A magical emergency department visit

When 3-year-old Vinny and his mom Nikki visited CHOC Children’s for the first time, they didn’t expect a calming experience thanks to a magic show, or that staff would go above and beyond to make them feel comfortable.  

 Vinny had a fever, and his pediatrician suspected pneumonia. After a few days of antibiotics, the fever returned, prompting his trip to the Julia and George Argyros Emergency Department at CHOC Children’s Hospital. 

“His pediatrician had told us that if Vinny didn’t seem to get better, we should rush him to CHOC,” Nikki says. 

Nikki called the emergency department before bringing Vinny in, to check on COVID-19 visitor requirements. His fever was nearly 104 degrees when they left the house for their first-ever visit to CHOC. 

 Nikki and Vinny remember feeling nervous, stressed and scared when they arrived, but appreciated how CHOC staff reassured the two from the very beginning.  

“Everyone had a very palpable sense of confidence that they will take care of the children, while also being super soothing and calming in their attitude and demeanor,” Nikki says. 

In the emergency department, Vinny was given a COVID-19 test. He’d had one before but had a much smoother experience this time. 

“Vinny has had a test done elsewhere prior to being at CHOC and that experience was traumatic for him,” Nikki says. “The test done at CHOC was faster and went smoothly thanks to the child life specialists who helped distract him.” 

Vinny’s vitals and stats were checkedand he was prepared for a chest X-ray. The X-rays showed that he not only had pneumonia, but also pleural effusion, a buildup of excess fluid in the lungs. 

Dr. Seth Brindisa board-certified pediatric emergency medicine specialist is an expert in taking care of sick kids. But before he discussed the X-rays results with Nikkihe put Vinny at ease with something else he excels in — magic tricks. He greeted Vinny by pulling a coin from behind the 3-year-old’s ear. That trick was followed by a series of magic tricks that brightened Vinny’s evening, and eventually, his entire experience at CHOC. 

Vinny pictured outside CHOC
Vinny smiles behind his mask outside CHOC, after being discharged.

Aside from magic tricks, Dr. Brindis also had a treatment plan up his sleeve. He sent Vinny home with a prescription for stronger antibiotics and ainhaler. He also explained to Nikki what should and should not happen with Vinny while he healed at home. 

choc emergency department
Dr. Seth Brindis often performs magic tricks for his patients.

“From early on, CHOC always had a future plan, and communicated that to us,” Nikki says. “I was always able to ask whatever questions, and they had answers.” 

Nikki and Vinny went home, but four days later his fever returned, and he was unable to breathe, so they returned to CHOC’s emergency department.  

This time, doctors determined that Vinny needed to be admitted to CHOC Children’s Hospital for further evaluation and treatment. As part of this process, he was tested a third time for COVID, an experience that again went smoothly, thanks to the child life specialists of the Cherese Mari Laulhere Child Life Department. 

Vinny stayed at CHOC for a week for stronger antibiotics, monitoring and supplemental oxygen. Throughout his stay, he was under the care of a multidisciplinary team of pediatric experts. This included Dr. Antonio Arrieta, medical director of infectious diseases, who was determined to help Vinny feel better. This level of care helped Vinny’s mom feel better, too. 

Dr. Antonio Arrieta
Dr. Antonio Arrieta, medical director of infectious disease at CHOC Children’s

Dr. Arrieta was truly one of the most intelligent human beings I’ve ever had a conversation with, and we felt extremely comfortable in his care and that of his whole team,” Nikki says. 

Being in a hospital for the first time was not easy for Vinny. He’s a naturally active child, but due to his compromised lungs and playrooms being temporarily closed due to the pandemic, he was unable to play in areas outside of his room. Luckily, Child Life had just the thing for him. A specialist showed up to his room with a box full of plastic bowling pins and a ball. Vinny was thrilled, and so was his mom 

“Every single nurse, respiratory therapist, child life specialist and doctor we met was just amazing,” Nikki says. “The only thing you truly want in a situation like this as a parent is for your child to be healing and comfortable, and they all worked to make that happen daily.” 

Vinny’s treatment plan was successfulAfter his fever subsided and his symptoms improved greatly, he was able to go back home. 

