When is it an emergency
When It's an Emergency: Stories from Seattle Children's ER (Parts 1 - 5)
we interrupt our regularly scheduled
program so that we may bring you a coma
for special presentation when it's an
emergency
stories from inside the Seattle
Children's emergency room it's always
open always ready you don't know what's
gonna come in you don't know how
families are gonna be he was having a
lot of distress freezing 24/7 365 days
of the year so there was like a lot of
blood and so I just called 911 the
emergency room of Seattle Children's
sees it all it's hard to see kids who
are sick or hurt from heartbreak so hope
everybody always says you know I was I
just looked away for a second
we take an inside look at the triage the
training and the typical I felt they
kind of Bend so I knew I think it when
it's an emergency
stories from inside Seattle Children's
er good evening I'm Molly Shen here we
are at one of the best places you never
want to go the emergency department at
Seattle Children's it's where you'll
find world-class pediatric emergency
care you hope your child never needs but
plenty do need to come here this ER had
almost 40,000 visits last year tonight
we take you inside to see the inner
workings of the emergency room of
Seattle Children's inside doors that
never closed and never turn away a
patient if there's such a thing as a
typical day at the emergency department
here at Seattle Children's it usually
involves some ambulance arrivals
sometimes even a helicopter will deliver
a critical case like this tiny baby with
big medical concerns but no matter what
comes in the door on any given day the
people who work here work very hard to
keep this place from feeling like a
prime-time TV drama in order for us to
provide the best care in the safest care
and very detail-oriented care and
mistake-free care the best environment
to do that in is not an environment
where everyone's shouting out orders and
running around it's one of as much
control as possible we drill often we
want people to be practiced we want
people to be gonna listen to you okay
very attentive to detail and and not
distracted and we want the family
experience to be positive too clinical
director of emergency services dr.
Russell migite knows families who are
here appreciate that environment in the
midst of their personal crisis where she
was submerged under water the family of
five year old Alena Jennings will
remember this day for the rest of their
lives the day they could have lost their
little girl in a swimming pool in the
blink of an eye and got her out in about
twenty or thirty seconds but she's been
having difficulty breathing she
swallowed some water and vomited up some
water and that can lead to some
difficulties especially within the first
12 hours while emergency providers work
with Alena you can see the stress on her
family it's pretty scary she's gonna go
to our intensive care unit and hopefully
and I believe that she'll probably keep
breathing on her own but she may need
some assistance the patient and family
experience is front of mind here every
day they're looking just to make sure
her blood gases stay good and that her
lungs are good and that she's breathing
okay and she doesn't want a respiratory
distress cases like Elena's show that
you never know what the day or night may
bring it's stressful and it's hard it's
hard to see kids who are sick or hurt
but we also know that it happens and so
the people who are here are here because
they want to make a difference and
people
who are here accept the fact that part
of making that difference in being
involved is dealing with the fact that
that sometimes there are very tough
situations to deal with Oscar is just
two days old but he looks really really
good
he definitely is breathing fast he's not
breathing with work he's not working to
breathe he's his mother's third child
and her instincts told her his breathing
didn't seem right there you go buddy
and she thought she should have him
checked he was having a lot of distress
breathing grandma agreed well I felt
that Children's Hospital was the best
place to go to make sure my little
grandson was taken care of properly
Oscar gets a thorough exam including a
chest x-ray so doctors can find out
what's going on with his breathing from
tiny newborns to teenagers I felt they
kind of Bend though and you were
thinking a broken bone a painful abscess
that'll need to be drained an asthma
attack all kinds of conditions and
concerns bring worried families through
the ER doors let's look at his palms and
their souls because I know he already
has a rationale but he may actually get
another rash with this in his throat I
think that's something that we have to
continue to be mindful of is the fact
that even for patients who don't seem
like they're here for a critical issue
it's the most important thing to that
family at that time the early diagnosis
for Oscar is extra fluid on the lungs
that didn't get fully squeezed out when
he was born that explains his rapid
breathing which is of course concerning
but not uncommon but this is a really
savvy mom who did all the right things
and saw all the things watched for all
the things that she needed to watch out
for and went to her primary care
physician of her primary care physician
sent her here so they have a good safety
net and the safety network for them it's
all serious to the people who are
involved but in the in the big spectrum
of things this is bread and butter
pediatrics and
you know it's part of what we do and
it's part of what we enjoy doing and the
good thing about this is I think this is
gonna have a really happy ending most
