Finding More Than a Cure in the Pediatric ER

By Marie Wolf

Movies, Video Games and Specialized Medical Care Take the Sting Out of Emergency Room Visits  

You won’t find clowns or balloons in a pediatric emergency room – no magicians or

What Is An Emergency?
Check these 11 signs.

jugglers either. Just a warm, welcoming environment, with walls that are painted in soft pastels and furniture sized just for kids. Here, children can play with toys, read a book or watch TV to tune out the fear of being in a hospital in the first place.

They may come in with an injury or a burning fever or because of an innocent mishap. We hear about mishaps every day. Two-year-old Stephen of Plainedge was rushed to the ER after he shoved a chocolate-covered raisin all the way up his nose. So was Matthew, a Plainview toddler, who munched on the neighbor’s hedges while his mother took him for a walk in the stroller through their neighborhood. And there was Sarah, a preschooler from West Babylon, who fell off her bed and broke her arm. She told her parents that she was "making believe the bed was a trampoline."

In all three cases, the children were taken to the nearest hospital, where they were treated and released. Sarah, however, was the only child of the three to be treated in a hospital designed with a separate pediatric emergency waiting room and a separate pediatric treatment area that was staffed around-the-clock by board-certified pediatricians. Her mom (who preferred not to give her name) says her daughter received "great care" at Good Samaritan Hospital Medical Center in West Islip. "The pediatricians and nurses were wonderful with her."

Is a Kid-Friendly ER Really Necessary?
American Academy of Pediatrics (AAP) believes so. In a policy statement released in 2001, the AAP concluded that, indeed, "Children requiring emergency care have unique and special needs." The statement further advised hospitals to begin incorporating the proper equipment, staffing and policies to carry out quality care for children.

Our lawmakers also recognized the necessity. In 1984, Congress approved funding for the program, Emergency Medical Services for Children (EMSC). Its purpose was to encourage emergency medical services (EMS) systems across the United States to provide quality emergency care to children. Since the program’s inception, training for paramedics and other emergency medical providers has increased, as well as the availability of child-size medical equipment in emergency departments and ambulances. 

Many of Long Island’s area hospitals are following the recommendation. A long-established pediatric emergency room is located at Nassau University Medical Center in East Meadow. Bella Silecchia, M.D., is the director of pediatric and ambulatory services and has been supervising emergency care for children there for the past 14 years. She believes, "It is important that a child be seen by a pediatrician from the get-go. The younger the child, the more important it is to diagnose correctly." Silecchia adds, "Many times children who are not seen in a pediatric emergency room very often have been misdiagnosed." This hospital has offered 24-hour pediatric ER coverage by attending pediatricians since 1987. Four more beds will soon be added to the area, according to Silecchia.

Schneider Children’s Hospital in New Hyde Park has also recently doubled the size of its pediatric ER, providing a total of 12 beds in its unit. Joy Nagelberg, M.D., chief of pediatric medicine, says, "If we can give definitive treatment and send kids home right away – that’s our goal."

The Pediatric Emergency Center at Good Samaritan Hospital Medical Center was opened in 1998 and the volume of young patients treated there has grown steadily, "eight to 10 percent every year since we opened our doors," says Medical Director of Emergency Services & Community Medicine Craig Smestad, M.D., FAEP. "PEDs [pediatric emergency departments] are becoming more and more of the standard in large facilities because there are a lot of idiosyncrasies involved in treating children that most physicians are not familiar with unless they have been trained in pediatrics and subsequently in pediatric emergency medicine."

It is clear that the medical community supports specialized emergency medical facilities for children. Are parents convinced? Consider the recent experience of the DiVerde family.

Kids Do the Darndest Things
Janine DiVerde of
Massapequa, a teaching assistant at a nearby nursery school, had just dismissed her summer preschool campers when her cell phone rang. Benny, her husband, who had the day off, was at home working on house repairs and watching their 7-year-old daughter Stephanie. He called to let Janine know that Stephanie had swallowed a penny, it was lodged in her throat and an ambulance was on the way to take their youngest to the hospital.

