San Rafael, CA – For decades, when a child was hurt or became dangerously ill in Marin County, the local care was variable and lacked a focus on pediatric best practices such as age-appropriate equipment and kid-friendly pain control and distraction techniques.
Emergency care for kids in Marin is handled with pediatric best practices, age-appropriate equipment, and kid-friendly pain control.Over the past five years, that has changed as Marin worked to improve its pediatric emergency care plans and capability. This dramatic change was recognized when the Marin County Emergency Medical Services for Children (EMS-C) Plan was approved by the State of California agency that reviews such plans. Complying with California Code of Regulations, Title 22, Chapter 14, might sound like a clerical achievement, but it’s seen as a major breakthrough among those who deliver emergency care to kids in Marin. That group includes Dr. Dustin Ballard, Medical Director of the Marin County Emergency Medical Services Agency.
“In large part due to the hard work and dedication of our hospital partners,” Ballard said, “we have created a system of care for children that not only provides better and more compassionate care but will be far more capable to quickly adapt to change and stress in the system, such as in a disaster situation.”
In 2020, 409 children in Marin required emergency medical service (EMS) ambulance transport, 217 of those for traumatic injuries and all but 18 were taken to hospitals in the county.
State acceptance of Marin’s EMS-C plan is notable for parents because improving pediatric readiness improves outcomes for children and their families. Hospitals with high readiness scores to treat children demonstrated a four-fold lower rate of mortality for kids with critical illnesses than those with lower readiness scores. MarinHealth of Greenbrae and Kaiser Permanente San Rafael are both certified pediatric receiving centers and both scored very highly in the ratings.
MarinHealth is an advanced pediatric receiving center at which all staff and physicians have special education on the treatment of pediatric patients. It is an “ouch-less” emergency department, promoting “no pain” when it comes to procedures involving kids. Young patients receive numbing medicine before getting a shot, and staff try to deliver medicine in needleless ways. The hospital has a child-life specialist who incorporates play into patient visits to educate, distract, and make a child comfortable in a scary situation.
“We are proud to live in a county where we collaborate very closely with our EMS partners in providing excellent care to our kids,” said Michelle Tracy, MarinHealth’s Director of Emergency, Trauma Services, Education and Professional Development. “So now, from the time an ambulance picks up a child until the time the child is discharged, they are receiving specialized pediatric care that they did not have to leave our county to receive. With his EMSC designation, our EMS agency has elevated the care for local children.”
The countywide achievement was celebrated at Kaiser as well. The staff there is committed to providing high-quality pediatric care in both its emergency department and in the pre-hospital EMS environment through its dedicated teams of physicians, nurses, and staff.
“I am grateful that Marin County has earned this important designation,” said Dr. Kristen Cadden Swann, Kaiser Permanente San Rafael’s Pediatric Receiving Center Medical Director. “It is a huge accomplishment for Marin, and I am honored to work and live in a county that cares so much about our pediatric population and making our patients safer and healthier. I am thankful that Kaiser Permanente San Rafael has partnered with the county and other health care providers to make this happen so that we can all strive together toward a common goal of having the best and safest care for our pediatric patients.”
The California Emergency Medical Services Authority notified Marin of its compliance on April 27, ending a process that was years in the making.
“We are thrilled with this achievement and so are our prehospital and hospital partners,” said Karrie Groves, a registered nurse and program coordinator with Marin EMS. “Children are not just small adults,” said Groves, “and require specific sizes of equipment for stabilizing airways, administering IV fluids and medications, and ensuring safety equipment for ambulance transportation. Changes in our system were made specifically to address this special population and are in place today.”
“This is great news,” added Dr. Matt Willis, Marin County Public Health Officer. “It’s another key step in supporting the health of our children. Well done, team.”