Part of the issue will be based on your state and local regulations. For
example some states have adopted rules that ED's must meet certain
requirements before they may advertise themselves as an "Emergency
Department Accepting Pediatrics" (EDAP), "Pediatric Critiical Care
Center" (PCCC), or "Pediatric Trauma Center" (PTC).
The first 2 are based on the guidelines from the Institute of Medicine
report on Emergency Medical Services for Children (Durch and Lohr eds.,
National Academy Press 1993). The later on American College of Surgeons
guidelines for trauma center designation (Committee on Trauma, ACS.
Resources for optimal care of the injured patient. ACS 1993). The AAP has
also published guidelines (Pediatrics 1995;96:526-37).
You facility, under the above guidelines, would qualify as a "Standby
Pediatric Emergency Facility." To meet this level a facility must be:
1) capable of identifying critically or potentially critically ill or
injured children; 2) able to stablize the child; 3) responsible for
assuring timely access to a definitive care facility and; 4) staffed by RN
or PA working under the direct supervision of a physician with pediatric
experience (may be by protocols, phone, etc., but prompt availability to
respond to emergencies is required).
Basically, it comes down to ethics and what the hospital's risk
management folks will approve. IMHO, if a hospital does not have
inpatient pediatric facilities it should not advertise or hold itself out
to be a "pediatric facility." You would proably be better off
establishing a relationship will your local tertiary care pediatric
facility and advertise your relationship with them.
Jeff Linzer MD MICP
Division of Emergency Medicine
Egleston and Hughes Spalding Children's Hospitals
Emory University School of Medicine
Chairman, Georgia EMS-C Advisory Council
1405 Clifton Rd, NE
Atlanta, Georgia 30322
(404) 315-2282 (fax)
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