For a child with autism or another sensory disorder, a trip to the emergency department can be overstimulating and traumatic for the patient. To combat this, Nemours Children's Hospital in Orlando, Fla., recently launched a specially designed ED care model focused on providing more accommodating care to patients who are easily distressed.
"Traditional emergency department settings are fast-paced, loud and overwhelming," said Cara Harwell, an ED nurse practitioner at NCH. "At Nemours, we want to be sensitive to all pediatric patients who come through our doors and alleviate any unnecessary stress our patients and families may experience."
The new complete care model is called REACH, for "respecting each awesome child here." The model includes elements for all aspects of the visit.
Upon arrival, families are told to alert ED staff if a child has autism spectrum disorder or another behavioral condition, at which point they are offered headphones, sensory brushes and other sensory-minimizing and -distracting resources, or given the option to occupy a separate, quiet waiting room or playroom.
During intake and assessment, the ED team is permitted to provide special accommodations to REACH patients upon request, including dimming lights, reducing unnecessary monitors and limiting the number of caregivers in a room at one time. A child life specialist also assesses the situation and ensures children and parents are comfortable.
Regarding treatment, REACH families are asked about their child's preferences, behavioral triggers and any adverse reactions to medications to help clinicians expedite choices surrounding consultations, medications, tests and environmental adaptations.
Prior to implementing the REACH program, Nemours' ED healthcare personnel were educated and on new techniques and the capabilities of the tools available. Three research studies are currently underway to evaluate the Nemours pilot program and similar efforts across the country.