CHOC’s New Emergency Department is Now Open – What to Expect During Your Visit

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.

Learn more about the Julia and George Argyros Emergency Department at CHOC Children’s.

Related articles:

  • Heads-Up on Teens and Pedestrian Safety
    By the time your child reaches his teen years, you’d think you no longer have to worry about him safely crossing the street. Think again. The teen pedestrian death rate ...
  • When Should I Take My Child to the ED?
    Unfortunately, many parents at some time will face the decision of bringing their child to the emergency department (ED). It can be a scary and confusing situation for children and ...
  • Emergency Medicine: Then and Now
    My first stop after falling out of that tree 50 years ago was the emergency department. So, it’s been especially fun watching how emergency medicine has changed since 1964 – ...

 

CHOC Children’s ED Strives to be ‘Ouchless’

Stitches, shots and sutures can be scary for Emergency Department patients of any age, which is why the Julia and George Argyros Emergency Department (ED) at CHOC Children’s Hospital strives to make visits as ouchless as possible.

Staff members take a holistic approach for pain management at CHOC: Not only do they focus on minimizing physical pain, but they also focus on alleviating mental discomfort. Staff members are versed in age-appropriate techniques, and also call on Child Life specialists to help or relieve fear and anxiety in patients. In line with CHOC’s mission to provide family-centered care, ED staffers also rely on the simple presence of a parent or guardian to help calm patients.

Distraction also plays a strong role in comforting patients. Here’s a short list of distraction methods or tools used in the ED:
• books
• iPad
• games
• movies
• stickers
• coloring books
• video games
• bubbles
• beads

ED staff members also have a variety of medical tools at their disposal to help ease pain and minimize discomfort during procedures. Here’s a short list:

Ultrasound-assisted blood draws

CHOC Children’s ED has a one-poke goal, meaning staff members work to ensure that a needle is injected just once during a procedure. If a patient’s veins are difficult to find, perhaps because they are dehydrated, staff may rely on an ultrasound machine to help identify the location of a vein. This increases the chances that one poke will be sufficient to achieve the procedure’s goal.

J-Tip Needle-Free Injection System

The J-Tip allows CHOC Children’s ED staff to administer numbing medication, such as lidocaine, transdermally and without needles. The device uses pressurized gas to propel medicine into the subcutaneous portion of the skin in less than a second. Once activated, the J-Tip emits a “pop” and “hiss” noise, similar to what’s heard when opening a soda can. The J-Tip is easy to use for staff and virtually painless for patients.

Toot Sweet

Efforts to minimize discomfort are made for even the smallest of patients at CHOC Children’s ED. Staff members offer babies pacifiers dipped in Toot Sweet, a 24-percent water and sucrose solution. Absorbed through the mucous membranes in the mouth, the solution has proven to calm and soothe infants. The solution can be administered just minutes before a procedure, or during as necessary.

LET

Patients receiving stitches at CHOC Children’s ED hardly feel a thing thanks to LET, a topical anesthesia mixture containing lidocaine, epinephrine and tetracaine. A staff member will apply the numbing gel to the affected area before administering stitches. The affected area will feel numb and weak, which usually wears off after 20 minutes or so.

LMX

CHOC ED patients who will undergo a lumbar puncture or who have ports that must be accessed will first be numbed with LMX, a topical liposomal lidocaine cream. It takes between 20 and 30 minutes to take effect, and wears off between 40 and 60 minutes after application.

The Julia and George Argyros Emergency Department at CHOC Children’s is located at 1201 W. La Veta Ave., Orange, CA 92868, in the Bill Holmes Tower. 

Related articles:

  • Heads-Up on Teens and Pedestrian Safety
    By the time your child reaches his teen years, you’d think you no longer have to worry about him safely crossing the street. Think again. The teen pedestrian death rate ...
  • When Should I Take My Child to the ED?
    Unfortunately, many parents at some time will face the decision of bringing their child to the emergency department (ED). It can be a scary and confusing situation for children and ...
  • Emergency Medicine: Then and Now
    My first stop after falling out of that tree 50 years ago was the emergency department. So, it’s been especially fun watching how emergency medicine has changed since 1964 – ...

Orange County’s Only ER Just for Kids

The Julia and George Argyros Emergency Department at CHOC Children’s Hospital is Orange County’s first all-pediatric emergency department. But did you know that children don’t have to appear seriously ill in order to come here for evaluation and treatment?

That’s because children often have quite different symptoms than adults. A high fever, stomachache or other mysterious aches and pains that would not to appear be serious in an adult can, in fact, be dire for children. When in doubt, it’s always best to let the experts decide. And no one knows more about babies, kids and teens than the pediatric professionals at CHOC Children’s. 

We sat down with James Pierog, M.D., medical director of CHOC emergency medical services, to find out what else parents should know about CHOC’s emergency department. 

Q. Okay, so how do I know if I should take my child to the emergency department?

Dr. Pierog: Always trust your gut. We treat a variety of ailments, big and small, from broken bones and small abrasions, to fevers and headaches. No matter is too small, and no patient is turned away. Even if your child does not need treatment, you’ll leave our emergency department with reassurance and education.

