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FrightenedChildAs I was rounding the corner from the adult area of the emergency department to the pediatric area I heard a child screaming at the top of his lungs, “I DON’T WANT A SHOT”. I knew at that moment I was being summoned. I walked into the room and I saw a mother with her 5 year old son in a full headlock, while a new intern was trying to look in his ears. I made eye contact with the intern said “maybe I can help” then turned my attention to mom and son.

I smiled, sat on the end of the bed and said, “Hi there, I’m Kristen. I’m a child life specialist, which is a fancy way of saying I’m the emergency room kid helper. It’s my job to make sure you understand everything we need to do while you are at the hospital and to help you not be afraid. Let me tell you about what we need to do today to help you feel better”. Within a few minutes, the child was educated, placed in a comfort position, and was distracted by a magic wand. The intern was able to finish her exam, left with a smile, and jokingly asked me if I could follow her around for the rest of the day.

Some call me the child whisperer, bubble lady, or kid helper. While all those names are fun and certainly help kids understand that I am a non-threatening person, what I really am is a Certified Child Life Specialist. As stated by Child Life Council, “a Child Life Specialist is a trained professional with expertise in helping children and their families overcome life’s most challenging events. Armed with a strong background in child development and family systems. Child life specialists promote effective coping through play, preparation, education, and self-expression activities.”

For example in the Emergency Department, Child Life can be in various ways:

Preparation: Teaching patients and families about the plan and procedures expected. Develop at coping plan and provide developmentally appropriate distraction during procedures.

Medical play: This modality of play helps children and their families become familiar with equipment and increase understanding of the experience.

Trauma/Code support: Working closely with the medical team to provide support to patient. Teach on the spot calming techniques to patient throughout trauma/code exam and procedures.

Transfer preparation: Provide age appropriate information to patient and families regarding transfer to Children’s Hospital for inpatient stay and/or surgery.

Play: Providing play helps children cope with the hospital environment. While playing on the iPad, watching movies, blowing bubbles seems like fun, each activity provided by a child life specialist is purposeful and geared toward each child to keep them distracted and help cope with the emergency department visit.

Since not all emergency departments are created equal and offer a child life specialist as an option for support, listed are a few of my favorite tips to help you and your patient have a successful intervention.

  • Use developmentally appropriate language – Providing information to children doesn’t always mean they will understand the message. “We are going to put you to sleep and reduce your arm” means something very different to a child (their dog was put to sleep and never came home and then you’re going to cut off their arm). Try this: We will give you some anesthesia which is a sleeping medicine. This medicine will make sure that you are in a deep medicine sleep while we will fix your arm and wrap it in a cast. You won’t feel or remember anything.
  • Preparation – Research has shown that children who are prepared have a better success rate of being cooperative. Try this: (for a throat swab) I need to take this long Q-tip and gently touch the back of your throat. That will tell me if we need to give you medicine for your sore throat. I want you to take a big breath in,  then out, then on the next breath in say Ahhh as big as you can, then breathe out. When you say Ahhh that is when I will touch your throat. It will only take a long as it takes you to say Ahhh.
  • Distraction – Distraction has been shown to minimize children’s fear, anxiety, and pain associated with acute painful medical procedures. Try this: Blow bubbles with infants, download a short game for your phone and let the child play while you are doing your exam.
  • Show interest in the child – Children have a right to be included in their treatment and will trust you more if you show you care about them. Try this: Get on their level, introduce yourself and shake their hand. Ask about their interests and/or school.

Emergency Departments can’t go wrong by hiring a Child Life Specialist. Through the marriage of medical care and Child Life support we are able to see children feel better and not be traumatized by their experience and to view the hospital in a positive way.

For more information on Child Life visit ChildLife.org

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Kristen Beckler, CTRS, CCLS

Kristen Beckler, CTRS, CCLS

Certified Child Life Specialist
Lucile Packard Children’s Hospital at Stanford
Pediatric Emergency Department
Kristen Beckler, CTRS, CCLS

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