It was a warm July morning, but Stephanie, who had been fighting a summer virus for the past few days, was confined to the house. Clad in pajamas, with no one to play with, she began to entertain herself. Somehow, (she can’t remember how) a penny found its way to her lips while she was playing and soon after, she says, "it grew wings and flew into my mouth."

She cried out for her father and ran to tell him what she had done. "At first," says DiVerde, "Benny didn’t believe her." After all, he rationalized, Stephanie was 7-years old – old enough to know better than to put a foreign object into her mouth. And, she adds, "she was breathing just fine." Soon though, Stephanie began to cry and tried to cough up the coin, but the penny had traveled somewhere below her Adam’s apple.

The child was quickly transported to the nearest hospital (one without a pediatric emergency room) and after X-rays were taken, she spent four long hours sitting on a bed in the ER with her parents, waiting for an on-call pediatric ENT (ear, nose and throat) specialist to arrive. The DiVerdes were told that a specialist was called in because the penny had to be surgically removed through a procedure called an endoscopy.

Two hours later, there was still no sign of the "on-call" specialist. By now, the DiVerdes were frantic. They concede that their child was in stable condition, but they were infuriated, nonetheless, with the lack of communication and bedside manner of the emergency room staff. "Stephanie sat on that bed with nothing to do. They didn’t offer her a book, they didn’t give her a blanket and no one talked to her. She wasn’t getting any care there," Janine DiVerde charges. So, she took matters into her own hands. "I called Winthrop University Hospital myself. I wanted her transferred there. All three of my kids were born there and I knew they had pediatric specialists."

The Joy Ride Begins
At the DiVerde’s request, the emergency room physician coordinated Stephanie’s transfer to
Winthrop and, soon after, an ambulance arrived with a pediatric resident aboard to facilitate the paperwork and accompany the young patient to Mineola. DiVerde says from that point on, their experience improved. During the transport, both the ambulance driver and the doctor joked with Stephanie. "One of them teased her and said, ‘If I bend your arm like a slot machine, will the penny come out?’" They covered her daughter with a blanket and kept her distracted by telling her about all the fun things that she could expect to find in the pediatric emergency room. "TV, video games and movies, they told her."

It was no exaggeration. Winthrop’s Pediatric Emergency Unit, which opened last November, is, indeed, child-friendly. The ER is furnished with 10 child-size hospital beds, with a TV at each bedside. DiVerde says that as soon as her child was settled in, the television was turned on. "And before we knew it, they had put on a Disney movie for Stephanie." The ER also has a rolling entertainment center with Nintendo® and Game Boy® units. There are books, puzzles and the always reliable crayons and coloring books.

Gerald Brody, M.D., chairman of Winthrop’s emergency services department, estimates that the unit treats about 1,000 patients (under age 21) per month. The staff sees children who are suffering from dehydration, diarrhea, asthma, infectious diseases, simple falls from the monkey bars and serious trauma. "Children have special needs and they need their own separate area," says Brody. "They need to be isolated from the adult [emergency] population, because that can be traumatic for kids. The flip side to that is that adults shouldn’t be exposed to kids either. A lot of crying and screaming can be quite upsetting to adults."

Someone to Talk to
So, how do you calm a crying child – one who is crying more from fear than from pain? Some hospitals employ Child Life Specialists, who float from the pediatric department to the pediatric ER when needed. Their job is to try to keep the hospitalized child in good spirits and lend support to parents.

In Stephanie’s case, a Child Life specialist was brought in to prepare her for "pre-op." DiVerde says the specialist explained that an X-ray would be taken. "Pictures that don’t hurt is how she described it." The specialist brought a box with a child-size cap and gown to show Stephanie what she might wear for surgery. Then she shared photographs of the operating room and pointed to the big, bright overhead lights. She kidded with Stephanie, telling her the lights looked like "flying saucers" but they really help the doctors see better.  Before surgery, Stephanie even had the chance to play with sand art. With all the attention and entertainment, "Stephanie was looking to stay the whole week," jokes DiVerde.

