An Emergency Department trip can be nerve-wracking and daunting – for children and parents alike. To help calm your nerves, here’s a summary of what you’ll encounter at the Julia and George Argyros Emergency Department (ED) at CHOC Children’s Hospital:

Parking

Pull into the ED driveway off Pepper Street. Valet parking is available for ED visitors: Just leave your keys with an attendant. Complimentary valet parking is available 24 hours a day, seven days a week.

Screening

Once you enter the ED lobby, a registered nurse at the screening desk will greet you and determine your reason for visiting. If there’s a wait, you will be called to the screening desk in the order of your arrival – unless your child’s condition requires immediate attention.

Registration

Next, an employee will obtain your registration information. This happens in two steps: When you arrive, the employee confirms your basic identification information. Before you leave, staff will ask for other information, such as your insurance carrier and primary doctor.

Triage

Your child will be called into a triage suite, where a nurse will ask questions, collect vital information such as temperature, pulse and weight, and perform a basic exam. During triage, the nurse assesses the child’s condition and determines the urgency of the situation and what type of care the child will need.

In most cases, children are seen by a triage nurse in the order that they arrived, but those with serious injuries or illnesses may go ahead of other patients. This is why you might notice some families being called first even if they arrived after you. If a treatment area or exam room is available upon your arrival, you will bypass the triage process entirely.

Lobby

If all treatment rooms are full following triage, you and your child will wait in the lobby. While there, please do not allow your child to eat or drink. Notify the screening nurse if the child’s condition changes or if she needs a scheduled medication. If you must leave the ED before treatment, notify an employee.

Treatment Area/Exam Room

Here is where your child will receive treatment. The ED has several types of treatment areas that are each set up to provide a specific type of care. You might notice another family called ahead of you from the lobby should a space related to that child’s needs become available.

Once inside, you will be given a hospital gown for your child. Please undress your child and place him or her in the gown as quickly as possible to avoid a delay in the exam. If you bypassed the triage process, your child will undergo a similar exam here before seeing an ED physician.

Your physician might order tests and perform treatments, which will all be carefully explained to you. The doctor will also review test results with you. The physician will also plan for follow-up care, and, if necessary, hospital admission.

Discharge

A patient is discharged once the physician gives approval for you and your family to leave. Be sure that you have a clear understanding of any instructions from your physician before you leave.
Your Emergency Department Packing List
The decision to take a sick or injured child to the ED can be abrupt, but if you have some time, consider bringing along a few items that could prove helpful during the visit:

• Diapers, formula and other baby supplies
• A list of any medicines your child takes
• Any referral paperwork, X-rays or lab results
• A blanket, stuffed animal, favorite toy or anything else that will comfort your child
• Personal necessities, such as a cellular phone charger, and change for the pay phone

Though documentation is not necessary, it’s important to know the following information when you visit the ED:

• If your child is current on his or her immunizations
• Your child’s primary physician
• Your child’s medical history

Here’s what not to bring to the ED:

• Food or drink is not allowed in the ED, and consuming anything before treatment can put a child at risk.
• If possible, try to make childcare arrangements for infant siblings during influenza season. Babies are at particular risk for contracting the flu.

To learn more about the Julia and George Argyros Emergency Department at CHOC Children’s, please click here: http://www.choc.org/emergency/.

Since 2006, father and son Jerry and Jeremy Wilcox have had a standing date every eight weeks at CHOC Children’s:  Together, they roll up their sleeves and donate blood.

“We both have the mindset that if we can help people, then we help people,” Jeremy says.  “We may not always have the money to donate to organizations, but we do have time and we do have the ‘good veins.’ Because of that, we are just doing what we can to help those in need.”

 The father-son tradition of giving life together is particularly significant with Father’s Day this weekend – as well as the nearing of summertime, which is traditionally a season of low blood donations at CHOC Children’s and blood centers nationwide. At CHOC Children’s, donation rates are typically 20 percent lower during this time.

The Wilcox men’s multi-generational tradition of donating blood extends well past 2006: Jerry’s own father was a frequent donor, which inspired Jerry to begin donating in college. Jerry had a similar influence on Jeremy.

In addition to providing a way to help others, the Wilcox men’s regular donations allow the duo an opportunity to take a break from their busy lives and catch up.

“I enjoy it,” Jerry says. “It’s a chance for us to see each other at least every eight weeks. We walk in, there’s no wait. We get to talk for an hour, and we get great cookies.”

Jerry began donating at CHOC Children’s in 2005 as a participant in the hospital’s Designated Donor Program, which allows blood donations to be directed to a specific patient.

Jeremy’s long tradition of blood donation began in high school. Now the father of two small children, he has a finer understanding of the significance of blood donations in a pediatric setting.

“If my kids got sick, they’d come to CHOC,” he says. “CHOC takes care of me, and I have all the confidence that they would take great care of my children.”

Despite the steadfast commitment from the Wilcox men and other blood donors, CHOC Children’s is in desperate need of blood donations of all types year round. Donations meet just 65 percent of the hospital’s annual need, and blood platelet donations meet just 35 percent of CHOC’s need. To supplement donations, CHOC spends more than $1 million annually to purchase necessary blood.

“Just try donating once,” Jeremy says. “It doesn’t hurt, and it gives you a warm fuzzy feeling that you could really help someone.”

Visit CHOC’s Blood and Donor Services http://www.choc.org/donateblood/index.cfm?id=P00208 to learn more about blood donation.

With warmer weather in sight, many families are spending more time outdoors. This could also mean you and your little ones may be more exposed to bugs and insects while spending time outside! To keep your family safe from stings and bites, take a minute to check out these important safety tips.

• Don’t use perfumes, scented soaps or hair sprays on your child.

