Medical groups sound alarm on emergency care for kids
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Illustration: Annelise Capossela/Axios
Outbreaks linked to declining vaccination rates are threatening to overwhelm hospital emergency departments — most of which aren't fully prepared to treat sick kids.
Why it matters: More than 35 million children are taken to emergency rooms each year, but most go to local hospitals that see fewer than 10 children a day.
- Only about 17% of hospitals met standards for high pediatric readiness in the most recent national study of nearly 5,000 emergency departments.
Driving the news: Medical groups including the American Academy of Pediatrics and American College of Emergency Physicians on Tuesday released updated guidelines for pediatric emergency care.
- The groups say the recommendations could save an additional 2,100 lives annually if adopted.
What they're saying: "When families see a large sign that says 'emergency,' there is an assumption that they can handle any emergency," said Katherine Remick, an associate professor of pediatrics at the University of Texas at Austin and lead author of the new standards.
- But emergency rooms that are behind the times "will struggle to be able to effectively care for those most critical children," she told Axios.
Between the lines: The revised standards come after studies showed hospital pediatric readiness stagnated from 2013 to 2021.
- There's also been a steady decline in pediatric inpatient services and consolidation of pediatric admissions in urban hospitals over the past decade that's resulting in longer travel distances for these services.
- Children's health has declined overall in the U.S. over the past 17 years as these trends have taken hold.
Zoom in: The new recommendations say emergency departments should periodically assess all staff members' knowledge of child-specific emergency care, keep a portable pediatric resuscitation cart ready and come up with a triage system specific to kids.
- ERs should also appoint nurse and physician pediatric care coordinators.
- That recommendation has been made before — and 42% of emergency rooms met the guidelines in 2013. But that dropped to less than 30% during the COVID-19 pandemic, per the technical report accompanying the updated recommendations.
- Another assessment of hospitals' pediatric emergency readiness will begin in March.
Additional recommendations include screening and treating kids for mental health challenges and to make connections to social workers who can refer patients to pediatric-specific community resources.
- Other medical groups involved in the recommendations were the Emergency Nurses Association and the American College of Surgeons.
The bottom line: 90% of children who live within 30 minutes of an emergency room have to rely on a facility that isn't fully prepared for pediatric patients, according to the new technical report.
- In emergency situations, "there's simply not time to be able to transfer those children out to another facility and hope that they get there in time," Remick said.
- "Every emergency department has to be ready to take care of children, regardless of whether they see high volumes of those children and regardless of their inpatient resources."
