5 new advances in pediatric emergency care

If you’ve ever had to bring your child to the emergency room, you know how stressful it can be. Yet what you may not know is that pediatric emergency care has improved in recent years, making the experience a little easier for kids. Read on for five new changes in the ER.

1. Better ways to give medication

When a doctor orders medication for a child, it’s ordered in milligrams, yet nurses have to translate it into other conversions depending on the child’s weight, the type of medication and indication. They also need to know if the medicine should be diluted and how fast it can be given. So, although the dose that was ordered was administered, the end result is a matter of decimal points, and the conversions are not documented.

“The process of giving medication to children is very complex and error-prone because there are so many steps involved,” according to Dr. James Broselow, creator of the Artemis system.
The Artemis system is software that syncs up with the barcode on any medication to provide the conversions in a matter of seconds. It is currently in use in 200 hospitals nationwide.

2. Less admissions

Being admitted into the hospital is less common than it used to be, according to Dr. Michael Gerardi, director of pediatric emergency medicine at Goryeb Children’s Hospital in Morristown, New Jersey. For example, work-ups for oncology patients can be done in the emergency room, and ultrasounds for appendicitis are now typically done before CAT scans.

“Ultrasound is getting more and more sophisticated,” said Gerardi, who also serves on the board of directors for the American College of Emergency Physicians.

Plus, babies older than a month who have a fever are no longer admitted as long as they meet certain criteria.

3. Fractures are easier to mend

Did your child break his or her arm? In the past, he or she would probably be sent to another hospital that could operate on children or would be deeply sedated, so the arm could be straightened out, according to Gerardi. Now, drugs like Ketamine have been ruled safe to use on children. The child is moderately sedated but doesn’t feel any pain, gets a cast and is released.

4. Imaging has been minimized

Previously, a child in the ER with a head injury who also had symptoms like blurry vision, headache, and vomiting, or who even lost consciousness briefly, was given a CAT scan, according to Gerardi. Yet, thanks to a new study published in the Lancet, doctors now know that it’s not always necessary to order a CAT scan, depending on the child’s symptoms and risk for traumatic brain injury. This new finding eliminates radiation exposure and sedation.

5. An alternative to IV

If your child has to be resuscitated, is having a seizure, or has low blood pressure because he or she is septic, doctors now use a tool called intraosseous access. So, rather than putting a central line in—which is more involved and takes longer— intraosseous is a fast and safe way to deliver medication, glucose or fluids.