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Kids aren’t small adults. They’re developing and changing every day, and when they get hurt or sick, they need care that understands the ways they’re different — and how they’ll be different next month, next year, five years from now. That kind of care requires specialized equipment and expertise. And unfortunately, most hospitals and emergency departments don’t have it.
No one likes to believe that any local hospital may not be the best. Colorado has dozens of great community hospitals, and their medical staff save lives every day. But research by the American Academy of Pediatrics shows that, when it comes to kids, those hospitals often just don’t have what they need to treat them safely and effectively.
Kids respond to tests, drugs and treatment differently. Because they’re growing, the treatment they get today can have major ramifications down the road, often for the rest of their lives. Their medical care needs to anticipate that.
Our specialists know what makes kids’ bodies different, but they also know how to engage kids, get them involved and get to the root of the problem.
That can be tricky, because kids are less able to communicate how they’re feeling. They can’t describe their symptoms, and they often confuse pain with fear. If they don’t like a doctor, they won’t pretend to — and they probably won’t cooperate for a physical exam.
We know that, to treat a kid, you first have to win them over. We also have the experience to often diagnose pediatric conditions on the spot, even rare ones an adult specialist might not see their entire career.
Wiggling and x-ray imaging don’t mix. At the same time, kids’ bodies are more sensitive to radiation — meaning it’s crucial to get it right the first time. Plus, kids’ bones have growth plates, making x-rays harder to read, but making the bone-setting that depends on them more critical.
Kids have smaller blood vessels and less blood, which means their lab work looks different. They have a higher heart rate and breathe faster, so their vitals look different. Kids’ livers process medications differently than adults’ do, so dosing looks different. Even getting an IV into small veins takes dedicated expertise.
Kids are different in thousands of ways that affect their care. Here are just a few:
Kids’ neurotransmitters are different, as are the connections between them, and the lining of the nerves is not fully formed. Kids’ brains are also softer due to higher water content, which makes them respond differently to surgery and traumatic injury. All these differences mean that the electrical activity of the brain looks different on EEG, confusing adult neurologists, who often misinterpret kids’ EEGs. Plus, any treatment needs to anticipate the brain’s long-term development — something adult neurologists don’t need to worry about.
Because the nerve in baby teeth is closer to the surface, cavities are more likely to get infected without treatment. Infection can damage the developing adult teeth underneath, and if baby teeth fall out prematurely, that can cause problems with crowding and spacing down the road.
Plus, their maximum heart rate is higher, meaning kids’ bodies work harder to deliver oxygen to working muscles. In adults, heart problems generally relate to the heart “wearing out” over multiple decades. In kids, it’s usually abnormal development of the heart structures before birth: holes, abnormal valves, underdevelopment of a heart chamber or blood vessel. Pediatric cardiologists have experience with identifying and treating these heart defects.
Because the pathways for air to fill the lungs are narrower in kids, a lung inflammation that might just cause coughing and discomfort in adults can render kids unable to breathe. Kids also take in more breath relative to their size, meaning they breathe in more toxins and pathogens, too.
In adults, treatment for a broken bone has to correct the injury. In kids, treatment also needs to anticipate how the bone will grow. Kids’ bones have growth plates, and they’re incompletely calcified, which makes them more flexible. Taking these differences into account in a broken leg, for example, could mean the difference between normal walking and a permanent limp.
And it’s not just because they’re sometimes rambunctious. Because their bodies are smaller, a traumatic event like a car accident exerts the same amount of force on a smaller area. Kids also have a higher cranial to facial ratio than adults, plus proportionally larger heads and weaker supporting neck muscles, all of which makes them more prone to brain injuries. And, because kids have more pliable bones and less abdominal wall protection for the liver, kidneys and spleen, they’re more prone to internal organ injury.
The list of differences is potentially endless, and knowing them could have an impact on the rest of a child’s life.
Kids are at higher risk for infection and complication of treatment. Their immune systems are less “experienced” at identifying infection, and their different anatomy sometimes fosters it. Kids do heal faster, but they get sick faster, too — meaning complications can worsen very quickly, sometimes to a life-threatening degree.
So how does your community hospital measure up? One way to find out is to simply call and ask.
How many children does the ED treat in a typical day? Do they have a pediatric emergency medicine specialist on call or on staff? Unfortunately, many don’t.
At all Children's Hospital Colorado Emergency Departments and urgent-care locations, everyone from doctors to lab techs specialize in pediatrics. Each location is directly connected to our hospital on the Anschutz Medical Campus in Aurora and has access to a pediatric emergency medicine specialist at all times. These doctors have at least six years of pediatric emergency medical training under their belts. The amount of time a typical ED doctor spends studying kids? About three months.
We see, treat and cures more kids than all other Colorado hospitals combined. This expertise helps us offer fast, accurate diagnoses and start treatment sooner.
And get there if you can. Of course, if a child is choking or needs immediate care, call 911 or go to the nearest ED. But if it’s possible, driving to the Children's Hospital Colorado pediatric urgent or emergency care location closest to you can help ensure your child gets the absolute best care, even for something as simple as stitches or a broken bone.