children who come here do get a happy
ending like Alena who never stopped
breathing on her own and now gets to
move to a regular room for what will
likely be a short stay mom pulled
through - oh my golly I love this
hospital the staff is over-the-top
amazing
it's another happy ending in a place
where a typical day is anything but
typical it's true that those who work
here never know what the day or night
may bring but they do know that they'll
be working with children from tiny
newborns to growing teens this ER and
all the people who work here are
uniquely equipped to deal with children
five-year-old Abigail Nelson took a bad
fall at her preschool playground and
landed in the emergency department of
Seattle Children's she managed to break
both bones in her forearm and the bones
are broken enough and they're displaced
enough that were going to need to put
the bones back into place so she can
feel properly her x-rays shows she
really did a number on that arm so these
are the two bones of her forearm her
radius and her own and you can see
there's definitely a fracture right in
the middle of the bone on both sides
this is why we always do two x-rays
because this x-ray you can see there's a
fracture but it doesn't look too bad
when we look at the x-ray from the side
you can see what's in what normally
should be a straight bone is quite
angulated and this is the part that
really needs to be fixed as those bones
need to be straightened so she can heal
properly
fixing Abby's arm doesn't sound very fun
one of the most important things that is
that we tried to make this as the least
amount of trauma in pain for Abby as
possible so we're going to give her some
medications that will treat not only her
pain but will help her basically fall
asleep while we get it done she won't be
completely asleep it's not Jenna Lana's
but she won't have a hole she won't have
any memory about what's going on and she
she won't really be aware of what's
going on in a room but the nice thing is
it's a very safe medication to get that
heavy sedation
Abbi will need an IV also not fun for a
five-year-old knock knock hi guys is
Abigail's room enter Paul foster my name
is Paul and I'm our Child Life
Specialist
the works here at the hospital so I'm
different than our nurses and doctors
okay so my job here at the hospital is I
help you understand what's going on and
then try to make it a little easier and
more fun does that sound okay Paul
prepares Abby for what she can expect in
a way that she can understand I'm here
to help make their stay a lot easier my
job is to help assess how kids are
coping with their emergency department
stay and I provide preparation education
and for our younger kids lots of
distraction to help get them through
certain invasive procedures how's he
been doing so far since you got into you
do okay in triage Paul is a Child Life
Specialist all of the providers here are
trained in dealing specifically with
children using comfort and distraction
techniques that are appropriate to a
child's age and situation but Paul is
the big gun called in when a patient
needs that extra special touch so this
is the small strong you wanna feel it
it's really soft it's mom and dad this
is an IV if you guys haven't seen one
before so what we do is we put the small
straw inside one of our bodies blue
lines and we can give you medicine
through it
and it makes you feel all better and
it's gonna help take away the alleys in
your arm he doesn't hide anything from
the kids rather he educates them on
what's about to happen and why in an
age-appropriate way so sometimes kids
ask me they say Paul what is this small
straw gonna feel like do you want to
know what it feels like yeah kids tell
me that it feels like a small pinch
I love the educational component I love
getting to educate kids about why they
come to the hospital and what the staff
are doing cuz you know for a lot of
people you know seeing the white coat
come into a room is kind of a scary
thing but you know knowing that all the
doctors and nurses here
really love to help kids get feeling
better and to educate them on you know
why we do a blood pressure cuff and why
we take their temperature and all those
things I really I like seeing that click
in the child's eye of oh oh that's why
they're doing that and I really enjoy
that and you watch with your eyes and
see if we find it Paul also uses
distraction to help young patients
through a procedure is that the one
instead of a be focusing on that IV
about to go in she's turned away
engrossed in a book that Paul brought a
broken bone an IV this is pretty typical
stuff here in the ER but it's a very big
deal for Abby and her family a yellow
frog okay Abby being five it's important
that I meet her where she is
developmentally understanding that she's
not an adult and she doesn't necessarily
want to know everything but she wants to
know everything that's important to her
so understanding what it is a
five-year-old understands and what it is
a five-year-old wants to know at the
same time providing an appropriate level
of information for the parents who of
course want to know everything I want to
make this for Abby like I said she's had
a bad day I want her to leave this
experience with not only without trauma
but hopefully with a smile we're gonna
give it to you right through your small
straw okay
so there's no there's no more owies nope
sometimes kids say that it feels a
little warm but no Ally's okay and then
you'll wake up and your arm will be all
fixed and you get to go home but what I
will please make you talk
that's right and you won't feel anything
yeah yeah it was it was really scary it
was huh the tumble three year old Peyton