“Bringing my child to the hospital for the first time was scary at first, especially during a pandemic,” Nikki says. “I will always remember the kindness and world-class expertise that helped my son feel better and get back to being a kid. Vinny will never forget how a doctor turned into a magician right before his eyes. 

Learn more about emergency services at CHOC Children's

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The most common summer injuries that bring kids to the emergency department

Summertime for many kids and adolescents means the excitement of water activities, fun in the sun and spending as much time as possible outdoors. Yet summer is also known as “trauma season” among pediatric experts like Dr. Ted Heyming, chair of emergency medicine at CHOC Children’s. According to Safe Kids Worldwide, a leading children’s safety organization, summer season represents millions of emergency room visits by children 14 and younger due to unintentional injuries, many resulting in death.

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Dr. Ted Heyming, chair of emergency medicine at CHOC Children’s

To help avoid unintentional injuries, Dr. Heyming recommends that parents and caregivers be on high alert and supervise children extra closely. The following are the top injuries Dr. Heyming and his team see in the Julia and George Argyros Emergency Department at CHOC Children’s Hospital during the summer season and tips to avoid summer injuries:

Head injuries
The risk of head injury is high in adolescents and especially common in the spring and summer months with popular outdoor activities such as bicycle riding, in-line skating and skateboarding. The injury can be as mild as a bump, bruise or laceration, or can be moderate to severe due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain. Parents should seek emergency medical attention for their children should any of the following occur after a head injury:

  • Vomiting more than once
  • Alteration in mental state
  • Increased irritability, fussiness
  • A seizure
  • Weakness in parts of the body, such as in an arm or leg
  • Bad headache

How to prevent head injuries:

Wearing a helmet whenever riding a bicycle, in-line skates, or a skateboard should be an automatic habit. Helmets should fit properly on your child’s head and also be fastened correctly. A helmet that fits and is fastened properly does not move around on the head. Worn properly, helmets are effective in preventing severe head injuries. Here’s a video with tips on how to properly fit a helmet.

Facial injuries 
Children may get minor cuts, wounds, and lacerations to the face while engaging in play or sports activities. Most of these injuries can be handled at home with simple first-aid treatment. Seek immediate medical attention for cuts and wounds on your child’s face if accompanied by any of the following:

  • Heavy bleeding that does not stop after 5 to 10 minutes of direct pressure
  • The injury involves the eyelids or eyes
  • Wound is gaping.
  • Injury is caused by a puncture wound, or dirty or rusty object or embedded with debris such as dirt, stones or gravel
  • The wound is caused by an animal or human bite
  • If your child indicates the wound is excessively painful, or if there’s a possibility of a fracture of the head or any other bone
  • Your child shows signs of infection such as increased warmth, redness, swelling or drainage

Help prevent facial injuries by teaching your child the following:

  • Not to poke or place objects in his ears or nose
  • Not to walk or run while holding an object in her mouth
  • Not to suck or chew on hard, sharp or pointed objects
  • Wear protective eye, ear, or face guards for sports activities that could cause injury

Wrist and elbow fractures
A fracture is a partial or complete break in the bone and can result from falls, trauma or a direct blow or kick to the body. Wrists, forearms and elbows are vulnerable to these injuries, and they are especially common among children ages 2 and older. Many occur with popular summer activities such as basketball, bicycle riding and skateboarding. The following symptoms in the injured area might indicate a fracture that requires immediate medical attention:

  • Pain
  • Swelling
  • Obvious deformity
  • Difficulty using or moving the injured area in a normal manner (unable to walk)
  • Warmth, bruising or redness

How to prevent wrist and elbow fractures this summer:

Although fractures are a common part of childhood for many active children, you can take steps to help prevent them through simple safety precautions such as making sure kids always wear safety gear like helmets and wrist guards when participating in sports.

Drowning

Summertime water activities are fun, but always present a risk for drowning. Drowning can happen without a sound. It is the leading cause of accidental death for children under the age of 5 and can happen in less than 2 inches of water. In 2018, Orange County had 36 drownings in children less than 5, and five of those were fatal.

