Pediatric Care in the Emergency Department

March 17, 2022 | Health System Risk Management


​​In 2018, about 20% of U.S. emergency department (ED) visits involved children under the age of 15 years (1), and about 90% of these were to general medical-surgical hospital EDs rather than pediatric hospitals with dedicated pediatric EDs (2).

Children present unique challenges in a non-specialized ED; they have different needs for appropriately sized medical equipment, specialized training by providers and staff, and medication dosing. They present with different illnesses that are sometimes unique to the patient population. Additionally, the margin for error may be small commensurate with the child's size, including recognizing the acuity of the condition, as well as medication dosing.

Even with most pediatric ED visits occurring in general medical-surgical EDs, most of these EDs do not see many pediatric patients. Nearly 50% of general EDs care for fewer than 10 pediatric patients each day. (2)

According to one study, children seen in general EDs are less likely to be admitted to the hospital (about 5% of these patients are admitted) than those seen in pediatric EDs (about 10% to 20%), implying that patients seen in specialized EDs are more ill (2). However, these data do not indicate whether patients are first seen in a general ED and then transferred to a specialized ED; thus, the more ill pediatric patients may be admitted to pediatric hospitals from their EDs at a higher rate, but it is unclear whether these patients always present to a specialty ED.

This guidance article is intended to support leaders in any ED, whether general medical-surgical or specialized for children, in preparing for pediatric patients, highlighting ways in which the ED can be made safer for the care of children.

ED staff, from providers to nurses to ancillary personnel, should be familiar with the American Academy of Pediatrics' (AAP)![](/_layouts/images/icpdf.png)Pedia​tric Readiness in the Emergency Department, which was formerly...

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