Minor Arriving at ER w/Unconscious Parent

justbishop

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13 y/o arrives via ambulance late night/early morning (maybe 4:30am-ish) with unconscious parent. The other parent is long deceased, and there are no family or close friends of age within the state (though an aunt and uncle in another state are listed somewhere as emergency contacts, and are called and arrive the next afternoon by plane).

Would the minor be allowed to walk into the building with the medical staff as they wheeled the parent from the ambulance on a gurney?

Would the hospital have some kind of liaison trained in dealing with children on hand when the ambulance arrived? What would this person do, exactly? I currently have the scene written with this person meeting the character as the parent is wheeled in, and sitting with the character in the waiting area as the staff works on the parent. There is a point when the liaison leaves the child sitting in the waiting area to be kept an eye on by the front desk people while waiting for the news on the parent.

Would the child be escorted to the parent's room when they were stabilized and admitted (keeping in mind that of age next of kin arrives within about 12 hours).

I'm hoping to be able to visit my local ER sometime soon, but thought it couldn't hurt to ask here as well :)
 

jclarkdawe

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So much of this answer depends upon the kid, who I'm assuming is uninjured. (If he's injured, this goes a lot differently from the beginning, including a separate ambulance.) From the point of view of the ambulance crew, if we can work with him, he goes up in the front seat for the ride to the hospital. If he's a pain in the ass, we dump him on the police.

Then the next question is how communicative are the relatives.

There's some 13-year-olds that will sit quietly in a room and stay out of trouble with a bit of baby-sitting. There's others that can't stay out of trouble for longer then a couple of minutes.

Best of luck,

Jim Clark-Dawe
 

justbishop

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The kid is completely uninjured. The incident wasn't a car accident or anything, she walked in on her parent having OD'd on Rx pills and alcohol.

And yes, she is the type of kid who can sit and keep out of trouble, once she's calmed down.

Thanks for the response :)
 

jclarkdawe

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Okay, with the additional information, here's how I'd do the ambulance end. One person on the crew, if we have enough people, would be assigned to calm her down and explain what's going on. That person would attempt to find out the relative/friend situation. Upon finding out the only contact is a distant relative, we'd ask for the phone number and give a call (an OD can afford to wait a bit as we do a thorough exam -- it's not a scoop and run call).

We'd call the relative, explain who we are and why we're calling. If we get a response that they're coming, great and we'll assume they'll put that in place as soon as we hang up. If the kid has a cell phone, we make sure the kid has that. Otherwise, we see if mom has a cell phone and grab that. We also ask if the kid wants to bring a gameboy, iPod, whatever with them.

Kid goes in the passenger seat of the cab of the ambulance. Driver continues to reassure the kid. At the hospital, we'll hand the kid off to the charge nurse, explaining what was going on and providing the relative's name and phone number.

If the kid is at all likeable and the ambulance crew is busy enough for multiple trips to the ER, often we'll check up on the kid when we show up for other patients.

However, because mom ODed while in charge of the child, child protective services will be contacted by the hospital. Depending upon the state, this is considered to be either child abuse or child neglect. The police can also be contacted and a criminal investigation started. This would not be mentioned to the kid, unless directly asked.

Once child protective services arrives at the hospital (which will probably be within a couple of hours of the ambulance arriving at the hospital), the CPS worker would be responsible for the kid. If the kid is good and staying out of trouble, they'll probably stay at the hospital. One of the goals here is to minimize the traumatic effect on the child.

Best of luck,

Jim Clark-Dawe
 

justbishop

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Ah, well crap. Looks like a rewrite is in order then. I have the desk staff at the hospital ER calling the next of kin while the parent is being worked on. As for the staffer in charge of tending to the kid, I had her meeting the ambulance at the door (where the kid promptly tells her to "F*** off" while holding for dear life onto the parent's gurney as it's wheeled in), then stepping back when the kid throws a fit necessitating security when she is stopped from going into the back area where they are going to work on the parent. Once the kid is calmed down and has agreed to wait in an appropriate area, I have the liason stepping back in to talk to her, but the kid is pretty cold and the liason leaves her for the desk staff to keep an eye on. Eventually a Dr. comes out to update her on the parent's condition (stabilized but admitted), and shortly after, she is escorted up to the parent's room.
 