How to prevent drowning

  • Never leave a child unattended near water in a pool, tub, bucket or ocean. There is no substitute for adult supervision.
  • Teach kids survival swimming skills.
  • Kids that are not strong swimmers should wear US Coast Guard-approved, well-fitting life jackets.
  • Make sure kids have constant supervision when they’re in or around water. Always designate at least one adult as a “water watcher.”
  • The home should be isolated from the pool with a fence at least 60 inches tall, with a self-closing, self-latching gate.
  • In 2015, Orange County created the Drowning Prevention Task Force, of which CHOC is a member, to develop recommendations on methods and strategies to improve drowning prevention efforts in Orange County. Learn more here.

Bringing your child to the emergency department

The emergency department is the best place for apparent life-threatening events. Not all emergency departments take care of children on a regular basis. It is best to go somewhere that specializes in children’s health with specialized training and equipment made just for kids.

This article was updated on May 15, 2020.

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CHOC1 Helicopter Marks 200th Flight

Marking the launch of a new era for emergency transport services at CHOC Children’s, the “CHOC1” helicopter landed for the first time atop the Bill Holmes Tower at CHOC Children’s Hospital in 2018.

In just ten months, CHOC1 has clocked 200 flights, traveling all over Southern California, even as far north as Bakersfield, to transport critically ill patients to CHOC. On a typical afternoon, CHOC1 can fly to CHOC Children’s at Mission Hospital in a mere seven minutes, as opposed to driving for one hour in bumper-to-bumper traffic on the freeways.

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The transport team is comprised of expert physicians, nurses and respiratory therapists.

The transport team is comprised of expert physicians, nurses and respiratory therapists. At the helm is Kevin Barber, lead pilot.

Throughout his 15-year career as a pilot, Kevin has flown many different types of aircraft on a variety of assignments, but he’s found the mission of flying children to be the most rewarding of his career. Prior to flying in the private sector, Kevin was a naval officer for seven years and holds a master’s degree in public administration.

“Aviation offers many different avenues but only being an emergency medical services pilot offers the ability to make a difference in your own community and help people on what is one of the worst days of their lives,” Kevin says. “Plus, the transport teams on our aircraft are top notch. There is a great amount of satisfaction flying with such professional physicians, nurses, respiratory therapists and paramedics.”

kevin-barber-CHOC1-helicopter-lead-pilot
CHOC1’s lead pilot Kevin Barber.

According to service partner Mercy Air, CHOC1 is the only helicopter in Southern California based out of a hospital, with four pilots and mechanics housed on site at CHOC, giving the transport team the ability to jump into action immediately.

State-of-the-art equipment on board

The helicopter is specially configured with high-tech equipment including neonatal isolettes and smart IV pumps that are loaded through the back of the aircraft and secured into a confined space.

One device in the helicopter is designed to cool critically ill newborn infants.

“To help reduce chances of neurological impairment in these sick newborn babies, cooling needs to be initiated within four to six hours of birth, or even earlier for better outcomes,” says Tari Dedick, manager of emergency transport services. “If we pick up a critically ill baby in the Inland Empire, we can begin cooling immediately at the bedside and continue the therapy in the helicopter on the way back to CHOC, saving precious time.”

Safety is the No. 1 priority for CHOC’s transport team.

Mercy Air maintains its Commission on Accreditation of Medical Transport Systems accreditation, which has stringent requirements about staff training, medical equipment and even what the CHOC transport team wears, including flight suits and helmets.

Among Kevin’s vast responsibilities as pilot is to closely track weight and balance restrictions. It’s often a tight squeeze in the helicopter, with every person and each device weighed prior to the flight to determine precise weight and balance.

Widening reach

CHOC’s transport team, using ground and air transportation, travels 100,000 miles each year to bring more than 4,000 patients to CHOC. Looking to the future, Tari says, the transport team anticipates eventually transporting trauma patients from all over Southern California to CHOC’s Level II pediatric trauma center.

“Without a doubt, CHOC1 is widening our outreach while bringing the Southern California community closer,” Tari says.

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Should I Take My Child to the Pediatrician, Urgent Care or Emergency Department?

By Dr. Sarah Kay Herrera, a CHOC Children’s pediatrician

At CHOC Children’s, we know that parents want to be confident they’re giving their child the best care. In order to do that, you need to know where to bring them when they’re sick, but the problem is there are so many options: Do I bring them to the pediatrician’s office? Urgent care? Emergency department? This can make you feel overwhelmed and confused – especially with cold and flu season just around the corner.

