When a child has a medical emergency, the first instinct is to rush to the nearest hospital ER. But, many emergency rooms are ill-equipped to treat infants and children and they are staffed with doctors and nurses who may not be trained in the specifics of pediatric care.

Of 30 million children 18 years old and under who end up in emergency rooms each year, close to 90 percent are treated in general community hospitals, which often have no pediatric unit. The ER staff often lack necessary emergency equipment, such as needles, catheters, breathing tubes and instruments designed and sized for different-aged children’s unique anatomy. They also may lack a plan to deal with children in a mass casualty incident or natural disaster.

Hospitals are now making more strides in improving emergency care for infants after years of taking baby steps to bring quality up to par. According to a national assessment of more than 4,000 U.S. hospitals’ readiness for a pediatric emergency, published earlier this month in JAMA Pediatrics, the median readiness score was 69 on a scale of 100, up from 55 in 2003.

The evaluation was based on the hospitals’ compliance with revised guidelines issued in 2009 by the American College of Emergency Physicians, the American Academy of Pediatrics and the Emergency Nurses Association. Close to 83 percent of hospital ER units responded to the Web-based survey.

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