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jclarkdawe

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Ah, well crap. Looks like a rewrite is in order then. I have the desk staff at the hospital ER calling the next of kin while the parent is being worked on. They could do it instead. Depending upon the circumstances, sympathy for the kid, and manpower, there's a lot of ways this plays out. As for the staffer in charge of tending to the kid, I had her meeting the ambulance at the door (where the kid promptly tells her to "F*** off" while holding for dear life onto the parent's gurney as it's wheeled in), then stepping back when the kid throws a fit necessitating security when she is stopped from going into the back area where they are going to work on the parent. Which means she was probably a pain in the ass at the scene. If I can't get her calmed down at the scene, she can deal with the police. Or I call in another ambulance and deal with her medically as a panic attack. The one thing I'm not going to let her do is interfere with treating her mother. Most ambulances are not going to let a kid ride in the back for an OD. If we have to administer charcoal, it's going to get messy and we don't need a kid freaking out. Once the kid is calmed down and has agreed to wait in an appropriate area, I have the liason stepping back in to talk to her, but the kid is pretty cold and the liason leaves her for the desk staff to keep an eye on. They're going to dump her on CPS quickly if she's a hint of a pain in the ass. Eventually a Dr. comes out to update her on the parent's condition (stabilized but admitted), and shortly after, she is escorted up to the parent's room.

For a big city rescue, an OD with kids is not unusual. You don't want to traumatize the kid any more then you have to, but you don't have a whole lot of sympathy here, either. We know for an OD the kid isn't going to be in the patient's room for quite a while and will explain that to the kid. But if she's freaking out enough at the hospital to require security, she's not going to be any calmer at the scene.

Firefighters and EMTs have a lot of liking for kids, but at 13, she's on the edge. Teenage brats don't get a lot of patience. I expect at that age that she's able to let us do our job without interfering. If she's not able to do that, that's what the police is for. And I'm not going to screw around long in making this decision.

Best of luck,

Jim Clark-Dawe
 

WeaselFire

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Ah, well crap. Looks like a rewrite is in order then. I have the desk staff at the hospital ER calling the next of kin while the parent is being worked on. As for the staffer in charge of tending to the kid, I had her meeting the ambulance at the door (where the kid promptly tells her to "F*** off" while holding for dear life onto the parent's gurney as it's wheeled in), then stepping back when the kid throws a fit necessitating security when she is stopped from going into the back area where they are going to work on the parent. Once the kid is calmed down and has agreed to wait in an appropriate area, I have the liason stepping back in to talk to her, but the kid is pretty cold and the liason leaves her for the desk staff to keep an eye on. Eventually a Dr. comes out to update her on the parent's condition (stabilized but admitted), and shortly after, she is escorted up to the parent's room.
Actually, that's pretty close for most similar incidents at our local hospital. The difference is we get them because the kid and mom are here as tourists, but very similar details. The hospital has a social worker to attend to the needs of the minor, but it depends on the time of day to some extent as well as the actual problem the adult is having.

The minor usually is taken into the emergency area and given a spot out of the way. If there are medical procedures, especially emergency work, they minor is usually kept away but there isn't a designated waiting area. A nurse, orderly or someone will always take interest in the minor and help them.

The issue becomes what care is given/needed. Almost nobody goes to a room any time soon. There are waiting areas for some functions, and a minor would be found a place if needed. The staff would get them food, drink, etc.

But circumstances can change. If a minor is endangered by the parent being incapacitated, the police will assign an officer and eventually a social worker will take over. Our department will ensure that responsible care is available, and that may involve an officer accompanying the minor during the hospital stay. Our officers won't leave a minor until there is either a social worker at the hospital available or a prognosis where the minor will not be in danger.

Go sit in the emergency room waiting area sometime. It's a different world. :)

Jeff
 

justbishop

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Thanks Jeff! I still might have a few rewrites to do, but at least it seems like I imagined the protocol somewhat realistically :)
 

jaksen

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There are also situations where the child's school would be called. If there are no close relatives nearby, friends are the next best option. The school would have a record of 'who to call' in an emergency, and if the child is 13, they'd prob. do this. If it's past school hours, no problem, the local police would know how to reach the principal, and he or she would drive to the school and look up the info. (Or go on his/her PC and find it.)

This has happened to fellow teachers I know. Sometimes a teacher has been called at home and asked to go to the hospital to sit and wait with the child until the appropriate relative or close and trusted friend can be reached. (Little children often don't know their grandparents except by the name, Nana or Gramma, but they can tell you they have 'Miss Alberine' for preschool class.)

And one time a teacher friend of mine had to go and ID a dead child - she was contacted through school resources. The child had no ID on him and was a foster child. It took a while to get hold of the correct adult(s).

Anyhow, don't forget schools and school records as resources when writing about children in emergency situations. Even during the weekend, they can be contacted. I once had to hunt down my principal on a Sunday when a student contacted me online with a serious and life-threatening situation. (I was also on the line with the local police.)

I got off topic a bit ...
 
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Pyekett

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Translated.
Sometimes a teacher has been called at home and asked to go to the hospital to sit and wait with the child until the appropriate relative or close and trusted friend can be reached. (Little children often don't know their grandparents except by the name, Nana or Gramma, but they can tell you they have 'Miss Alberine' for preschool class.)

And one time a teacher friend of mine had to go and ID a dead child - she was contacted through school resources. The child had no ID on him and was a foster child. It took a while to get hold of the correct adult(s).

Thank goodness for teachers.