Emergency Medicine

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Studies highlight a need for pediatrician offices to be ready to handle emergencies, available data also demonstrate that many practices, including those that have already needed to treat a critically ill child, are not adequately prepared because they lack the relevant protocols, training, and tools.

Rashes and fevers are among the most common complaints seen in the pediatrician’s office. The differential diagnosis is often large and ranges from entities the pediatrician sees commonly such as erythema infectiosum to the less common diseases such as Kawasaki syndrome, to more potentially serious conditions such as vaccine preventable illnesses and everything in between.

In the mid-1990s, David Monroe, MD, a pediatrician in Columbia, Maryland, remembers having to admit children with common diagnoses such as appendicitis, asthma, and pneumonia to hospitals 30 or more miles away. That was because Howard County General Hospital, the community hospital in Columbia, was struggling to maintain pediatric inpatient care.

Imagine that you are working in an outpatient pediatric practice one morning when a mother arrives with her 3-month-old infant who is in respiratory florid distress.

When the medical diagnosis of "concussion" is given to explain injuries in children, it may be misleading to parents and physicians, causing them not to realize the potential severity of brain injuries in children, according to a study published in Pediatrics.

Office preparedness for pediatric emergencies is assumed in the training, certification, and continual vigilance that defines a proficient practice. Yes, you're confident in your traditional medical skills-but what about when a psychosocial crisis arises?

A state-by-state survey conducted by the American College ofEmergency Physicians (ACEP) has found widespread gaps in emergencycare in the United States. Access to emergency care is seriouslylimited in many states, with no excess capacity to cope withdisasters and with frequent shunting of patients from one hospitalto another when emergency department beds are full, as they oftenare.

Emergencies in pediatric offices are not uncommon, but practices are seldom prepared to respond. Implementing an emergency office protocol and a mock code program?like those detailed here?might save a life.