Pediatric Emergency Contact Notifications Made Easier
For the head of the trauma department at one of America's top pediatric facilities, Chicago's Children's Memorial Hospital, having to notifying parents that their children have been the victims of trauma or identify pediatric Jane Does, is an every day occurrence. But just because they look like they're handling it well, doesn't mean that it ever becomes routine.
When a child comes into the ED without a parent, it's usually the result of an accident or traumatic event. Even though their first priority is to tend to the child's medical needs, their next priority is to identify the child. They need to get his parents or guardian down to the hospital, to give consent for his treatment, provide vital medical history and most importantly, to be at their child's side when he needs them most.
You'd be surprised how often a child is brought into Children's Memorial without anything pointing to his or her identity. Many times it's the result of a car accident, where the parents are injured as well as the child, and are taken to another hospital, while the child is brought to Children's for specialized pediatric treatment. Since children don't have driver's licenses or checkbooks, identifying a child can be challenging.
Just the other day, three children ranging from 8 months to 3 years were brought into the ED after a serious automobile accident.
Their parents, who were in bad shape, were taken to another hospital and the paramedics had no clue about their names, ages or medical history. The trauma team began their medical evaluation and as they always do when dealing with an unidentified child, opened a trauma pack for each, using a patient number to identify them. We estimated their ages, did a full physical description including any identifying marks and clothing, then ordered a full set of x-rays, which helps to identify any conditions or injuries that aren't readily apparent.
The team's biggest asset in this situation was the solid relationships that they've built with police, fire department, and other local hospitals ? as they work together to get the children identified as quickly as possible. After a major accident like this, the police and fire department were already in the ED coordinating efforts. With their special emergency landline system they're instantly linked by phone with any local hospital they need to reach. As the team began calling to find out where the children's parents were taken, hospitals began to call them, to say, "I know you're looking for the mom and dad of the accident victims. They're not here," saving them precious time. In this case, we found the hospital relatively quickly and found out that even though the children's parents had been seriously injured, the children's caregiver who had also been in the accident, was fine. The hospital sent her over to Children's and she ? and later on the parents ? were able to give them all the information theyneeded to identify and treat the children.
In the case of a completely unidentified child, especially babies, they depend on our procedures. Usually the fire department, police or DCFS dropped the child off, so they are already aware of the situation and have already begun going through the child's clothing and personal effects to gather evidence and identify the child. The trauma team will send the police or paramedics right back to the scene to gather additional information, medicine bottles, names, and to canvass the area. There is almost always someone who saw something. Someone from pastoral care automatically comes down and a social worker will get involved if it looks like any abuse was involved. Together, they take care of figuring out where to go from here, while the team takes care of the child medically.
If these steps don't elicit any clues to the child's identity, the hospital will get media affairs involved. Children's will never show the face or reveal the name of any child. Instead, they photograph the child's clothing and personal effects and release it to the media along with the child's estimated age, description and the vicinity in which she was found. They work closely with detectives and DCFS to give them all the details they need to chase down any leads they get from the public. Many times just calling DCFS or the police will locate parents or bring about an identification. In the case of severe trauma, abuse or inflicted injury, Children's always balances treating the child, with carefully gathering as much evidence as possible, to help the eventual police investigation. They had a young girl a few years ago, whose brutal attacker was convicted mainly on the evidence gathered and catalogued in the trauma room.
When it comes to providing emergency contact information, kids aren't always the best source. They have seven or eight year old kids come in everyday, who I'm sure are sophisticated in every other way. But get them in a trauma situation and ask them what their mom's name is and they'll say it's "mom". In this case, the first thing they'll do is look at whatever they brought in with them. School-age kids almost always have a backpack. If they don't find anything there, they'll check our records to see if the child is in the system and begin to gently probe the child for information. They ask them where their house is, what their school looks like, information about their friend's houses, maybe a familiar landmark on the corner like a 7/11 or the name of a park. If you can't find their contact information right away, try to find the name of their school. Their books will probably have the name of their school stamped inside.
Schools are also a great source for emergency contact information. They'll often even list alternate people to call in an emergency if the parents are at work or hard to reach. In an emergency, schools will usually send someone directly down to the hospital with the child's emergency card and emergency consent forms. If the injury occurs at school, most schools will send someone from the school along with the child to the hospital, while someone else is calling the parent. For parents, I would suggest that every parent name someone else on the child's emergency card, who knows the child well and would be able to step in to help out during an emergency if the parents can't get there right away.
