Emergency Medicine Has a Kid-Friendly Attitude at Packard Children's Hospital; New, Child-Focused Pediatric Emergency Department Makes Visits a Lot Less Scary.

STANFORD, Calif. -- Emergency rooms aren't supposed to be happy places, are they? But most sick kids (and their parents) could use a little cheering up. Beginning December 1, nearly all of the 10,000 children each year who come to the emergency department shared by Lucile Packard Children's Hospital and Stanford Hospital & Clinics will be directed to a new pediatric emergency department, which combines Packard Children's trademark kid-friendly atmosphere with a coterie of pediatric emergency medicine specialists equipped to handle any medical problem.

The new kids-only space -- one of only two pediatric emergency departments in the Bay Area -- is brightly lit and colorful, with whimsical patterns in the floor and artwork taken from familiar children's books on the walls. Light maple wood and lots of internal windows surrounding a central nursing station give a sense of spaciousness, and each of the seven exam rooms has a television and a new iMac computer preloaded with children's games, music, movies and internet access. A big screen television in the waiting room will show short cartoons and informational materials.

This new department functions under the auspices of the current emergency facility, but the construction of the space was a true team effort: Packard Children's Hospital, Stanford Hospital & Clinics, the Lucile Packard Foundation for Children's Health and more than 50 individual donors from the community banded together to make a child's trip to the emergency room less scary and more productive.

"No physician can do an adequate lung or abdominal exam on a screaming child," said Bernard Dannenberg, MD, Packard Children's Hospital's first Davies Family Endowed Director of Pediatric Emergency Medicine, who emphasized that children are much more likely than adults to be bewildered, anxious and stressed when brought to the emergency department. "We are now able to reduce a child's anxiety through play and distractions such as movies and games, which allows us to get a better exam and ultimately arrive at the answer we need much faster."

Children and their parents will follow a blue river pattern in the floor from the current emergency room to a waiting room that is not only stocked with new toys and activities for the children, but free wireless internet access for parents who bring their own laptop computers. The latest in medical technology is available in the exam rooms.

"The buck stops with us," said Dannenberg. "We have everything necessary to take care of children: monitors in every exam room that are linked to the central nursing station to allow constant observation of a patient's vital signs, and headboards equipped with the latest in medical technology. In addition, two of the exam rooms can function as isolation rooms -- providing negative air pressure to isolate children with communicable diseases." Overhead cameras also provide around-the-clock security to patients and staff.

But the most special thing about the 24-hour facility is less visible: the pediatric specialists, from physicians and nurses to a child life consultant, who have been assembled to tend to all the medical problems, from minor to life threatening, that afflict children from around the Bay Area. Dannenberg himself is one of only a few physicians in the country who has completed medical residencies in both pediatrics and emergency medicine -- rendering him uniquely able to treat medical emergencies in the smallest of patients.

Most children who need emergency treatment have infectious conditions, such as colds, acute gastroenteritis, croup, and bronchiolitis. Others have chronic, recurrent illnesses such as asthma, sickle cell disease, cancer, hemophilia, AIDS, or seizures. Kids with acute traumatic injuries, from serious motor vehicle accidents, window falls or severe burns to simple fractures and lacerations, round out the department's roster of reluctant visitors.

Although most of these children can be adequately cared for in a "normal" emergency department, pediatric emergency departments affiliated with children's hospitals have some unique advantages above and beyond the child-friendly atmosphere.

"Emergency physicians are trained to take care of children and do an excellent job," said Dannenberg. "But their resources are often limited specifically when it comes to obtaining specialty treatment from, for example, trauma surgeons or pediatric neurosurgeons." In contrast, Packard Children's Hospital, as a tertiary care facility with all pediatric specialties, routinely accepts cases from local community hospitals that require a higher level of care, such as severe pediatric traumas and those requiring pediatric intensive care.

The pediatric emergency department is a testament to the commitment of both Packard Children's Hospital and the community to provide the very best care to sick and frightened children. More than 50 donors together contributed $11 million to the project, which included a match by the David and Lucile Packard Foundation. The adult and children's hospitals also contributed financially to the construction of the facility. Individual donors paid for the whimsical river in the floor, the iMac computers and other specialized equipment and child-friendly improvements in each room. Donors also endowed Dannenberg's position and support for other pediatric emergency department staff.

"We have listened to the community and now have a facility specifically built for and dedicated to children," said Dannenberg. "Most people who have seen the space say 'Wow. The kids will never want to go home.'"

About Lucile Packard Children's Hospital

Ranked as one of the nation's top 10 pediatric hospitals by U.S. News & World Report, Lucile Packard Children's Hospital at Stanford is a 264-bed hospital devoted to the care of children and expectant mothers. Providing pediatric and obstetric medical and surgical services and associated with the Stanford School of Medicine, Packard Children's Hospital offers patients locally, regionally and nationally the full range of health-care programs and services from preventive and routine care to the diagnosis and treatment of serious illness and injury. For more information, visit http://www.lpch.org.

About Stanford Hospital

Stanford Hospital & Clinics is a university-owned, non-profit corporation known for advanced patient care. The 613-bed hospital in Northern California consistently ranks among the top in the nation in surveys by consumers and health professionals. Stanford Hospital & Clinics, in cooperation with the Stanford University Medical School, has pioneered medical advances that save lives and protect against disease. For more information, please visit our Web site at www.stanfordhospital.com.