took while vacationing in Seattle
certainly scared her and her parents my
daughter had a fall over at the Science
Center into an open what used to be it
look like a little pond and fell over
the chain wha and hit her best at her
head but the time in the emergency room
even the stitches really weren't so bad
and Paul who helped her just kind of
ease made her laugh and brought him
bubbles and books and coloring and
everything so she was much more
comfortable with that part of it and
then he came in and talked to Peyton and
explained to her the process of what
they were going to do and so she could
understand an ER visit as a child can
set a lifetime attitude toward all
things medical good or bad if this is a
traumatic experience
patients could fear doctors hospitals
even needles well into adulthood those
who work here in the emergency
department know the importance of making
this experience as painless and positive
as possible I just always yeah well she
did a great job tolerated everything
great so in terms of giving you advice
for what to talk to her about at home I
can't think of anything because she did
so well okay so but if questions do
arise usually she'll kind of express it
through play house or just kind of keep
an eye out through that we try to have a
pain-free environment so we always want
to make sure patients don't have pain
but we recognize that a lot of the sense
of pain is anxiety and if we have people
who are specially trained to reduce the
anxiety but as our physicians our nurses
but especially our Child Life
specialists it makes a huge difference
for the family that children leave
smiling and happy even after an invasive
procedure Abbey is waking up to an arm
that's put back together so it can heal
doctors fixed her arm it's all better
now
she's now excited about a pretty pink
cast in her future and not at all upset
by the day's events and Peyton heads
home with some souvenir stitches and a
smile Paul isn't the only Child Life
Specialist here at Children's while he
works in the ER other Child Life
specialists in other parts of the
hospital help kids deal with surgery
cancer treatment and hospitalization
coming up that top reasons for emergency
room visits here at Seattle Children's
can you guess what's number one and how
prevention can be the best medicine what
doctors are doing to keep you from
having to come here in the first place
you
here are the top ten reasons for visits
to the Seattle Children's emergency
department number 10 a rash 9 laceration
which is a cut or gash number 8 otitis
media
a middle ear infection number 7 a broken
bone 6 asthma 5 abdominal pain the
fourth most common reason for an ER
visit to Seattle Children's a soft
tissue injury like a bruise sprain or
strain number 3 upper respiratory
infection number 2 gastroenteritis a
stomach virus and the number one reason
for an ER visit to Seattle Children's
fever you can see from that top 10 list
that many of the things that bring
children here are certainly concerning
but not that high adrenaline
life-and-death situation that Hollywood
portrays fortunately those situations
don't happen often but they do happen
that's why everyone here has to be ready
for the big one at all times tune into
any Hospital TV show and you'd think
emergency rooms are constantly bringing
people back from the brink but that kind
of excitement is more about ratings than
real life we know when you watch ER on
TV or other shows everything is really
acute and emergent and I think when we
look at our patients most ers don't have
that high level of acuity and
emergencies so we might have one or two
percent of our patients per year that
need a full blown resuscitation but we
have to be ready for that any time of
day or night for any cost whether to
trauma cause whether it's a medical
cause when it's a cardiac cause drowning
or anything else we have to be ready for
that so Ronnie we've gotten we're in the
IDI Air Lift has just transferred her
over she's already on monitors she's got
a working IV ready for anything at any
time that's why training and lots of it
is so important patient weighs 12.5
kilograms and is no drug allergies teams
run scenarios complete with role playing
sometimes with scripts to follow to
fine-tune communication so we just did a
scenario which nr in terms of simulation
that's practice we're practicing it's an
opportunity for us to work on skills and
on communications challenges that we
face every day and it's a chance for us
to work on them and practice them over
and over again so our skills get better
and our processes run smoother
some simulation training is so realistic
it's hard to tell it isn't the real
thing correct comedy as this team tries
to deal with the resuscitation drill a
technician makes the sim babies
breathing blood pressure and heartbeat
react as a real babies might so Sarah
after you've gotten the intubation meds
ready then we'll start a bolus this is -
dropping and I'm struggling eventually
the staff at Seattle Children's are
national leaders in developing and
implementing simulation training like
this sequence medications they set the
standard for how providers across the
country train and prepare let's top the
scenario with practice this kind of
emergency becomes routine even though
it's relatively rare as appropriate and
immediate response can be life-saving
and it's probably similar to what pilots
do you know they practice and they
practice and they practice so when they
have an emergency it's second nature and
one of the most important things the
emergent partment is to anticipate and
be prepared of the nearly 40,000
emergency room visits to Seattle
