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1-12 May 1998

Vol. I, No. 30

Health Matters

Parents tending to children in the ED

What should I do if I have to take my child to the emergency department?

While emergency department (ED) visits can be extremely nerve-racking for children of all ages, parents can help allay their fears by remaining at their side, if possible. According to Howard Bauchner, M.D., director of general pediatrics at Boston Medical Center and professor of pediatrics at Boston University School of Medicine, parents should feel comfortable remaining with their children in the ED for common procedures. "I don't think that being there is enough, however. Parents have a role, and that role is not to restrain their children, but to help them cope with a medical procedure, which sometimes causes pain and often generates anxiety," he says.

If the child must undergo a more invasive procedure such as a chest tube insertion or a lumbar puncture (i.e., a spinal tap), Bauchner believes that parents do not necessarily need to be present. "I would be hesitant to say universally that parents should be present for such procedures," he says, "especially when the child's life is at stake, because doctors and nurses need to be left alone to tend to a critically ill child." In severe cases a child may be taken to a specialized trauma suite, where family members will almost certainly be asked to leave the room.

Most ED visits, however, involve routine procedures such as drawing blood or starting an IV (intravenous line), and research done by Bauchner suggests that in these instances children are more relaxed when accompanied by their parents. "Older children always say that they want to be with their mom or dad," he says. His study also concludes that parents who stay with children undergoing invasive procedures experience less anxiety than those who are not present.

Parents can soothe their children in a number of different ways. "Some children will want to hear a story, others a song, and some will be content just having their parents present. All these are acceptable solutions," Bauchner says. "If you're tuned in to your children's needs and don't make assumptions about what they want, they'll let you know how to help." Children who are not yet talking especially benefit from being able to see, touch, and hear their parents. "There's some evidence to suggest that you can stabilize a child's vital signs more quickly if parents engage more than one sense," he says.

Parents should feel free to ask about the procedures being performed on their children, although occasionally physicians may be reluctant to explain themselves. "Not all physicians feel comfortable having parents in the room when performing procedures because they feel it can affect their concentration. Sometimes you may need to weigh the risk of not being with your child against making the physician nervous," Bauchner says. The calmer you remain through this process, however, the calmer your child is likely to be.

Finally, make sure that no matter how you tend to your child, you remain seated. "It's conceivable that parents will see a procedure as basic as drawing blood, and faint. If you do so while standing, you might end up hurting yourself as well," he says.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on emergency room protocol or other health matters, call 638-6767.