By Dr Y Arvind

Paediatric emergency care in India is evolving and is an essential aid in functioning of a tertiary care paediatric hospital. In busy paediatric outpatient departments, patients have to pass long waiting queues to reach the paediatrician, by which there could be a delay in addressing a critical issue where the need for paediatric emergency departments is very important.

At Rainbow Children’s Hospital, we have a structured approach where all the patients waiting in OPD are screened and any child requiring immediate attention is identified and directed to the emergency department. The child received in the emergency is immediately triaged by the triage nurse and addressed by the doctors. Our emergency department has evolved over 20 years and through the pandemic, and is now well established with state-of-the-art equipment, covered by Paediatric Emergency Medicine Consultants round-the-clock, ably supported by Intensive Care Teams and various sub-specialities.

The major challenges for a paediatric emergency physician, when compared to an adult emergency physician, are inability of children to communicate unlike adults; lesser volume of blood and smaller respiratory structures making them prone to decreased oxygen supply to brain even with small volume loss, like one large stool or one large vomit; or difficulty in breathing for short duration of time. Lastly the developing brain of the child would start to get affected with longer durations of decreased oxygen and nutritional supply, this damage can be irreversible and can start as early as within 5 min in severe conditions.

Dr. Y. Arvind
MBBS, MD Paediatrics, Fellowship in Paediatric Emergency, Consultant
Rainbow Children's Hospital, Banjara Hills, Hyderabad

The lack of basic emergency facilities across the country is very concerning. It is about time, that with improved connectivity, we should look at providing emergency care on wheels from point of contact with the patient until reaching the tertiary care hospital, thus preventing mortality, and more importantly the morbidity which in most of the cases more painful than the mortality parse. 

A major role of the paediatric department is to identify the early signs and prevent the irreversible damage to the vital organs. Our aim is not only to save the life of the child but also to ensure the same quality of life as prior to the illness. The early signs which help any mother or care giver to pick up the critical illness early and reach for emergency care are a lethargic child, excessively sleepy child and a child who is not as usual, add continuous irritable cry for very young children to the above mentioned symptoms.

This article was published in association with Rainbow Children’s Hospital.