Children's last year a good number of
those were for things that could have
been prevented no offense but when it
comes right down to it doctors would
rather not see you here not if taking
their advice can keep your child safe
and healthy Ben Franklin once said an
ounce of prevention is worth a pound of
cure that sentiment rings true every day
here at the emergency department at
Seattle Children's any parent here would
love to turn back time anything to have
avoided this visit in the first place
anything to keep their child safe hi I'm
dr. Ben Danielson a pediatrician at
Seattle Children's Hospital I'd like to
talk with you a little bit today about
pedestrians
doctors at Seattle Children's want kids
to avoid ER visits just as much as
parents do that's why they take the time
to star in public service announcements
over the airwaves and on websites to
share important and specific safety
information there's no question that the
best way to protect your child when
they're on a bike a scooter or skates is
to wear an appropriately sized helmet
they give tips reminders and advice that
might keep them from seeing your child
in the emergency room wear a life jacket
as ER Doc's they'd love nothing more
than to put themselves out of business
to never be needed again each year
almost 5000 children nationwide fall out
of windows such simple things as an open
window at home or a hard hit at practice
can turn an ordinary day into an
emergency situation make sure your child
has the right safety gear and then it
fits properly in an instant those safety
caps only work for so long accidental
poisonings send 50,000 children to the
hospital every year nationwide i'm dr.
suzanne nazar an emergency room doctor
dr. Suzanne Mazur sees an average of 3
or 4 cases in the Seattle Children's er
each week kids who've gotten into
prescription pills or household cleaners
because parents didn't take steps to
keep them out of the hands and mouths of
babes two-thirds of kids who are
poisoned are kids less than aged five
and almost all of those are preventable
so an unsupervised kid getting into a
medicine you know just for a minute
the parent looks away and the child gets
into a medicine Seattle Children's also
hosts community events educating and
equipping families to keep kids safe
the trials are outreach events such as
this one at Green Lake offer bike
helmets and life jackets at low prices
and properly fitted in hopes they'll get
used and potentially save lives I think
it's cool that there
life jacket since it should be required
I think it's a great excellent program
and I think everybody should take
advantage of the outreach the education
first insist on adult supervision
all of these ounces of prevention can
add up and make a weighty difference
learn to swim drownings for instance
have dramatically decreased in the past
few decades since dr. Linda Kwan made it
her mission to help stop such
preventable tragedies we have worked
really hard by trying to get families
aware of the risks and we've worked hard
with a Health Department they've been
amazing leaders in this with us partners
with us and with work to get legislation
passed to to make children safer like
wearing lifejackets and the health
department has worked to have
legislation to make our pools safer and
so all of this has has led to
contributed to I believe that the reason
why we're seeing so so few drownings the
ER at Seattle Children's is here when
you need it you should wear a helmet two
kids are more likely to wear a helmet if
their parents do but hey if you can
avoid ever having to come here even
better
absolutely prevention is the name of the
game Seattle Children's has compiled
many safety and wellness tips for
parents and caregivers if you'd like to
learn more go to seattle children's org
slash safety
- wellness sadly not all emergency room
visits are the result of accidental
injury or illness abuse is a reason for
a small percentage of pediatric ER
visits again prevention is key when it
comes to abuse prevention begins very
early and with education a crying baby
an exhausted parent this is the time a
child is most at risk of abuse the peak
age at which it occurs is somewhere
around two to four months of age and
that coincides with the time when babies
are crying the most if you look at a
large population of Bay
there's big Criers and their little
Criers but they always start low about
two to four butts that they're at the
peak and then it falls off after that
and it's right around the time when
babies are most fussy and most crying
that the injuries tend to occur a lot of
times in the history particularly if
there's a confession you learn that it
was inconsolable crying that led to the
events I couldn't make him stop crying
so I got frustrated I felt like the
worst mom on the planet I felt like
maybe I had a bad baby this is a video
produced by the National Center on
shaken baby syndrome as part of a
statewide program to prevent abuse many
birthing hospitals in Washington are now
giving these DVDs to new parents telling
them it's normal for babies to cry
sometimes inconsolably and giving them
ways to cope when that happens it's okay
to be frustrated it's what you do when
you get frustrated I think anybody who's
been a parent of an infant and it's
being honest well it will tell you they
hit a point when they were extremely
frustrated and even angry with the baby
and we want parents to know that's going
to happen they're not bad parents
because of that but they have to be able
to react in a way that won't injure the
baby as past medical director of Seattle
Children's Protection Program and a
former emergency room physician here dr.
