MDNews - San Antonio

"The pediatric emergency physicians are all trained and credentialed in pediat- ric moderate and deep sedation," Dr. Dire says. "We can sedate kids down here for fracture reductions and other procedures that ordinarily might have to go to the operating room in another facility." Because of the close ties to all those pediatric subspecialists at UT Health, University Children's ED tends to see patients with a higher level of acuity than other children's ERs, Dr. Dire said. Families of kids with chronic or complex illnesses are directed to go there if and when urgent problems develop. Nurses are trained in basic and pedi- atric advanced life support, as well as advanced cardiac life support and the Emergency Nursing Pediatric Course, says Michele Jakubczyk, RN, Director of Pediatric Emergency Services and Pediatric Critical Care Transport at University Hospital. The team also participates in decontamination training and Satori alternatives for managing aggression. "The Children's ED staff uti- lizes protocols for many types of complex care patients. Hematology- Oncology has protocols for their patients that we use. We are an extension of that specialized care," Jakubczyk says. "It starts here in the ED and continues until they get admitted to the hospital or are discharged from the ED. We have asthma and bronchiolitis proto- cols that provide algorithms for the respiratory therapists and nurses to perform interventions based on a severity scoring tool. This allows for standard- ized care and a collaborative e•ort in an approach that is quick to initiate and easy to understand. A number of smaller regional hospitals have adapted the same scoring system as University Health System's asthma protocol, "so if they transfer the child to us we're on the same page," Jakubczyk says. A DEDICATED TRANSPORT TEAM Jakubczyk also heads University Health System's Pediatric Critical Care Transport Team, which works hand-in-hand with the Children's Emergency Department and inpatient pediatric departments. The 15-member transport team, which includes pediatric critical care registered nurses and respiratory therapists, uses helicopters, ambulances and fixed-wing aircraft — including University Health System's specia lly equipped pediatric and neonatal ambulance — to transport pediatric patients from across town or across the state to University Hospital for a higher level of care and specia l- ized treatment. The hospital has a dedicated, specially trained team to provide extracorporeal membrane oxygenation (ECMO) to very sick kids needing advanced life support. ECMO performs the work of the child's heart and lungs to allow them to recover. T h e f a c t t h a t U n i v e r s i t y Hospita l — including its Universit y Children's Emergency Department — is an academic hea lthcare center with a mission to train new physicians and other health professionals gives it an advantage for patients and families, Dr. Dire says. He notes that a number of studies have shown that teaching hospitals provide better care. O ne r e a s on i s a c om m it ment t o evidence-based medicine. " We tr y to stay on the cutting edge of what 's going on in our specia lt y," Dr. Dire says. Fo r m o re i nfo r m a t i o n a b o u t th e U n i v e r s i t y C h i l d r e n's E m e r g e n c y Depar tment at University Hospital , go to universitychildrenshealth.com or call 210-358-5437. ■ The San Diego Zoo Kids channel, a grant-funded, closed-circuit feed, is broadcast on a large screen in the University Children's Emergency Department at University Hospital. University Hospital Sky Tower Daniel J. Dire, MD, Medical Director of University Children's Emergency Department and a Clinical Professor in the Departments of Pediatrics and Emergency Medicine at UT Health 0 8C O V E R S T O R Y 0 8

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