, falls, cuts and lacerations.

When a parent is on their way to the emergency department with the child, who could be a bit distressed, what would you recommend?

Yes, so you can certainly try and prepare them and prepare their expectations for what they’re going to find and experience in the emergency department. We always recommend that if you can, parents bring in things that might comfort the child; their special blanket or their special teddy bear. If they feel safe and comfortable and able to sleep in their pram or stroller then by all means bring that in as well. What we would tell them to expect would be that you’ll be seen by a doctor and a nurse, they might have some special machines to check things like your heart rate and/or temperature, they might give you some medications to make you feel better, and we might do some tests, so we might take an x-ray or catch a sample of your wee.

What will happen when you arrive at the emergency department?

First things first, when you arrive at the emergency department you’ll see a triage nurse first. They’ll do a quick assessment, maybe check some vital signs, decide whether the child is really sick or really injured and how urgently they need to be seen and sorted out. After that, usually, we’ll grab some details off mum or dad, or whoever is with the child. So, name, date of birth, medicare card, private health insurance and the GP’s details; they’re quite important because we like to make sure the GP is really kept in the loop about what’s happening. Shortly after that you might go through to our waiting room or you might get brought straight through to the paediatric area of the emergency department. We’ve got four beds and a treatment room tucked around the corner specifically staffed with paediatric trained nurses and dedicated doctors on shifts allocated to see the children as they come in.

When you do arrive, will there be a long wait or do children have priority?

We’re pretty good at getting our children seen and sorted out. We know that it’s a potentially distressing time for them and we like to try and prioritise them. Usually, once we’ve seen them at the triage area we’ll do whatever we can to get them into the department and treated from there. That might mean getting some pain relief on board, particularly in the case of broken bones or injuries. Or, something maybe to help with nausea and vomiting. We like to get things started and started quickly.

Can a parent accompany a child the whole way through?

Yes, absolutely. We would certainly encourage that as it’s going to be best for the kid and best for the parent as well. Mums and dads can go with their kid, they can go with them to the x-ray, they can pop on a lead apron and ‘have their picture taken at the same time’. That’s always reassuring. We would always encourage them to stay and stick around.

And that would be the same if the child had to stay overnight?

If a child gets admitted then they (parents) can stay overnight in the same room. I know that they provide sleeping arrangements and meals and everything. That certainly helps reassure children as well that they won’t be separated from mum or dad.

What happens after leaving the emergency department?

If a child gets admitted they’ll be brought up to our paediatric ward which is also staffed by our dedicated paediatric nurses and our paediatric medical and surgical doctors. Their treatment will continue, depending on what their problem is. If children are sent home then we try and make sure they are followed up and seen by someone. That might be a GP, so a letter will go off to the GP explaining what we’ve seen and what we’ve done. We certainly encourage parents to take their children to the GP as a follow up to make sure treatment is helping and to make sure they’re getting better. Sometimes we arrange for people to come back into the emergency department to be reviewed by us, ideally by the same doctor, so as to make sure that treatment is working and the child is getting better and they’re comfortable. If we do a plaster, for example, we might bring people back for a plaster check the following day just to make sure it’s not too tight and that it fits correctly.

What would you say are the difference between going to a public and a private emergency department?

So, overall I would say our private emergency department is a calm and quiet place - most of the time. We know that our children’s hospital provides a great service to the children of Victoria but it’s often very busy and often people are quite concerned about the amount of time that they might spend waiting to be seen by a doctor or a nurse. If you’re sick, you’re sick. You’ll pretty much get seen straight away, but for people who might not needing to be seen quite as urgently they might be waiting quite a long time. So what we try to do here at Epworth is try and see our children as a priority and get them sorted out regardless of what they’ve presented with.



Epworth

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