William Lennarz, MD: Unique Aspects of a Pediatric ER

Caring for children requires a unique set of training, skills, and equipment, William Lennarz, MD, Pediatrics Systems Chair at Ochsner Medical Center, told MD Magazine®. Doctors, nurses, and other staff are trained in childhood development, which influences care and the delivery of care in a pediatric emergency room. At Ochsner, the efforts to better serve children in emergency situations is extending beyond the ER—they’re working with EMS staff so children experience continuous care from ambulance to hospital.

What characteristics are unique to a pediatric ER?

How is Ochsner working to improve pediatric emergency care further?

Most pediatric ERs—all pediatric ERs that are genuine pediatric ERs—have completely separate staff. So, the nurses, for example, that take care of kids in the pediatric ER don't take care of adults. They have special training in development, in sort of the psychologic approach. But also, if you think about it, the mechanics of taking care of a patient are really different when they can range from this big to full adult size. So, we have to have equipment of lots of different sizes and probably the thing that you have to be most skilled at, or one of the things that requires most skill, is medications, because we give all medications according to weight in pediatrics. And so, we need to be working in an environment where those calculations are done, and the medicine is safely delivered at the right dose.I think in pediatric emergency medicine, one of the, not so much a trend, but [one of the] ways that we can improve care is by working even outside the ER before kids get to us. So, for example, we have recently added to our staff a pediatric emergency medicine doctor who specializes in teaching EMS, or ambulance personnel. And so, the hope is that we increase the care—the standard of care—and benefit children in true emergencies long before they even come through our doors, and that what we might do in the ER has already started in the field and just gets continued.