From Deseret News archives:
Kids' health needs overlooked
The IOM discussed the findings of its landmark analysis, Emergency Care for Children: Growing Pains at Primary Children's Medical Center. Many people are not aware how medically different children are from adults, but just as kids need a special seat when they ride in a car, they need special equipment for health care.
From needles and tubing to oxygen masks and ventilators to imaging equipment and laboratory technology, children need equipment that has been specifically designed for their size. They also need different dosages and formulations of medicine than adults — not only because they are smaller, but also because some drugs are not safe for children. Children also have less blood than adults, so relatively small amounts of blood loss can quickly become lethal.
In the case of a terrorist attack or comparable disaster, children are particularly vulnerable. Toddlers and young children may not have the physical ability to escape from the site of a hazard or disaster, or they may not even understand that they are in danger.
Furthermore, kids normally breathe more times per minute than adults, making them extra vulnerable to aerosolized biological or chemical agents. And compared to adults, children have a greater risk for post-traumatic stress disorders.
In 1984, Congress passed legislation to improve emergency care of children, establishing the Emergency Medical Services for Children program. Despite our progress since 1984, proper care for children in medical emergencies is not universal. The IOM analysis shows that special emergency medical needs of children are often overlooked.
According to the report, half the hospitals in this country do not have all the essential equipment and supplies recommended by the American Academy of Pediatrics to manage pediatric emergencies — and hospitals that cannot care for pediatric trauma patients often lack adequate systems to transfer children to appropriate facilities. And almost no medications that are regularly prescribed to children have been adequately tested for use in pediatric populations.
Moreover, many ambulance and emergency department health-care providers give children less pain medication than adult patients with similar injuries. Finally, disaster preparedness plans usually do not address the needs of children.
Utah was the first stop in the IOM's nationwide tour to discuss its report. That's largely because Primary Children's Medical Center is one of the top 10 children's hospitals in the United States, with state-of-the-art facilities. Utah is among those leading the nation in addressing the unique needs of children in all aspects of our medical systems, whether it involves disasters or everyday emergencies.
But the state — and the nation — can do better. Children cannot express their medical needs; we must continue to speak for them. Children account for 25 percent of the U.S. population, but they represent 100 percent of our future.
Dr. J. Michael Dean is the H.A. and Edna Benning presidential professor of pediatrics chief at the University of Utah School of Medicine. Orrin G. Hatch is Utah's senior senator.
