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Visiting the Emergency Room

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Family F.Y.I

Family F.Y.I

with Your Special Needs or Behaviorally Challenged Child

By Suzanne Niro, BSN, CPEN

Visiting the ER with a sick child is stressful for any parent. It can be even more challenging for parents of a special needs child or one with behavioral issues. Many of these families have navigated through the ER multiple times for various reasons but each visit can be quite unique. These patients are often dealt with by staff unfamiliar with their extensive histories and complex medical and emotional needs. In addition, prolonged waiting times expose them to other sick children, which can be very problematic.

SOME TIPS FOR PARENTS BEFORE COMING TO THE ER

• Check in with your child’s primary health care provider before heading to hospital. Often an ER visit is unavoidable and children with chronic conditions subsequently require admission to the hospital at high rates (24% to 38% of the time). Consulting with their primary care provider may save the child a trip to the

ER, depending on the severity of the complaint. The primary caregiver may be able to arrange an outpatient specialty visit or even see the child themselves to determine if an ER visit is absolutely necessary. • If an ER visit is unavoidable, make sure to bring the

child’s medications or, at minimum, an updated medication list including doses and times given.

A quick summary of the child’s complex history is also valuable, including names and numbers of clinicians who are involved in the child’s care. Patients with complex medical needs are often on multiple medications, doses are frequently being changed and

some med changes may not even be updated in the patient’s medical history. In addition, some meds may not be immediately available in hospitals, in which cases exceptions can be made and families may give meds from home. • Be sure to bring any personal items such as blankets

for comfort, or security items such as teddy bears,

etc. Although one may anticipate a quick visit, some may last hours, depending on wait time, even if admission is not needed. Having a security item can help the child feel more secure in a stressful situation. In addition, many hospitals offer Child Life services. These clinicians are highly trained individuals who specialize in helping families cope with the visit. They can provide valuable distraction during unpleasant procedures as well as explain to the child and family what to expect during their stay and how the staff can best accommodate their unique needs. • If your child requires special formula or is on a

special diet be sure and bring these with you.

Although many hospitals can accommodate these needs on inpatient units, they may not be readily available in the Emergency room.

Given these challenges, improving the delivery of patient and family centered care in the ER requires collaboration between the parents and health care clinicians. Being a strong advocate for you child is essential for an ER visit. Clinicians are trained to “listen” to your valuable advice and expertise regarding your child’s unique and individual needs. r

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