Kenneth Feldman says ER teams are
trained to look for signs of abuse
especially in babies so often we see a
bruised infant at an age when they're
not mobile enough to bruise themselves
there we see tears in the mouth and if
we look closely with x-ray will often
see broken bones elsewhere in the body
even one abuse case is one to many but a
few years ago the number of cases spiked
we
thought we were seeing about one and a
half a month between children's and
Harborview which are the two
institutions that get the majority of
these kids in the central Puget Sound
area in 2008 we saw a major jump to the
mid 30s associated with the onset of the
recession and then over the last couple
years had settled down to where we're
seeing in the mid 20s a year there are a
number of reasons why shaking through
the DVD and educational pamphlets it's
hoped parents will understand that
crying is a normal phase of development
for an infant and that they'll make a
plan for dealing with it in a way that's
safe for their baby the main tip for
parents dealing with a crying baby after
ruling out that the baby needs to be fed
changed or is in some sort of pain put
the baby in a safe place such as a crib
for a few minutes while you take a break
the baby will be okay to cry it out for
a little bit and you'll feel better able
to cope after a short time away coming
up when your child is hurt or sick how
do you decide whether to come here or go
to an urgent care clinic we'll have
advice for parents and later come along
on a journey on which you've probably
never been down deep to retrieve a
swallowed coin this is a rather frequent
journey at Seattle Children's and it's
not just coins doctors removed see the
unique collection of things once
swallowed snorted or stuck in ears
in the last year a total of 735 patients
an average of 2 each day were treated in
the Seattle Children's emergency
department for mental health issues some
of the top mental health problems that
bring children to the ER include
depression anxiety disorders eating
disorders bipolar disorder and
aggressive or violent behavior when
something happens that requires more
than a band-aid and a kiss it can be a
fine line between a trip to an urgent
care clinic or appear to the emergency
room here's a look at how to navigate
that decision-making process I want you
to look right 12-year old Nick got a
piece of burning ash in his eye at a
bonfire with friends the other night we
got some water some splash it try to go
peace out it's not bothering Nick too
much but it is concerning his mom it was
swollen in red so Nick is here at
Seattle Children's Urgent Care Clinic in
Bellevue on a Sunday afternoon to get
that I checked a lot of families come
here rather than the emergency room when
their concern can't wait for regular
clinic hours I think the main thing to
think about is if you think it's clear
that your child is very very ill and may
need to be admitted to the hospital or
have a procedure done that's gonna
require subspecialty care that you
should probably go to the main emergency
department for a more kind of minor
complaints a lot of the cough and cold
complaints and sore throats and year
there you know does my child have an ear
infection that's something we're very
capable of dealing with here sometimes
it's hard for a worried parent to decide
between the ER and an urgent care clinic
let's ask dr. Josh Weldon for some help
starting with a for allergy attack if
your child has respiratory symptoms as a
result of an allergy like they have a
known allergy and they're having trouble
breathing
that's 911 or to the emergency
department if your child has a rash and
you're not totally sure why it's
certainly something we can evaluate how
about asthma also depends a little on
severity will usually initiate that
treatment here but if it's clear that
they're fairly sick and might need to be
admitted then we'll transfer them to the
Maine Edie B is for broken bone most can
be handled at the urgent care clinic but
any fracture where there is visible
deformity should be handled at the
emergency room if your child broke their
arm and it's sticking out of its skin
hopefully that would nobody wants that
to happen but if that happens you need
to go to the Maine emergency department
because you're going to need to have
sedation and C orthopaedic and those
kinds of things minor burns dehydration
diarrhea all common reasons for urgent
care visits same with E and F ear
infections and fever most cases can be
seen here H head injury a patient who
hit their head and had a very brief or
no loss of consciousness is a patient
that were happy to evaluate here but we
do not have a CT scanner here so
patients with severe head injuries who
are not at their back to their
neurologic baseline or clearly have have
significant head injuries need to be
seen in the emergency department there's
an entire alphabet of reasons your child
may need to see a doctor when their own
isn't available if it's life-threatening
call 911 injuries though an urgent care
clinic is often the perfect fit you know
our our job is to is to take care of
patients and families close to where
they live and we enjoy doing that we
often really want to do our best job
interfacing with people's primary care
doctors seven-year-old eight aya got
very sick from an infection that
required bloodwork and IV antibiotics
dad and siblings enjoy a video game in
the lobby
