In our last post, I shared some advice from members of our Family Partners Council on waiting while in Le Bonheur Children’s Emergency Department (ED).  Waiting is such a major element of the process that there are still more bits of advice.  ED visits usually surprise people, and as Sheila, a member of the Le Bonheur Children’s Family Partner Council, put it, “it is sometimes hard to think quickly when it becomes an emergency.” 

After talking with some more parents and the ED child life specialists, here are the pointers we received:

• Comfort Items: If there is a favorite pacifier, stuffed animals, or blanket.  If your child gets upset, it is always nice to have a familiar item there to comfort them.  It helps to bring a little bit of home to the hospital.
• Toys and Activities: If time permits, grab some age appropriate activities.  Handheld games (i.e. PSP, Gameboys), favorite toys, portable DVD players, iPods, or any other toys (or gadgets) your child might take on a long car trip.  It’s always a good idea to grab headphones to help your child and you.
• Entertainment for Mom: Additionally, Sheila recommends “likewise for mom bring your Blackberry, iPhone, or whatever.”  Le Bonheur Children’s has free wireless internet access, so feel free to bring along a laptop.  All of these devices are great helps in keeping other people aware of what’s going on.  Crystal, one of the ED child life specialists, mentioned the importance of grabbing charging cables.

Don’t be afraid to create games and play with your child.  It will help to keep both of you focused, and help the time pass faster.  One of my favorite games has been to count ceiling tiles, and to see who can do it the fastest.  Other games might be I Spy and 20 Questions.

Two of the most important things that will help make waiting a little easier on everyone are humor and patience.  Everyone who comes to a ED is in a stressful situation, and sometimes just being able to laugh things off can go a long way.

Perhaps one of the most difficult parts of visiting any Emergency Department (ED) is the waiting.  As I was asking some parents for advice on the ED, waiting came up time and again.  Renee, a member of the Le Bonheur Children’s Family Partners Council, described the experience in an ED as being a lot of “hurry up and wait.”

Whether it is to be taken into the back, for a nurse or doctor, to be admitted, or to be discharged, waiting is a part of the process.  One of the hardest parts of waiting for the ED associates are that they cannot tell you how long you may have to wait.  As we discussed the triage process, there may be critically ill patients that may be arriving by ambulance and helicopter, and you might experience a slight delay.

There are steps that you can take to help make the waiting a little easier on yourself and your child. 

Michelle, another member of the Family Partners Council, suggests that parents try their best to leave other children at home.  As she puts it, “it makes everything so much more stressful for everyone – patient, parent, nurses and doctors when there are other children running around.”  It is not that other children are not welcome, in experience of our seasoned parents, it adds another layer of stress for the parent.

Additionally, Renee wanted to stress the importance of not letting your child eat anything while waiting.  She states that “certain tests will require that [your] child be NPO [nothing by mouth], but you may not know that coming into the hospital.”  This can be stressful for parents, but it is important to help you get through the process faster.  Once in your are being treated, you can ask the nursing staff if your child can have something to eat.

In the next post, we’ll look at some other strategies that can help make the waiting go by faster.  And if you have any suggestions, leave a comment to pass them on.

Yesterday, I talked about the importance of the triage process, and how a decision is made to determine the degree of treatment need for your child.  If the decision is made that a lessened degree of treatment is needed, you will be assigned to the Le Bonheur Children’s ED Fast Track.

If you are not sent to the ED Fast Track, don’t worry.  Despite what the name may imply, it actually makes visits to the Le Bonheur Children’s Emergency Department faster for everyone.  If a patient is kept in the main emergency department it is because of the need for that level of care.  The ED Fast Track is a little bit closer to a minor medical center.

So, once you check-in with the triage nurse, they will give you a “blue pager.” This circular pager will appear similar to those that you might get at a restaurant on a busy night.  However, this pager will help you more than you realize.  During the wait time, we know that people get nervous about even getting up to go to the bathroom for fear that they will miss their name being called.  There isn’t need to worry about being called.

Once you are sent over to the Fast Track area, you will check-in with their team at the window.  They will give you another set of paperwork to be completed.  At this point, you’re still going to hold on to the pager.  Once you’ve completed the paperwork, you will turn it back in at the window (and still hold to the pager).

Now comes the fun part, you get to wait for the pager to go off.  The great news is that this group works tremendously efficiently, and will do everything in their power to treat you in our child as quickly as possible.  Once your pager lights up and vibrates you and your child will go to the window, give the staff the pager, and they’ll take you to a room to be treated.

So, in a few short paragraphs, that is the Le Bonheur Children’s Emergency Department Fast Track.  Also, if you've been to Le Bonheur Children's ED before, you may have heard of the Fast Track referred to by other names (examples of previous names have been Non-Acute Care and Zone 8).

