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We have this scenario quite a few times a day, and our ED is physically 
separated into an ED and Urgent Care side with separate physician 
coverage.  

Single-family siblings all get triaged and registered one-by-one then will 
get clustered in accordance with the patient with the highest acuity:  e.g. -
 if two kids present with URI and one is a cardiac infant, then they both 
enter the high acuity side.  Siblings are always in the same room / space 
with 1 or more caretakers, and we usually place them in one single room 
instead of divvying them up.  

The exception is two acutely presenting siblings; for example, we have 
two Propionic Acidemia siblings who usually get sick together, and we 
squeeze in two full beds in a large room, with mom in the middle.

As much as we don't like the idea of kids who 'tag along,' they can 
sometimes be useful for diagnoses.  There was one 4-year-old I was 
debating doing a Rapid Strep test for fever and abdominal pain only, and 
then her 3-year-old brother also came in for exudative pharyngitis and 
peeling of the hands.  

I'v also found that having siblings present in the same room makes the 
exam for the younger kids more cooperative.  Having the 5-year-old go 
through an exam successfully with the 2-year-old watching makes the 
subsequent exam slightly calmer.  Slightly.

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