her mom was happy to come here instead
of the hospital er I'm glad that you
know that Children Hospital is here on
in Belleville instead of you know like
in Seattle like we used to go at the
convenience and it's closer to our house
don't worry if you guess wrong between
the ER and urgent care clinic Urgent
Care doctors and nurses here at the
Bellevue clinic canis
a situation quickly sometimes consulting
with emergency medicine providers and
decide on the most appropriate place for
care almost every day they transfer a
patient from this clinic to the ER
either by ambulance or parents car why
don't you lay back okay this is not
painful I promise if it was gonna hurt
I'd tell you Nick got to get his eye
examined with some cool glow-in-the-dark
drops and a type of backlight to check
for damage to his eye he'll go home with
some antibiotic drops after a short
Sunday visit with a doctor close to his
home okay you did great wasn't so bad
right in an effort to better serve the
urgent medical needs of patients and
families Seattle Children's will be
opening two new Urgent Care locations in
the coming year the plan is to offer
urgent care clinics in three locations
Seattle Mill Creek and Bellevue similar
to the urgent care clinic located at
Seattle Children's Bellevue clinic and
surgery center the two newest clinics
will be open evenings weekends and
holidays when your regular doctor is not
open coming up overcoming language and
cultural barriers in the emergency room
ha Seattle Children's works to speak
your language when a patient is on the
way to the ER by ambulance helicopter or
sent by a primary care doctor the
communication room will know about it
this room is part of the ER is staffed
by ER nurses and helps providers prepare
for what's about to come in the door
then we're prepared and we give better
care we get safer care it's um it's less
chaotic in an emergency situation clear
communication is crucial we've seen how
the team here frequently trains and
practices together and how communication
is key to sound emergency care but the
patient and family are part of the care
team too so when an emergency brings a
child in the ER doors effective
communication with them is also
important no matter what the language
and that's what you've seen before when
she's need to come in
the hospital a trip to the emergency
room can be scary enough but imagine
having a sick or injured child and you
don't speak the same language as the
medical staff that's a frequent
occurrence here in the Seattle
Children's er has anyone else been sick
at home and we often will have patients
for four or five different nationalities
in our merged apartment at any one time
many who don't speak English as a
language or even as a second language
Meno Constanzo is one of about 20 staff
interpreters at Seattle Children's why
do you ask if there was blood Mino or
one of his colleagues can be here in the
ER within minutes helping bridge the
language and potential cultural
differences between the patient family
and providers make sure that
communication is flowing and that their
families and understand what is being
done to their children so no impetus you
say it bein psych when I do that you can
see how the family's relaxed and they
open up a lot easier and if they didn't
ask question I understand what's going
on it's invaluable you know we have
families that are not english-speaking
and their child is ill and so they're
already under a lot of stress and so to
have professional interpretive services
here just really helps relate
information in a much more efficient and
clearer way and I think it really helps
decrease the family's stress and it
definitely helps with our efficiency go
home - okay now the communication goes
both ways not only do families need to
clearly understand what providers have
to say doctors and nurses also want to
understand the concerns and needs of
patients and their families in a
culturally sensitive way we have our
on-site interpreters it allows us to
really interpret the cultural
differences and find out what the family
is really thinking what they really need
beyond just the medical verbage going
back and for
come with open than that deviled annuity
and Seattle Children's provides free
interpreter services day and night with
in-person interpreters in many languages
and has immediate access to telephone
interpretation in more than 150
languages and dialects it's crucial for
an ER that covers such a large and
diverse population we have just a superb
bunch of interpreters who are here 24/7
they come in when we need them we have
some that are in the hospital all the
time and then others that come in and
it's amazing because sometimes I'm not
even sure where the country is where
their folks are from but we have an
interpreter who speaks that language and
it just makes the care so much better
and allows them to really again be part
of the process and help us with the
solution rather than being told what
they have to do in a way that they may
not understand it's a job that's very
rewarding and at times challenging the
most difficult part for me it's when I
have to deliver bad news to the families
as much as I try to not get involved
with the situation it's sometimes it's
very hard especially with families that
are not understanding very well you know
why their kids get cancer for instance
I'd say it's pretty tough sometimes but
then again there are a lot of good news
