Calif. county pediatric emergency care system approved

Richard Halstead
The Marin Independent Journal, Novato, Calif.

MARIN COUNTY, Calif. — The state has certified Marin County’s emergency treatment plan for children, an action the county described as a breakthrough after five years of effort.

“In large part due to the hard work and dedication of our hospital partners, we have created a system of care for children that not only provides better and more compassionate care but will be far more capable to quickly adapt to change and stress in the system, such as in a disaster situation,” said Dr. Dustin Ballard, medical director of the Marin County Emergency Medical Services Agency.

The California Emergency Medical Services Authority notified Marin of its compliance in April. Prior to that, the local standard of emergency care could vary and might not always incorporate pediatric best practices such as age-appropriate equipment and kid-friendly pain control and distraction techniques, according to the county.

In 2020, 409 children in Marin required ambulances, 217 of those for traumatic injuries. All but 18 were taken to hospitals in the county.

During the Korean and Vietnam wars, doctors discovered that survival rates improved significantly when patients were stabilized in the field and transported immediately to an emergency medical center. This approach was incorporated into the treatment of adult patients in the U.S. beginning in 1975, and medical outcomes improved dramatically.

It wasn’t until 1984, however, that Congress authorized the use of federal funds for emergency medical services for children.

A study published in the medical journal Pediatrics in 2019 found that the risk of mortality was four times higher among children who arrived at emergency departments with low pediatric readiness scores. The data involved 20,483 critically ill children at 426 hospitals.

An emergency department is considered pediatric ready if it has appropriate processes, staff and equipment to treat children and can determine when a child might require more specialized care.

“Children are not just small adults, and require specific sizes of equipment for stabilizing airways, administering IV fluids and medications and ensuring safety equipment for ambulance transportation,” said registered nurse Karrie Groves, a program coordinator with the Marin County Emergency Medical Services Agency. “Changes in our system were made specifically to address this special population and are in place today.”

MarinHealth Medical Center and Kaiser Permanente San Rafael Medical Center are both certified pediatric receiving centers. MarinHealth is an advanced center; all staff and physicians there have received special education on the treatment of pediatric patients.

MarinHealth’s center stresses pain avoidance with numbing medicine before injections, and chooses alternative methods of delivering medicine when possible. MarinHealth also employs a specialist who uses play to educate and distract nervous young patients.

“We are proud to live in a county where we collaborate very closely with our EMS partners in providing excellent care to our kids,” said Michelle Tracy, MarinHealth’s director of emergency and trauma services. “So now, from the time an ambulance picks up a child until the time the child is discharged, they are receiving specialized pediatric care.”

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(c)2021 The Marin Independent Journal (Novato, Calif.)

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