The penny was successfully removed and the DiVerdes were pleased with the outcome. The worst part of the ordeal, according to their daughter, was pulling the tape off from the IV – but even the "ouch" from that was remedied with an iridescent bandage.

Kid Comfort in Suffolk, Too

Carol Corcoran of
Lindenhurst tells a similar story about her 5-year-old’s emergency room visit to Good Samaritan Hospital during the winter of 1997. "Sean had an intestinal virus and couldn’t keep anything down. He had pains in his side. My pediatrician thought it might be appendicitis." Corcoran followed her doctor’s advice. Rather than wait until morning for an office visit, she and her husband took their son to the hospital that night. The ER was packed with adults waiting to be seen and Corcoran resigned herself to a long wait. But immediately after they signed in, Sean was brought into the treatment area. "The nurses told me they could see how weak, how lifeless, my son looked."

"Sean was dehydrated so they started an IV to give him fluids. Then they had to draw blood. The nurses and the pediatrician on call had wonderful bedside manner," says Corcoran. "That means a lot, especially when a parent is hysterical and thinking the worst." This was the scene at Good Samaritan Hospital a year before they even opened their Pediatric Emergency Center. And the "wonderful bedside manner," according to others interviewed, seems to be genuine and doled out daily.

"We see about 25,000 kids a year in our pediatric unit (ages 18 or under)," says Smestad, adding that Good Samaritan is the only hospital in Suffolk with a pediatric emergency department. "When you have a catchment population of half-a-million people, you see everything that there is in the textbooks. You see leukemia, brain tumors, hereditary conditions, congenital conditions and even abuse."

Young patients here are entertained with TVs, video games, toys and books, too. And this 12-bed facility employs board-certified pediatricians and some who are sub-specialty trained in pediatric emergency medicine. Add to that, medical equipment down-sized for children, topical anesthetics that help numb the pain of certain procedures and a computerized radiography system. "I can zoom in and look at tremendous detail," explains Smestad. "You can’t do that with the old X-rays, unless you use a magnifying glass."

Hopefully, most
Long Island parents will never have to set foot into an emergency room to seek help for their child. In the event, though, it may be comforting to know that more and more hospitals, including South Nassau Communities in Oceanside and Mercy Medical Center in Rockville Centre, are adding pediatric emergency treatment areas to their facilities.

Here on the Island, procedures are in place, professionals are standing by to offer expert care – and when all else fails to bring a smile to your child’s face – there’s always the magic of video games.



When Molly Was in the Hospital: A Book for Brothers and Sisters of Hospitalized Children, by Debbie Duncan, Rayve Productions Inc., 1995.

Clifford Visits the Hospital, by Norman Bridwell, Scholastic Inc., 2000.

Going to the Hospital, by Fred Rogers, Putnam Publishing Group, 1997.

Hospitals with Separate Pediatric Emergency Rooms or Treatment Areas

Good Samaritan Hospital Medical Center, 1000 Montauk Hwy., West Islip; 631-376-4094.

Mercy Medical Center, 1000 North Village Ave., Rockville Centre; 516-705-1022.

Nassau University Medical Center, 2201 Hempstead Tpke., East Meadow; 516-572-0123;

Schneider Children’s Hospital, 26901 76th Ave., New Hyde Park; 516/718-470-3800;

South Nassau Communities Hospital, One Healthy Way, Oceanside; 516-632-3000.

Winthrop University Hospital, 259 First St., Mineola; 516-663-2525.


• American Academy of Pediatrics (AAP), 141 Northwest Point Blvd., Elk Grove Village, IL.; 847-434-4000; – This organization offers health-related information for parents of children ages birth through 21.

EMSC National Resource Center, 111 Michigan Avenue, NW, Washington, DC 20010;   – This is a national initiative created to reduce child and youth disability and death caused by illness and injury.

United States Department of Health & Human – Offers a fun-filled kid’s activity page with facts about good health, safety, drug prevention and more.