How We Care for Your Child in the Emergency Department

When you and your child arrive at the ED, you will go through a quick registration process with one of our patient access representatives. This will add your child’s name in our system. Next, the nurse (triage nurse) will see your child to conduct the initial evaluation. This evaluation helps us to assess your child and their medical needs. Depending on their medical needs, your child may be assigned to the main ED or the Fast Track area of the ED. Please be aware that patients who come after your child may be seen before yours if they are sicker and need immediate attention.

If you speak a language other than English, we have interpreters and access to audio and video interpretation for over 50 languages, including ASL. Let us know your preferred language so we can accommodate you.

Next, a staff member will take your child’s vital signs (like temperature and blood pressure) and get more information about your child’s symptoms and history. The assessment may happen before or after you are brought back to the treatment area. A nurse may give medicine for pain or fever to help your child to feel better. They may also order a radiology test (like an X-ray) so that the results are ready when a doctor, physician assistant (PA), or nurse practitioner (NP) is ready to see you.

Your child’s comfort is a priority, so please share any information that would help us provide the best possible care for you and your child. We want to partner with you to understand your child’s medical history, including medical conditions, medications, and allergies.

Sometimes the ED can be busy, and space in our treatment area may not be available. During these times, you will be asked to wait in the waiting room. As soon as space is available, your child’s name will be called, and a staff member will take you back to the treatment area. If your child’s condition seems to be getting worse, tell a staff member right away.

The monitors above the registration desk show how long you have been waiting and the order shows when you may be called. There are two monitors. The top monitor shows patients who will be seen in the Emergency Department area of the ED. The bottom monitor shows patients who will be seen in the Fast Track area of the ED. Your child’s number on the monitor is the last 5 digits of the ACC# on their ID band. Your child may be called next when their number is at the top of the list.

When there are many patients waiting, the monitor may only show part of the list at one time. There is a scroll bar the right side of the screen to show which section of the list is being displayed. The monitor will rotate through the different sections of the list.

A patient access representative (sometimes called “registration”) will register your child into the ED by entering your child’s name and other information into the computer. They will get your insurance information if you have it and ask you to sign a consent form. They may ask you for a co-pay if your insurance requires it.

You will meet several different nurses during your ED visit, and all are specially trained to care for children. The triage nurse in the waiting room will ask you about your child’s symptoms, do an initial evaluation, and determine the treatment area where your child will be seen. Your bedside nurse will talk to you and examine your child. They will talk to the provider and discuss what needs to be done. They may give medicines, start an IV or draw blood, or measure your child’s vital signs. They will also notify the doctor if your child is getting better or worse. They will help teach you what you need to know to care for your child while they are sick or injured.

This person is a student or a doctor-in-training, and they may see you first. They will talk to you and your child, examine them, and help figure out what tests or treatments are needed. The resident or medical student will then confirm with the doctor what needs to be done.

You may be seen by a doctor, a PA or an NP. They will talk to you and your child and examine them. They will try to figure out what is wrong, and order any tests or treatments needed. There are senior doctors, called attending physicians, who supervise care in the ED.

Your patient care or trauma tech may put in stitches, start an IV, draw blood, place a splint, teach you to use crutches, measure vital signs, help with a procedure, or take you to X-ray or another part of the hospital.

A child life specialist may help your child during procedures, such as getting a cut repaired. They use calming techniques and distraction to make the procedures as easy as possible for your child. They are available on most days, but not every day.

The ED team may speak with a consultant (specialist) about your child’s care. The consultant is usually another doctor at Children’s National who is an expert in treating a specific type of illness or injury and who may see your child for follow up care. Occasionally the consultant will need to see your child or do a procedure in the ED. They come as fast as possible, but they may be delayed because they are coming in from home or because they need to take care of patients in another part of the hospital.

A pharmacist or pharmacy tech may review your child’s home medications with you to make sure that your child receives all the medicines they need while in the ED.