• Avoid walking barefoot while on grass.

• Stay away from areas where insects nest or congregate, such as stagnant pools of water, uncovered foods and gardens where flowers are in bloom.

• Use insect repellents containing DEET when needed to prevent insect-related diseases. Ticks can transmit Lyme Disease, and mosquitoes can transmit West Nile Virus and other viruses.

• The current AAP and CDC recommendation for children older than 2 months of age is to use 10% to 30% DEET. DEET should not be used on children younger than 2 months of age.

What to Do if Your Child Gets Stung
Most insect bite and sting symptoms usually begin to go away in a day or two and don’t require medical attention. Some kids however, who are allergic to some insect stings, may have more serious symptoms and may require emergency treatment.

Signs of a mild reaction include red bumps, itchiness and mild swelling. If the child was stung and the insect’s stinger is visible, remove it quickly as possible by scraping the skin horizontally with the edge of a credit card or your fingernail. Wash the area with soap and water, and then apply ice to the area to relieve pain and swelling.

 A severe allergic reaction can include swelling of the face or mouth, difficulty swallowing or speaking, chest tightness, wheezing, dizziness or fainting. If there are signs of a severe reaction – call 911. If the child is conscious, give him or her dyphenhydramine. If the child has an injectable epinephrine (EpiPen), it should be given.

In addition, seek medical care if the sting or bite is near or inside the mouth, or if the site looks infected (increasing redness, swelling, or pus occurring several hours or longer after the sting or bite).

For more safety guidelines, please visit the Kids Health Patient Education Resource on choc.org at: http://kidshealth.chocchildrens.org/PageManager.jsp?lic=456&dn=Childrens_Hospital_of_Orange_County&article_set=22987&cat_id=20812

By Mary Sowa, MS, RD, clinical dietician at CHOC Children’s

Just in time for National Fruit and Vegetable Month, check out these helpful guidelines on incorporating more fruits and vegetables into your family’s diet. One focus of the USDA’s new “MyPlate” guide is to make half of our plate, fruit and vegetables. 

Fruit and vegetables are delicious, crunchy, easy to prepare, low in fat and full of vitamins, minerals and fiber.  They are also rich in antioxidants and phytonutrients that provide the color to many fruit and vegetables and are being linked to boosting the immune system, prostate and eye health.

Lycopene and anthocyanins give fruit and vegetables their pink and red colors. Foods to include in your diet from this group include beets, cherries, pink grapefruit, red grapes and peppers, pomegranates, strawberries and tomatoes.

Carotenoids give fruits and vegetables their yellow and orange coloring. Foods from this group include apricots, squash, cantaloupe, carrots, pumpkins, corn, sweet potatoes and mangoes. 

Lutein gives food like spinach, kale, green peppers, peas and cucumbers their green color.

Anthocyanins provide color to blue and purple fruits and vegetables.  Some of these foods include blueberries, eggplants, plums, prunes and purple grapes.

Some easy ways to include more vegetables and fruits, as recommended by the USDA, are:

• Get creative with your salad – Toss in shredded carrots, strawberries, spinach, watercress, orange segments, or sweet pease for a falvorful salad. 
• Salad bars aren’t just for salads - Try eating sliced fruit from the salad bar as your dessert when dining out.
• Be creative with your baked goods - Add apples, bananas, blueberries, or pears to your favorite muffin recipe.
• Make a tasty fruit smoothie - For dessert, blend strawberries, blueberries, or raspberries with frozen bananas and 100 % fruit juice for a delicious frozen fruit smoothie.
• Liven up an omelet - Boost the color and flavor of your morning omelet with vegetables. Simply chop, saute, and add them to the egg as it cooks.

Needing more inspiration to make half your plate full of fruit and vegetables? Click on these links to the some of the USDA “Choosemyplate” website tip sheets.

1.  “Add More Vegetables To Your Day”
http://www.choosemyplate.gov/food-groups/downloads/TenTips/DGTipsheet2AddMoreVegetables.pdf

2. “Smart Shopping for Veggies and Fruit”
http://www.choosemyplate.gov/food-groups/downloads/TenTips/DGTipsheet9SmartShopping.pdf

3. “Kid Friendly Veggies and Fruits”
http://www.choosemyplate.gov/food-groups/downloads/TenTips/DGTipsheet11KidFriendlyVeggiesAndFruits.pdf

Summer is just around the corner! To ensure your kids have a fun – and safe – time in the water this season, check out this Q&A with CHOC Children’s Community Education Coordinator, Michelle Lubahn.

Q: What is the most important thing you can tell parents about water safety?
A: Make sure you keep an eye on your kids even if there is a lifeguard on duty. Children need constant supervision in and around water. Designate an official “water watcher” to make sure someone is keeping an eye out at all times.

Q: What are some effective pool protection measures?
A: It’s important to have multiple layers of protection. Kids are fast and can get into things in a matter of seconds. You may want to consider investing in fencing, gates, alarms, and covers for pools and spas.

Keep in mind other sources of danger too, such as bathtubs, toilets, buckets, ice chests, even dog dishes! A child can drown in as little as two inches of water; it happens quickly and silently, too. Latch the toilet seat, and never leave your child alone in the bathtub. Be sure to empty buckets and ice chests as soon as you’re finished with them.

Q: What about water safety tips while at the beach?
A: Watch for and adhere by rip current and weather condition signs posted at the beach. Swimming in the ocean should only be allowed when a lifeguard is on duty.  Also, never swim alone – even good swimmers need buddies!

For more tips, check out this video: http://www.choc.org/video/index.cfm?vid=50.

For more information, or to learn about water safety classes, please contact the CHOC Community Education Department at 714-509-8887.