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09:49 PM

Experiencing the ER with Your Kids: 5 Things to Remember

A Child Life Specialist walks you through the Emergency Department experience

It can be difficult to imagine what you will find when you walk into the emergency room with your kiddo. Chances are you’ve debated coming, but it’s Friday night and you’ve hoped all day that your child would start to feel better. The weekend is fast approaching, and you missed the doctor’s office window. It could also be Sunday night, and you thought you could hold out until Monday morning. Now you realize that it would be better to figure this out before the school week and work week grind begins. You may be debating whether that cut on your kid’s hand really needs stitches, and surely the arm that your little one is complaining about is not broken; but this is day 2 of the complaining, and you’re starting to wonder…

You walk through the door of the ER to see no one else signing in. You breathe a sigh of relief. This doesn’t look so bad. You get checked in, and it’s not long before they call you back to a room - triage. Your child gets their vitals taken, the nurse asks you a slew of questions and the doctor sees you. Then you are back in another waiting room...WAITING. You think it’s not going to be long, but 45 minutes turns into a couple of hours and you are still waiting.

The ER is just that - an emergency room. Most people try to avoid it completely, while for others, it’s their go-to for health care. No matter where you land in that mix, there is more going on behind the scenes than what you see in the waiting room. 

This is your first tip from an ED Child Life Specialist and mom. Every time I walk through the waiting room on my shift, I think like a mom for those few seconds. I don’t know about you, but as a mom I avoid waiting with my children for everything. This is why drive-thrus were invented! If I can’t avoid it, I come armed with everything possible to make it more bearable. Usually there is a bribe attached to this option.

As a mom with behind-the-scenes experience, there are a few things I think you should know before you sit and wait or, unfortunately, experience a really scary emergency.

What To Remember at the ED

1. The emergency room is full of sights, sounds, and emotions. It is naturally a fairly over-stimulating environment from the moment you walk or roll through the door. Someone will immediately start assessing your child and bombard you with questions. Your child’s vitals (blood pressure, temperature, oxygen levels) will be checked multiple times, and you will tell your story so many times you will feel like you are reading a script. The new ER has private rooms in every area; however, you will still experience other people’s stories. You may wait with someone for hours in the waiting room and learn their whole story. You may be a few doors down from a very critical patient, or you and your child may hear the cries of another patient or concerns of another family member. You could meet and interact with upwards of 25 staff members during your time in the ER. Not only will you meet them, they will have contact with your kiddo at some level. There are also lots of sounds that many of us are not used to: beeping, paging, even the simple sound of the blood pressure cuff. It’s good for you and your kids to be prepared for this amount of stimulation and contact.

2. Unless you’re rolling through the door from an ambulance, bring what you need to wait well. Many times it’s helpful for your kiddos to not eat or drink in the waiting room. There are many procedures that could be delayed if your child has eaten or drank. While this may feel unrealistic for the toddlers of the world, it’s best to not pick snacks as your go-to distraction. Comfort items from home, activities, even an electronic device would be a good option for the ER waiting room. Hospitals are typically cold, so a hoodie or blanket is always helpful. You may not only wait in the waiting room but also spend time waiting in a private room. Remember, there is a system in place, but feel free to ask questions about the next steps and plan to get comfortable.

3. The emergency department has a system. When you are checked in to triage, you are assigned an acuity number. Patients are seen based on their acuity (seriousness of their illness). It’s important to remember this as you wait or watch others go in front of you. There are separate teams of staff for certain circumstances (i.e. cuts or broken bones); so they may be taken back before your kid even if they arrived after. Remember you are not seeing all that is happening. There could be several traumas roll in behind closed doors that are bumped to the front of the line because of their acuity. There are several staff people making sure this system runs smoothly and reassessing to make sure everyone’s needs are being met in a timely and appropriate fashion. We recognize that your experience is most important to you, but it’s good to remember that there are others in the emergency room experiencing something most important to them.

4. Pain control and comfort for your child are important to us. It is not the desire of any staff person to have to perform an invasive procedure on your child. However, invasive procedures are often required in the ER. This could mean a blood draw, an IV, numbing and suturing a wound, or even a strep test. All of these procedures and more are considered invasive, and they have the potential to cause anxiety for you or your child. We are also aware that the amount of stimulation in the ER may have already attributed to some of your or your child’s anxiety. We have protocols in place to make sure children feel safe, understand what is happening to them, and are supported through their procedures and experiences. We do NOT like surprises in the ED. It is important to us to be honest with kids about what is going to happen to them. Child Life Specialists play a large part in preparing your child for procedures and implementing coping strategies for your child; however, all of the ER staff shares the responsibility in providing care that places your child’s pain and comfort at utmost importance. We encourage you to be an active participant in supporting your child through procedures also. Research is clear that parental presence for procedures is helpful to the child and the staff provided the caregivers are well-prepared and able to cope well through the procedure themselves.

5.You are your child’s best advocate.  Often times, parents and caregivers can feel like they have even less of a voice in the emergency room simply because things need to move more quickly depending on the circumstances. It is important to stop and ask questions when you have them, or speak up when you feel concerned or confused about something. If you are concerned about your child or you feel something is not right, do not hesitate to inform a staff member of your thoughts. Your assessment of your child matters to us. It is also important for you to feel comfortable with the assessments and decisions being made by the healthcare team in the ER. We all work as a team in the ER, and you and your child are part of that team. We also encourage patients to advocate for themselves and let us know their thoughts and concerns.

The emergency room is a necessary place, and we know how much you don’t want to be there. Trust me, I’ve debated going at midnight with the screaming baby whose ear infection came on within a matter of hours on a Friday night. Confession: I let my oldest go two days with a broken arm and had no idea. The second time, I had her x-rayed the day of. Being a caregiver comes with so many decisions, and I know that deciding whether or not to go the emergency room is one of the hardest ones. Remember that we are here to help you and your child through these hard moments and illnesses that come with childhood. Our motto is: It’s all about the kids! And we mean it!

About the Author

Ashley Pagenkopf is a Child Life Specialist in the Emergency Department at Cook Children's Medical Center. The Child Life program at Cook Children's offers a variety of services, all designed to make your experience at Cook Children's the best it can be. Our services include educating, preparing and supporting your child through tests and procedures, as well as coping with any life challenges you and your child may face. 

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Comments 1 - 2 (2)
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Charles Rodenberger
Thanks for a well-written helpful article. You are a great child care expert, mother and granddaughter!
Webb Hersperger
Extremely well written and so necessary for orientation. Thanks!