Pediatric ED at RWJ Hamilton proves ready for crisis
Mar 09, 2012 12:30AM ● Published by Community News Service
Registered Nurse Kasia Wolan and pediatric clinical coordinator Julie McGuire work in the Pediatric Emergency Department at Robert Wood Johnson University Hospital Hamilton Feb. 20, 2012. (Photo by Stacey Pastorella.)
The Pediatric Emergency Department at Robert Wood Johnson University Hospital Hamilton had just begun its 80th day of operation Feb. 16 when word came that a school bus had collided with a dump truck in nearby Chesterfield Township.
Seventeen of the 25 elementary school passengers on the bus were injured in the tragic crash, including 11-year-old Isabelle Tezsla, who was killed. Eight of the victims were treated in the recently opened Pediatric ED at RWJ in perhaps the sternest test yet of the facility and its professional staff. Staff members escorted those patients from the waiting area to the Pediatric ED where they were evaluated and treated for cuts, bruises and head injuries, said Julie McGuire, the hospital’s Pediatric Clinical Coordinator. Employees from throughout the hospital were eager to help after hearing about the situation, McGuire said. “Nurses from other floors came down to see if they could help, make sure everything was fine. So, we had a lot of support,” said Lauren Stabinsky, the hospital’s Director of Nursing for the Emergency Department. Two patients not treated in the Pediatric Emergency Department at RWJ Hamilton were brought to the hospital’s main emergency department by ambulance. After receiving treatment, one was released. The other was transferred to the Bristol-Myers Squibb Children’s Hospital at RWJ’s New Brunswick campus for further evaluation. Opened in November, the Pediatric ED has eight pediatric treatment rooms arranged around half of a circular building. The area was retrofitted for that purpose, and a link was constructed to connect the Pediatric Emergency Department to the hospital’s main Emergency Department. Seven of the eight rooms have one bed, and one room has two beds. The rooms also have couches that can be converted into beds for family members. “It’s child-friendly without being juvenile,” McGuire said. “It moves the children out of the adult (ER) experience, which can sometimes be very harrowing for both the parent and the child.” The Pediatric Emergency Department treats patients ranging in age from newborns to 18-year-olds. The equipment used in the Pediatric Emergency Department varies greatly in size, allowing medical staff to find the best fit for each patient. The department is stocked with intubation equipment in pediatric sizes, smaller material for casts, and blood pressure cuffs that range from neonatal to adult sizes, McGuire said. The hospital has also incorporated suggestions from members of the community, such as one request for smaller blankets. “They let us know what they think is working well, and what we could improve upon, and we do our best to make those changes,” Stabinsky said. McGuire said that before they opened the Pediatric ER, they did some community research and spoke to the pediatricians to see exactly what they wanted to see in a Pediatric ER. One of the main focuses was communication, McGuire said. The hospital’s doctors communicate with their patients’ pediatricians about the treatment that the patient has received and plans for follow-up care. The hospital also faxes patients’ charts to their pediatricians within 24 hours of discharge. In addition to keeping doctors informed, the hospital’s staff communicates with the parents of the patients. The staff makes follow-up calls after a child is released, and parents are provided with copies of lab results or radiological images. Treating the hospital’s youngest patients in a separate emergency department is also beneficial to adult patients, Stabinsky said. Before the hospital’s Pediatric Emergency Department was established, the hospital treated about 8,000 pediatric patients in its main emergency room each year. “It helps to decompress the main side so we can get more patients into the back as soon as possible,” Stabinsky said. “So, it’s been a real help to the main side as well as to the pediatric side.” A representative for the hospital said the establishment of a Pediatric Emergency Department was the first step in a three phase process to expand the hospital’s Emergency Department. The hospital also plans to add eight fast track treatment rooms for adults in the same building that houses the pediatric treatment rooms. In the final phase, the hospital plans to create an exterior entrance to that building. After the bus accident, and when those patients were ready to be released, medical staff spoke with parents, informing them about what to expect, and advising them to monitor their children for about 24 hours, McGuire said. Caring for the young patients was an effort that required contributions from several different departments. Since the children were in the hospital during the lunch hour, the dietary staff provided assistance. Members of the pastoral care team were available to speak with patients and their families. The hospital’s security and administrative staff also played significant roles. For more information about Robert Wood Johnson University Hospital Hamilton, visit rwjhamilton.org.