too because kids are very resilient and
they you know they have this energy to
to get better and and the parents are
very hopeful too and they're very
attentive to to the care that their
children need so there's a lot of good
news to him that's a very fulfilling
that makes me feel great I love my job
interpreter services aren't offered only
in the emergency room but also
throughout the hospital and clinics here
at Seattle Children's
coming up next the changing role of the
Seattle Children's er through the years
a look at its history and future and one
of the more unique collections you'll
see coins jewelry pretty confetti oh the
places they've been and what stories
these objects can tell
although children make up nearly a third
of all ER visits nationally it is
estimated only about 6% of hospitals
have all the pediatric supplies they
need according to a report from the
Institute of Medicine Seattle Children's
is among that six percent that does have
all the needed pediatric supplies the
emergency department at Seattle
Children's started as just a small room
next to a clinic
it really was an emergency room now it's
an entire department serving nearly
40,000 cases a year a lot has changed
Seattle Children's first opened its
doors more than a century ago with a
small Children's Ward in Seattle General
Hospital four years later Children's
opened a 27 bed hospital on Queen Anne
Hill polio and tuberculosis were among
the most common diseases treated it
wasn't until the hospital moved to its
present location in 1953 that it had
even a one-room emergency department in
the following decades doctors and nurses
treated emergencies in just two small
rooms then you began to see relatively
rapid expansion we had a new expansion
in the mid 1980s and then that pretty
fairly soon was not adequate that was
doubled in the 90s and then now we have
it on both sides of the hall a fairly
significant area but we're growing out
of space though children's provides the
best pediatric emergency care in the
region the current ER built in 1993
wasn't designed to accommodate the
growing number of patients who need it
patients like eight month old Caleb
we're in today because initially he had
pulled his feeding tube out and he was
having a hard time breathing caleb has
biliary atresia a life-threatening
disease of the liver and desperately
needs a liver transplant his doctors say
he won't make it to his first birthday
without it is that them
Caleb's fragile medical condition means
frequent trips to the ER for emergency
issues all the problems are compounding
and the closer we get to his liver
failing the more problems were going to
find so there was like a lot of blood
and so I just called 911
19 month old Tori has a genetic disease
that requires many cranial surgeries and
a tracheotomy tube that tube came out
somehow Tori was rushed to another
hospital that wasn't equipped to handle
such a specialized pediatric emergency
so she came here the ER at Seattle
Children's have the equipment and
expertise to take care of it and made it
look easy today doctors and nurses treat
nearly 40,000 patients in the ER each
year many of those have serious medical
conditions and rely on the unique
expertise that Children's er provides
especially at night and during weekends
when other resources are not available
visits to Children's er have increased
more than 30 percent in the last five
years alone population growth medically
complex and fragile children and a
difficult economy that limits access to
health care are taxing the current er
that acts as an important safety net for
children who need it most
current physical space constraints can
impact all children who need er services
especially during busy evening and early
morning hours and during the high volume
viral seasons if we have a breakdown in
our primary care system we're going to
be using emergency rooms more and more
I'm concerned with this current
budgetary problem that actually access
to primary care is going to decrease and
the need for the emergency room will
increase to add to that a children would
have very complex problems or acute
problems and our desire in society to
make sure these children survive as
quickly as possible and do as well as
they possibly can you need emergency
services for that he's breathing with
support from the community Children's
will move the emergency department to
the ground floor
of their new building named building
hope where it can expand to better serve
the growing number of patients coming
through the doors if you want to learn
more about plans for expanding Seattle
Children's a our and other parts of the
hospital go to seattle children's org
slash building hope so a lot has changed
over the years one thing that hasn't
changed is a common way that otherwise
healthy children end up here in the ER
you're about to see a strange kind of
collection so we have the whole range of
coins we have quarters and this one's a
dime we have a couple pennies it's not
so rare to collect coins we have a
Mexican coin here or pretty pins what's
rare about the items in dr. kathie C's
collection is where they've all been it
is eye-opening for people to know what
kids get into and and helpful for them
to know that just these little things
can cause problems these are all things
dr. C has removed from children things
swallowed inhaled or shoved into an ear
or nose we have had stories of kids who
are doing counting projects in preschool