Once you’ve navigated to the appropriate check-in desk, you begin the process of triage and registration.  This is an important step in the emergency department process, and there are several things that you can do to help.  The first thing you will need to do is fill out the necessary paperwork.  I know it’s not the most fun step, but it is important.

After/while you fill out the paperwork, your child will be triaged.  Triage is a system of prioritizing patients for treatment, and there is a dedicated registered nurse to that will determine the degree of treatment need for your child. Le Bonheur Children's uses a 5 point scale, with a score of 5 having the lowest degree for treatment need and a score of 1 being the most.

One of the things that can be frustrating to families waiting is seeing a child, who arrived after you, to be called back before your child.  Because some injuries and illnesses are life threatening and require immediate attention, emergency rooms cannot operate on a first come, first served basis.  The triage system makes sure that sicker children will be seen first.

During the triage process, you will be asked for information about your child.  This could include their date of birth, a home/cell number for medical follow-up, your child’s doctor.  Additionally, there are other things that you might be able to tell the triage nurse that will help them make a more informed decision.

A parent, with whom I recently spoke, mentioned the important of giving specific information such as “any pre-existing conditions, prior history of the same illness, or whether you were referred by a pediatrician.”  For instance, mention a history of seizures, diabetes, asthma, or any other pre-existing condition can help the nurse to assign the appropriate degree of treatment. 

Additionally, it may be important to tell the triage nurse if your child is not acting like themselves.  For instance, if your child is sitting and watching the room, when normally they would be bouncing off of the walls, it could make a difference.  Explain what a child's  "baseline" will help to paint a fuller picture, and remember, you are the one that knows what your child is like when they're not in the hospital.

This is the first official post in our Parent’s ED Primer, a new ongoing series to help families navigate a visit to Le Bonheur Children’s Emergency Department.  We will tag all of the posts in this series with a Parents_ED_Primer to help you pull up the entire series.  Please feel free to ask questions, and I’ll do my best to answer them.

When coming to any emergency room, it can be overwhelming.  If you have made the decision to go, things are serious enough that you know you need help, and where you check-in at may not be the first thing that you think about.  Typically, you are just looking for help and to get the procress started as soon as possible.

The reason that I am talking about check-in is because there are three possible desks/windows that you see when coming into Le Bonheur Children’s ED.  It may seem confusing but each one serves a purpose.  Here are the desks and their purposes, in the order that you would see them (when coming in the front door):

Security Desk:  This desk is staffed by one of Le Bonheur Children’s security guards.  They are there to help people find areas of the hospital, answer questions, and make sure that the ED is safe and secure.  If you have general questions about where things (i.e. snack machines, bathrooms) are, they are the perfect folks to ask.

 

Admissions Window:  This is an office for the Le Bonheur Children’s associates that work for the admissions department.  Don’t worry about having to stop here because they will come to you to bring necessary paperwork or other things.  However, much like all Le Bonheur Children’s associates, they are more than willing to help you in anyway the can.

 

Check-in/Triage Desk:  This is the first desk that you need to go to.  You can always spot the Check-in Desk by the big green sign above.  This desk is staffed by the Le Bonheur Children’s triage staff, and they will help you check-in.  They will get you underway of receiving care.

Hopefully all of this information will help make sense of the first step when you come to the Le Bonheur Children’s Emergency Department.  In the next post, I’ll discuss the triage process, and help to make sense out of some of the questions that parents often have.

Recently, I asked some of our readers what we needed to write about. We received several suggestions, and the one that was selected impacts lots of families: The Emergency Department. More importantly is what do parents need to know when coming to Le Bonheur Children’s Emergency Department.

Hopefully you will never need to our Emergency department, but when you do need it, we want you to know the important stuff. In 2009, Le Bonheur Children’s Emergency Department (or ED) treated more than 75,000 patients. As you can imagine, that’s lots of families, and unfortunately, when you need the services of the ED, you don't have time to research "what to do".

We have had families that have spent more time than they care to think about in the Le Bonheur Children's ED, and they have learned some tricks and tips. Our ED staff is another great resource, but how often do families have the time to ask them "specific" questions. Our thought was "why not talk to both groups and see what they have to share." In response, I started working on a Parent’s Primer: The Emergency Department.

I’ve been on a journey of talking with staff, asking parents for advice, and finding all of the answers that you might need to know when you come into Le Bonheur Children’s ED. This week, we’ll be sharing our findings. So, first things first: checking in.

However, there are lots of other areas, tips, and tricks to know about a visit to the Emergency Department. I’ll keep discussing those, and if you have questions or questions leave them, and I’ll try my best to answer them.