So once you identify a child, how do you know if the person who comes to the hospital is really his parent or relative? It's not always easy. Remember that the parents didn't expect to have to come to the hospital today, and probably won't be carrying three forms of ID and their child's birth certificate. For people that come in and say they're related to a child who's been in the media, they get as much ID as they can, be it a driver's license, pictures or other proof. With kids, the biggest test is to watch their response when that person goes in the room. Usually you'll here a resounding "Mom!" or "Daddy!" and you know you've got the right person. If there's no response from the kid, or if they're not sure of the adult, it's probably not the right person. Or worse, the child might recoil from the adult, which could indicate an abusive situation.
Treating kids also means caring for their parents. When Children's has to make a notification call they'll begin by telling the person on the phone who they are and ask them how they are related to the child. If it's the mom or dad, they'll tell them that their child has been brought to Children's Memorial Hospital. Of course the parent will immediately ask how the child is. This is always the hardest part of the call. If the child is clearly fine, they'll say "Don't worry, they're fine, we just need you to come down here." But if there is a more serious injury, or if the child hasn't survived, they say that the child has been in an accident, that they need to come down, and if necessary, that they need to get their medical history. If they refuse to get off the phone until they find out what's wrong, the trauma coordinator will say that they're very concerned about their child's health and that they need to come down right away. They'll always try to calm the person down as much as they can ? tell them to go and get a pencil and paper to take down the address of the hospital, to take down the hospital's name and they're direct number. They tell them to ask for them right away when they get here so they don't have to waste any time at the desk and then try to make sure they have someone to drive them over. And they finish by reminding them that they need to drive carefully and slowly and to make sure that they get there in one piece!
At Children's the top priority is the restoration of the health of every child who comes through our door, no matter who they are and where they come from.
For tools you and your staff can use to facilitate pediatric notification, identification and communication, download a free copy of the Seven Steps to Successful Notification System, in PDF format, at the Next of Kin Education Project web site. Along with the Information Kit, you'll find patient chart pages and notification worksheets using the Seven Steps, that you can purchase and customize to use as part of your own charting system. You'll find them on the NOKEP web site along with reminder products like mouse pads, posters and coffee mugs, to keep the Seven Steps at your staff's fingertips.
Laura Greenwald, CEO/The Next of Kin Education Project email@example.com
Understanding Tumescent Liposuction
Tumescent liposuction is done using a local aesthetic. A large volume of saline solution containing the aesthetic and a drug called "Epinephrine" is injected directly into the areas where there are excessive fatty deposits. Epinephrine is important in the surgical process because it shrinks capillaries and minimizes blood loss. Minor sedation may be required for those who feel a little nervous about the surgery; however the patient is usually completely conscious during the surgery.
Facial Pain: When a Nerve Is a Live Wire
Of all the places in the body that can hurt, the face might seem the strangest. But for some people, that's exactly where the agony occurs, and the cause is a nerve gone haywire.
Why Drug Companies are Naughty and 5 Remedies to Cure the Symptoms
With the hum of the election campaign and the debate of "big business," versus human interest, I decided to do a bit of muckraking into the art and science of the recent removal of Merck's Vioxx. My motivation of course; to look for clues as to the role drug companies play in our health and wellness (or lack thereof).
Prescription Drugs from International Pharmacies Save Elderly Money
As pointed out by *Jack Shapiro, an internationally-known healthcare marketing consultant "For the first nine months of this year, the U.S. imported $40 billion in pharmaceuticals and exported only $21 billion. In 2003, we imported $50 billion and exported $23 billion." So what makes buying from your local U.S. based pharmacy any safer then purchasing from Mexico or Canada?
Could This Be Arthritis In My Hands
Hi Rusty. A few days ago, I slightly injured a finger on my hand. Now my hand is swelling with severe joint pain in the fingers. At first I thought this was a possible sprain in that region, but now my other hand is showing the same swelling of the fingers and pain of the joints. Should I go check this out right away? It doesn't seem to be getting worse today, but the pain and swelling are persistent. Could this be a sudden arthritis attack? I'm 38 years old and in good health (I just had a check-up at the doctor last week and the blood work came back okay).
First Step To Addiction Recovery
The first step to over comming any addiction is to detoxify the body of the addictive substance. Whether it's herion, crack, or meth detoxifcation of the liver is essential to addiction recovery. There are several methods to bring the chemicals out of your body. One is sauna or sweat therapy.
The Truth about C Reactive Protein and Cholesterol Lowering Drugs
You might disagree, but hear me out on this...
