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Most ERs aren’t fully prepared to handle children’s emergencies

Children’s lives could be saved with greater pediatric readiness, a new study says.

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Researchers developed a model to project the benefits, risks and costs of greater readiness in U.S. emergency rooms. (Bing Guan/Bloomberg)
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Some 80 percent of U.S. emergency rooms are not fully prepared to handle children’s emergencies, a recent analysis suggests.

Writing in Health Affairs, a national group of researchers says the quality of care for kids in U.S. emergency rooms is “highly variable,” but that achieving high readiness nationwide is “highly cost-effective.”

The researchers developed a model to project the benefits, risks and costs of greater readiness in U.S. emergency rooms, using nationally representative data from 747 emergency departments in Arizona, California, Florida, Iowa, Maryland, Minnesota, New Jersey, New York, North Carolina, Rhode Island and Wisconsin.

To be ready to address children’s emergencies, ERs need “key pediatric equipment and supplies,” training, policies and personnel tailored to pediatric needs, the researchers write. The analysis looked at outcomes for a variety of pediatric patient types, comparing them with expected outcomes if they were treated in better-prepared ERs.

Increasing pediatric readiness would reduce mortality, increase life expectancy and improve pediatric patients’ lives, the researchers write, cutting ED and hospital mortality by 33.47 deaths per 100,000 children.

“Achieving and maintaining high pediatric readiness for all EDs in the US could save the lives of thousands of children each year, at an annual cost of approximately $260 million,” the researchers conclude. It would be more cost-effective than other interventions such as routine hepatitis A vaccination, hepatoblastoma screening for children with extremely low birth weight and other programs, the researchers note, calling a nationwide investment in pediatric ER readiness “robustly cost-effective.”

According to the Agency for Healthcare Research and Quality, kids make up about 20 percent of ER visits annually; in 2015 alone, the agency notes, 17 percent of all U.S. children made at least one visit to the emergency room. Respiratory disorders, injury and poisoning made up the bulk of pediatric ED visits in 2015.