Pediatric-Ready ERs Save Lives
January 15th, 2020
Children account for over 30 million emergency department visits each year, and most of these visits occur in general emergency departments that may not be equipped to handle pediatric emergencies. According to an analysis published in the journal Pediatrics, critically ill children brought to hospital emergency departments that are ill-prepared to care for pediatric emergencies have more than three times the odds of dying compared to those brought to hospitals well-equipped to care for them.
University of Pittsburgh researcher Jeremy Kahn, MD, MS, and his team obtained data from 426 hospitals in the United States on 20,483 critically ill patients age 18 or younger who were brought to the hospital emergency department. They cross-referenced the patient outcomes with the “pediatric readiness” score of the hospital’s emergency department and found that hospitals in the low-scored groups had a pediatric death rate for critically ill children of 11.1%, compared to 3.4% for the highest-scored groups. Pediatric readiness is a score based on several factors, including hospital equipment designed for use on children, pediatric-specific protocols for medical procedures and care, and educational programming to keep clinicians up-to-date on the latest guidelines in pediatric care.
The results have important implications for pediatric emergency and critical care. “Our findings indicate that it matters which hospital a critically ill or injured child is brought to in an emergency,” said co-author Jennifer Marin, MD, MSc. However, Dr. Marin explained that many questions remain when trying to improve care, “Should we focus only on improving the pediatric readiness of all hospitals, potentially investing money and resources in hospitals that rarely see children? Or should we do more to direct pediatric emergencies to hospitals well-equipped to care for them, potentially increasing transport times?” she asked. “Some combination will likely be needed and potential solutions also could incorporate telemedicine and processes to promote quick recognition and transfer of pediatric emergencies to more prepared hospitals.”
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