Acid Reflux ? Symptoms and Treatment
Acid reflux (also known as GERD or heartburn) is a common condition -- Over 60 million Americans experience it at least once a month.
Coumadin Users Can Avoid Unnecessary Complications By Wearing Identification
The police arrive at the accident scene promptly. A driver has run his automobile into a guardrail while exiting a highway. The driver does not seem to be injured but is somewhat incoherent and is slipping in and out of consciousness. Did he strike his head? Is he inebriated? Is he on drugs? A quick review of the driver's attire reveals a medical alert bracelet that identifies him as a Coumadin user. This is crucial information for those responding to the incident.
The Equine Cushings Cure
Equine Cushings disease is caused by a tumor in the pituitary gland, which is responsible for the production and regulation of hormones. Symptoms include a long, shaggy coat that does not shed, excessive drinking and urination, laminitis, a tendency for recurring infections in the hoof (foot abscesses), and a loss of muscle mass, especially along the topline and rump.
Low Blood Pressure ? Why is Your Blood Pressure Low?
Why is your blood pressure low?
Zyprexa - History of the Drug
Since the beginning of mankind, mental illness has played a role in our society. Victims of such illnesses have been outcast, stereotyped and often ridiculed. However, over time, medical and psychiatric science advanced and the medical community became more knowledgeable of these conditions.
Zoloft Side Effects: Akathisia and Violent Behavior
Zoloft is an SSRI (selective serotonin reuptake inhibitor); a prescription drug that combats depression, anxiety, posttraumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder (OCD), as well as other various problems. SSRIs work by allowing more serotonin to be released through the brain. Seratonin is a brain chemical associated with happiness. Between nerve endings in the brain, there are synapses. All signals in the brain are transmitted through chemicals being produced then absorbed by one nerve and another. When these chemicals are released they are either taken in by the next nerve or the nerve that released them will re-absorb them and the signal doesn't pass. Some antidepressants work by blocking the reuptake of Seratonin by the releasing nerve. That means that more Seratonin stays in the synapse in the hope that it will be absorbed by the new nerve which, in the case of Seratonin, would continue the signal of happiness.
Hacking through the Medical Scheduling Software Jungle: Helpful Search Tips
It is the reality of the 21st century medical practice that in order to ensure the most effective office management and to provide the best service to patients, a medical office must incorporate medical scheduling software. Medical scheduling software helps to run the modern medical practice. But, to find the right medical scheduling software is like searching for buried treasure.
Stop Taking Blood Pressure Medications with Your Doctors Approval
I have been swallowing three varieties of blood pressure pills for 10 years. In another month, I expect to be off of them entirely. And that's with my doctor's approval.
Patient Communication: Picking Up Where Medicine Leaves Off
We've all seen patients who were far beyond the reach of medical treatment suddenly defy the odds and recover. We've also seen patients who were well on the road to recovery, take a turn for the worse for seemingly no reason at all. No matter what the technology or how terrific we are at our jobs, sometimes medicine just isn't enough.
Toenail Fungus: Treatment and Prevention
A thick, yellowish nail with splotchy white areas is a classic presentation for a fungal toenail. In the early stages the toenail is only slightly discolored, or slightly thickened. In the late stages the nail can become very thick and has a tendency to "grow up" more than in grows out. The nail will be very discolored, typically dark yellow-brown and will start to change shape and crumble. In some cases the nail becomes very loose and many will lose the nail, only for it to regrow with the fungus.
Signs of Suicide : Learn What They are and How to Deal with Them
The true numbers are probably much higher because many suicides are reported as accidents or illnesses. Suicides are usually the result of a complex combination of emotional, social, and biological factors. For that reason, learning about the warning signs of suicide can be difficult yet so important.
Implant Dentistry ? The Convenient and Safe Alternative to Dentures
If you are missing a tooth or a group of teeth, you may find that you are afraid to smile, you don't like to speak because you think you sound funny, or you may not be able to eat certain foods that you enjoy. Until recently, your only option was to replace these missing teeth with dentures. Patients often complained that dentures were uncomfortable and inconvenient.
Death by Fluoride
A wee bit of fluoride makes teeth and dentists happy, we're told. Dr. Happy Tooth's smiley face turns into a frown when his favorite decay buster is busted as a killer. Anything in large doses kills, bristles Drill & Fill, DDS, even Dihydrogen Monoxide, they often tease. Ha, ha, get it ? water ? H2O. Stop picking on fluoride, they say, you make us look bad.
|home | site map|