with beans and we've had little runs of
you know kids two or three kids from the
same preschool class with beans in their
ears and beans in their nose plenty of
beans pieces of pretty confetti even
shards of glass
ouch there's glass that was stuck in the
voice box and so as you can imagine
those have sharp edges and can cause a
lot of injury kids don't seem to be
picky about what they'll inhale or
ingest parents need to know that healthy
kids can get into anything that lives
around common household objects you can
see there's quite a variety but coins
take the cake for most popular most
common things we take out of kids are
coins from the esophagus and you know we
all have coins lying around the house
they're shiny and they're pretty and so
young kids will tend to put them in
their mouths and it's a normal
developmental stage and sometimes
they'll swallow them that's exactly what
happened here on an x-ray it's easy to
see the one
shiny pretty nickel now residing in this
baby's esophagus it's not quite so easy
to get it out doctors must go on a
search and remove expedition fishing for
something that went where it shouldn't
nickels dimes even quarters are
regularly retrieved usually with very
little damage done it's all still
potentially dangerous though and very
serious some things are especially so
the main public health messages recently
has been the the problem with disk
batteries as we have more and more toys
that are powered with disk batteries and
electronic objects lying around the
house we're always changing batteries
out and those little disk batteries can
be really problematic they can actually
be life-threatening
the charge from the battery when it's in
contact with a moist surface will
actually start to erode through the
tissue and it can cause death we
consider that a true medical and
surgical emergency even somewhat minor
things can constitute an emergency
inhaled popcorn pieces or tiny chunks of
nuts can lead to big problems here are
some beads this is a bead from the ear
we tend to get little plastic things
this speed was in the nose most pieces
of dr. C's collection have been removed
from babies and toddlers most not all
these blow darts are kind of a theme
where it's a usually straight pin with
some sort of soft stuff at one end and
those we tend to get out of teenagers
and typically teenage boys where they're
blowing dart through a straw or
something and instead of blowing out
they take a deep breath in there's
another blow dart dr. C started this
collection 20 years ago and this is only
a small part of it with each passing
month each swallowed ring or inhaled
sunflower seed her collection grows as
does the safety message this all
represents a message she hopes everyone
will swallow it tells a story of what
kids get into it's just nice for people
to see the things that kids can
ingest or aspirate kids who are
otherwise healthy are at risk for for
foreign body aspiration and foreign body
and Jessen and I think it's important
for parents and the general public to
understand their risk back to esophagus
cam there's that nickel found at last
and plucked from where it doesn't belong
yet another addition to dr. sees growing
collection dr. C hopes to one day
display her entire collection in a
public part of the hospital she wants a
visual and effective reminder of what
kids can get into and the damage it can
cause when we come back an update on
some of the little ones we met
throughout this program how they're
doing now
for most patients a few hours is all
they'll spend here in the emergency room
but they may remember it for a lifetime
throughout this special that was shot
over the summer we met several children
experiencing an emergency situation
here's an update on how they're doing
now
three-year-old Peyton is doing fine the
gouge on her forehead that required
stitches is healed now her mom says she
has a small scar slightly visible in her
hairline and a good story to tell about
her family's vacation to Seattle little
alina who went under in a swimming pool
has no lasting physical effects from her
ordeal she is more afraid of the dark
and of being alone her mom says but is
otherwise healthy and happy caleb is
still waiting a liver transplant and his
condition has worsened his family says
the waiting can be excruciating not
knowing when or if a liver will become
available in time on a happier note
caleb recently rolled over and sat up on
his own for the first time he giggles
frequently and is a happy baby
Caleb's family urges everyone to educate
themselves on organ donation more than
100 thousand people in the US are
waiting for a life-saving organ
transplant some of them are just babies
like Caleb and finally we're happy to
report that a broken arm didn't slow
five year old Abby at all she had to
miss swimming lesson two this summer
but managed to still crime on playground
equipment cast and all Abby's cast is
off now and her arm has healed one thing
about an emergency room visit very few
people know ahead of time that they're
coming fewer still would expect a TV
camera to be part of the deal we would
like to thank all the families who
allowed us to be part of their er
experience and to share this inside look
with you thanks also to the providers
who work here for letting us capture
part of their world and thank you for
watching
good
Fisher Communications
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