We believe parents should have peace of mind they are getting their child the best care. We know it can be scary, stressful and sad to have a sick child. That’s why our Primary Care Network has 16 convenient locations throughout Orange County and beyond. CHOC Children’s Hospital in Orange offers the only emergency department in Orange County that’s just for kids. At the Mission Hospital Emergency Department, in partnership with CHOC Children’s at Mission Hospital, kids and families have access to pediatric-trained nurses, physicians and specialists.

To help you make decisions about where to go for care, consult this guide:

1. Pediatrician

Your pediatrician’s office is not only a place for check-ups, but your primary resource for sick visits as well. Your child’s pediatrician is the doctor who already knows your child’s medical history.

  • You will need to set an appointment for a sick visit, which could include symptoms like fever, runny nose, cough, ear pain, headaches, sore throat, rashes or abdominal pain.
  • If your child is experiencing a chronic lingering issue such as abdominal pain or headaches, it is best to see your pediatrician as they can provide ongoing care and find a pattern in the symptoms, which is important for more complex illnesses.

Here’s a helpful guide of what to bring to the pediatrician’s office.

2. Urgent care

  • Urgent care offices are usually open after business hours, which is typically after 5 p.m. and weekends.
  • Most are walk-in clinics and do not take appointments. This means you can usually expect long wait times. This is the best place to go for acute illness such as fevers, ear pain, runny nose, cough, sore throat, vomiting, diarrhea, minor falls, and stitches.
  • Sometimes your pediatrician or an urgent care provider may decide your child is too ill to go home and they may send you to the emergency department for further treatment or testing.

Emergency department

  • In some cases, it’s best to go straight to the emergency department for apparent life-threatening events, which could include rapid and fast breathing, head trauma, trauma with loss of consciousness or vomiting, motor vehicle accidents, severe abdominal pain or dehydration.
  • An infant less than 28 days old with a fever of 100.4 degrees or higher is considered an emergency and should be taken directly to the ED.
  • Here’s a helpful checklist of what to bring to the emergency department.
  • Not all urgent care clinics and emergency rooms take care of children on a regular basis. It is best to go somewhere that specializes in children’s health. Pediatric-focused facilities have specialized training and equipment to offer the best care for your child.
  • Most pediatrician offices have a phone triage line to help parents decide which place may be best for their child.
Looking for a pediatrician? Find one near you.

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What Every Parent Should Know About Emergency Departments During Flu Season

This year, thousands of people are packing their local emergency department during flu season. As the region’s only pediatric-dedicated facility, the Julia and George Argyros Emergency Department at CHOC Children’s Hospital is seeing an extremely high number of patients, from infants to teens. Our physicians and staff understand how anxious and scared parents and children can get when faced with a trip to the emergency department. They offer the following information and tips for parents coming to the emergency department during the busy flu season:

  • Be prepared to see a full lobby, including people seated in chairs down hallways and in additional areas throughout the department. Typically, the department gets busier as the day progresses. CHOC has added staff to help manage wait times.
  • Leave siblings and other family members at home, if possible. This will help ease crowding, but more importantly, keeps well children from being exposed to sick ones. Also, parents’ attention should be focused on their ill or injured children.
  • Patients are seen based on how sick or injured they are, not on the order they arrived in the emergency department. Please keep in mind there are patients who arrive in ambulances – admitted in an area beyond your view. Our staff must treat the sickest first. If you’ve been waiting and are concerned your child’s condition is getting worse, please ask a nurse to reassess her.
  • Hold off on giving food or drink to your child until she’s been seen by the doctor. A full stomach can delay procedures and the use of sedatives.
  • There are nurses and emergency medical technicians (EMT) who work in the lobby and have different roles. Nurses, dressed in maroon scrubs, help screen and assess patients; some will assist with lab work or X-rays. EMTs, dressed in tan scrubs, can only take vitals and measure height and weight. EMTs will notify the nurses in the lobby of any changes they observe in patients’ conditions.
  • Don’t expect a prescription for antibiotics, which aren’t always the answer. Antibiotics can only treat infections caused by bacteria. Cold illness caused by viruses can’t be cured with an antibiotic.
  • Try to stay calm. Children can pick up on their parents’ fear and anxiety. Take deep breaths for your and your child’s sake.
Download a checklist of what to bring to the emergency department

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