Stand alone peds ER's in So Cal.

[Level1pedstech]

There are of course the big players like LA childrens,OC childrens and others but what about the smaller facilities that have dedicated peds ER's. Many of the smaller ER's mix patients which is fine but having worked in both I can tell you that overall the experience for the patient and family is generally going to be better in an ER that is totally focused on pediatric emergency medicine.

My question is what hospitals can you think of that have ER's dedicated to only peds. These could be ER's that have one side for adults and one for peds or facilities that have a seperate ER totally dedicated to peds. Looking from Santa Barbara to San Diego. Please include your thoughts on dealings with these facilities if you wish.

 

[JPINFV]

CHOC and CHOC at Mission Hospital (Mission Viejo) both maintain their peds ED as side-by-side facilities at the partner acute care hospital (St. Joseph Hospital and Mission Viejo Medical Center respectively). While UCI has a large peds service, I don't think they separate their ED in the same vein as the CHOC hospitals. I don't consider the side-by-side EDs to really be dedicated only to peds as it's basically used in the same sense that trauma centers have bays dedicated to trauma patients, but aren't considered a stand alone trauma-only ED. Similarly, I think all EDs should be able to handle both peds and adults. Sure, the pediatric patient may need to be transferred to be admitted, to a specialtiy hospital (CHOC or Children's Hospital at UCI), but all EDs should be required to be ready to treat children.

 

[adamjh3]

In San Diego I don't know of any that separate peds and adults except for maybe the Balboa Naval hospital, but I haven't been there in quite a while. Rady's Children's hospital is Peds only. It's been an awesome experience every time I've gone there. From a strictly professional point of view the staff is always extremely friendly and treats the kids like kids, not little adults. As far as the actual quality of treatment I can't comment because frankly at my level of education I wouldn't know good from bad care unless there was something grossly wrong.

It is a level 1 trauma center

 

[DesertMedic66]

Loma Linda University Medical Center (LLUMC) has an ER for adults and a separate ER for peds. You have to walk through the adult ER to get to the Peds ER.

 

[Level1pedstech]

CHOC and CHOC at Mission Hospital (Mission Viejo) both maintain their peds ED as side-by-side facilities at the partner acute care hospital (St. Joseph Hospital and Mission Viejo Medical Center respectively). While UCI has a large peds service, I don't think they separate their ED in the same vein as the CHOC hospitals. I don't consider the side-by-side EDs to really be dedicated only to peds as it's basically used in the same sense that trauma centers have bays dedicated to trauma patients, but aren't considered a stand alone trauma-only ED. Similarly, I think all EDs should be able to handle both peds and adults. Sure, the pediatric patient may need to be transferred to be admitted, to a specialtiy hospital (CHOC or Children's Hospital at UCI), but all EDs should be required to be ready to treat children.

We had a true side by side set up with dedicated peds providers offering care from 1200-0200 after hours peds were seen on the adult side which is when I noticed problems. Having a sick child and their family exposed to the never ending conga line of your typical inner city after hours ER patients was one thing that I never really cared for. We did eventually go stand alone 24/7 but still within ear shot of all the commotion next door. Thankfully they are now safely tucked away in their brand new childrens hospital.

In general dual function ER's are more than able to provide care for for their pediatric patients. The quality of that care is quite often not as good I know from observing trauma transfers from smaller 1's and 2's to our level one. My point is how much the attending staff from techs to the attending ED MD's are into treating even the most basic pediatric patient. Facilities that are true stand alone are more likely staffed from top to bottom with providers who have as their number one goal to provide the best care possible for kids. These people like kids and are comfortable with all the issues that come with caring for them. Experience both in the ER and in the field has shown me that there are providers at all levels that may have the education and skills to treat peds but its not always pleasant for either the patient,provider or family. Quality care but care that might not offer that little extra you find in a stand alone.

My goal when I started working in the ER was to get as much pediatric experience and knowledge as I could then take that back and help make better field providers. We all know there are people in every area of medicine that are uncomfortable around children when they are just needing a nap. The same people are then asked to deal with a very sick child and that very sick childs family or caregivers and it can get ugly. There is nothing like working in a room full of people that you know are all 100 percent within their comfort zone.

 

[Level1pedstech]

In San Diego I don't know of any that separate peds and adults except for maybe the Balboa Naval hospital, but I haven't been there in quite a while. Rady's Children's hospital is Peds only. It's been an awesome experience every time I've gone there. From a strictly professional point of view the staff is always extremely friendly and treats the kids like kids, not little adults. As far as the actual quality of treatment I can't comment because frankly at my level of education I wouldn't know good from bad care unless there was something grossly wrong.

It is a level 1 trauma center

Treating "kids like kids not little adults" is something we should have all been taught as basics but sadly its often lacking even at the highest level of providers. Great observation.