Q. What is so different about CHOC’s emergency department? Why do kids need a special place?

Dr. Pierog: It is the only emergency department in Orange County that has been designed, equipped and staffed with an all-pediatric focus. Children are not miniature adults, and it’s not simply a matter of ordering smaller blood pressure cuffs. Children and teens are physiologically different than adults. Our pediatric physicians, nurses and staff members know how to treat their unique medical needs.

We also offer services you won’t find at regular hospitals, like child life specialists. These trained child development professionals are experts at providing comfort to patients and families. They can help explain procedures or ailments in a way that is easy for children – and their parents — to understand. They also provide distractions to help alleviate pain, minimize anxiety or pass the time.

Q. Can I stay with my child?

Dr. Pierog: Absolutely. In fact, our exam rooms are larger to accommodate family members, including younger siblings and their strollers. A parent’s presence is the best coping mechanism around, and siblings also have a role in treatment and healing. Just keep in mind that a visit may take awhile, and small children may grow inpatient.

Q. Will the wait be long?

Dr. Pierog: Our emergency department is designed for fast triage, rapid diagnosis and speedy treatment to streamline each visit. Still, it is hard to estimate how long a visit will take. It will depend on the type and severity of your child’s ailment, as well as other patients visiting the ED that day. We usually see patients in order of their arrival, but children with serious illnesses or injuries may be seen first.

Q. I have an HMO: Do I need to get approval before coming to CHOC?

Dr. Pierog: CHOC does not require approval from a patient’s healthcare provider to offer care at the Julia and George Argyros Emergency Department. However, you should check with your provider for more details regarding coverage specifics.

What To Bring With You
• Diapers, formula and other baby supplies
• A list of any medications your child takes
• Referral paperwork, X-rays or lab results, if available
• Blanket, stuffed animal, favorite toy or other comfort item
• Cell phone and charger, or change for the pay phone.

Learn more about the Julia and George Argyros Emergency Department at CHOC Children’s Hospital.

Related posts:

  • Heads-Up on Teens and Pedestrian Safety
    By the time your child reaches his teen years, you’d think you no longer have to worry about him safely crossing the street. Think again. The teen pedestrian death rate ...
  • When Should I Take My Child to the ED?
    Unfortunately, many parents at some time will face the decision of bringing their child to the emergency department (ED). It can be a scary and confusing situation for children and ...
  • Emergency Medicine: Then and Now
    My first stop after falling out of that tree 50 years ago was the emergency department. So, it’s been especially fun watching how emergency medicine has changed since 1964 – ...

OC’s First “Kids’ ER” Opens in March

Staffed around the clock by our world-class team of pediatric emergency medicine physicians, pediatric nurses and other specially trained healthcare professionals, the Julia and George Argyros Emergency Department opens in March 2013 in our new state-of-the art patient tower at CHOC Children’s Hospital. It will be Orange County’s first and only exclusively pediatric emergency department, providing advanced, leading-edge care within a kid-focused, family-centered environment.

Thanks to the Argyros family’s generous $5 million gift, every inch of our new 22,000-square-foot emergency department will be designed and equipped to meet the special needs of babies, kids and teens.“Children are not merely miniature versions of adults,” said Frank Maas, R.N., director of the Julia and George Argyros Emergency Department at CHOC Children’s. “Physiologically, developmentally and emotionally, their needs are quite different. They require a sophisticated level of specialized care, especially in an emergency situation.”

From Left to Right – Kimberly Chavalas Cripe, President and CEO, CHOC Children’s; Julia and George Argyros; Stephanie Argyros, CHOC Children’s Foundation Board of Directors member, and her children.

Located on the first floor of the new patient care tower, the Julia and George Argyros Emergency Department will  feature:

  • 31 treatment rooms
  • 14 rapid medical exam rooms
  • Three triage suites

The Julia and George Emergency Department is among many new services being offered in CHOC’s new tower. For the first time in CHOC’s history, all patient care services will be provided within an all-pediatric environment under one roof. This includes advanced operating rooms, laboratory, pathology and imaging services. These capabilities, along with enhanced patient and family amenities, will create the most serene, healing environment possible for the youngest members of our community.

 

 

Advanced Patient Care, Safety Features
Featuring leading-edge advancements in technology and patient safety, our new seven-story tower will position CHOC as a premier children’s hospital, including:

Lower Level —Laboratory, Blood Bank, support services

1st Floor — Julia and George Argyros Emergency Department, main lobby, admitting, radiology

2nd Floor — Patient and family amenities, including in-house radio station and multimedia center, public and patient outdoor area, Meditation and Prayer Center, Family Resource Center, Café

3rd Floor — Robert L. Tidwell Surgical Center, CHOC Children’s Heart Institute

5th Floor — Hematology and Oncology, including 28 new beds

4th, 6th, 7th Floors — Shelled space for future needs

Related articles:

  • Heads-Up on Teens and Pedestrian Safety
    By the time your child reaches his teen years, you’d think you no longer have to worry about him safely crossing the street. Think again. The teen pedestrian death rate ...
  • When Should I Take My Child to the ED?
    Unfortunately, many parents at some time will face the decision of bringing their child to the emergency department (ED). It can be a scary and confusing situation for children and ...
  • Emergency Medicine: Then and Now
    My first stop after falling out of that tree 50 years ago was the emergency department. So, it’s been especially fun watching how emergency medicine has changed since 1964 – ...