Dr. Claire McCarthy is a primary care physician and the Medical Communications Editor at Boston Children’s Hospital. Along with her blogs here on Thriving, you can find her at the Huffington Post and Boston.com. Follow her on Twitter @drClaire.
I had never had to make a decision like this before—all of our emergencies had happened at home, near Boston Children’s. Was it okay to go to the community hospital? Was there a hospital nearby that had pediatric expertise?
We don’t usually think about the kind of hospital and its areas of expertise when we go to an emergency room. By definition, it’s, well, an emergency. You think: Hospital. Nearest. Now.
But not all hospitals are the same and some are better prepared to handle pediatric emergencies. Kids are not small adults. They often need different medications, different equipment (even smaller tubes for blood tests, so you don’t have to take so much blood!) and sometimes a different level of expertise. Making diagnoses can be tricky with kids who can’t explain what they are feeling, or just may have different symptoms than grownups. Then there are the childhood conditions that not all physicians may not be as familiar with, like bronchiolitis or the rashes of childhood. Or the ways a seemingly simple injury can be more complex in a still-growing child when the injury affects the growth plate. And anyone who has held a panicky kid still for a shot or to get their ears checked knows that they need a different, um, approach than adults. Pediatric providers are trained to recognize those subtle cues, and specialize in a kid-centric approach.
I realized, as I thought about it, that stitches are something that can be done at a community hospital. But I also realized that I needed to do my homework and find out about hospitals in the area—because some illnesses and injuries really do need pediatric expertise.
And while we don’t like to think about it, sometimes even seemingly simple things get complicated. Sometimes a specialist is needed, like a pediatric orthopedist or hematologist. Not every hospital has pediatric specialists or an affiliation with a hospital to provide consultation. And if that emergency room visit leads to an admission (like it did for us when Elsa was a baby and her fever turned out to be meningitis), you really want to be somewhere that has a good pediatric inpatient staff.
For children with special health care needs, like asthma or diabetes or heart defects, emergency care can be more complicated. Those families need to go somewhere with lots of pediatric expertise and specialists who understand their unique needs.
We don’t like to plan for emergencies beyond sticking the number for the pediatrician and maybe the poison center on the bulletin board by the phone. It feels like, I don’t know, tempting fate. But a little bit of planning for the possibility of an emergency room visit can go a long way.
Here are some suggestions:
- Since your pediatrician knows your child’s medical needs best, get his or her advice about where you should go in an emergency.
- Check out the hospitals around you. Find out which ones have special pediatric expertise, both in the emergency room and inpatient unit.
- Put the address of the hospital(s) you want to go to in your GPS device before an emergency happens. The last thing you want to be doing in the midst of an emergency is hunting down an address.
- If your child’s school or childcare is far from your house, do some investigating about the hospitals in that area. Same applies if their sports take you outside your neighborhood.
- Before you go on vacation, do some homework and figure out which hospital you would go to if necessary
They say that bringing an umbrella on a cloudy day keeps the rain away—maybe being prepared for an emergency will keep the emergencies away. But if it doesn’t, and you find yourself in the car with a hurt or really sick child, think of how much better you will feel knowing you are on your way to the best place to care for your child.
In the event of an emergency, Boston Children’s Hospital has pediatric providers in emergency departments throughout Massachusetts:
Beverly Hospital: 85 Herrick Street, Beverly, MA (978-922-3000)
Boston Children’s Hospital: 300 Longwood Ave, Boston, MA (617-355-6611)
Norwood Hospital: 800 Washington Street, Norwood, MA (781-769-4000)
South Shore Hospital: 55 Fogg Road South, Weymouth, MA (781-624-8000)
Winchester Hospital: 41 Highland Avenue , Winchester, MA (781-729-9000)