Pediatric Emergency Care
- More advice about Emergency & Urgent Care
Parent Q&A
Archived Q&A and Reviews
Best ER for kids?
March 2006
After having an awful experience at the Oakland Kaiser ER, we are looking for a better ER (i.e., kid-friendly, adequate staffing, clean). We currently have Kaiser insurance, but will be able to change plans soon if necessary. Would like to hear about any good/bad experiences at other Kaiser ERs or other local hospital ERs (Alta Bates, Children's Hospital, etc.) mom of 2 active boys
We've taken our sons to Children's Hospital Oakland whenever needed. Always a good experience. One of our sons was recently admitted, when the Drs weren't 100% sure what the cause of his symptoms were. With pediatrics, they know not to throw caution to the wind. Children's Hospital of course has pediatric specialists, and are equipped and experienced to handle typical pediatrics emergencies. Don't judge the care by the waiting room. The facilities and staff are outstanding. My son truly didn't want to leave after one day, as children are treated so well.
We use Richmond Kaiser and have always been treated quickly and well, for me, my husband and my kids. Richmond Kaiser is smaller and usually less crowded than Oakland. Although it's been a few years since we've been to the emergency room I never felt it was dirty. I''ve heard horror stories about waiting 8 hours to be seen in Oakland. Never my experience in Richmond. anon
I felt we received good emergency care at the Richmond Kaiser for our one year old daughter. We were seen right away and the waiting room was not unpleasant. We have also been very happy with their pediatrics department. We have heard good things about Children's Hospital but our one experience there was so-so. anon
Funny you should inquire about pediatric ERs-- I just had a very lousy experience at Alta Bates with my 4 year old vomiting son last week. I am a pediatrician (altho I have not practiced since moving to Bay Area a couple years ago), so I have a fairly informed perspective on this. I went to Alta Bates bcs it was close by and I knew all my son needed was some intravenous fluids as he was getting dehydrated. It took over an hour to be triaged (this may not sound that bad, but dehydration in children can be life-threatening; no one even looked at him except a kind security guard who brought over an emesis basin and blanket when he continued to throw up while waiting); then the triage nurse told me rather defensively that he was not THAT sick, despite multiple signs of dehydration (pulse 50% elevated, dry mouth, extreme thirst, complaints of dizziness, no urination for hours), so we sat and waited another 4 hours before seeing a doctor. In a pediatric ER they might have offered pedialyte to try while you're waiting, but here it was a struggle to get a glass of water. Then they were unable to get a blood pressure on him bcs of not having appropriate sized cuff or some malfunction with machinery. The nurse's aide went off to get a manual BP machine but never returned. The doctor was nice enough, but clearly not that experienced with kids, and seemed ready to send us home altho readily agreed to give him some IV fluids when I suggested it. The nurse who put it in was very kind and actually did a great job both technically and talking my son thru the insertion, altho she had to ask another nurse for help with the details of the tubing (''We don't get that many kids here'', she told me). After the fluid went in, which was the only reason we were there as far as I was concerned, we had to wait over another hour to be discharged; we finally got home at 5:30 am. The discharge instructions were preprinted, and they made no sense-- on the SAME page, the instructions advised NOT to give your dehydrated child sports drinks or popsicles in one section; further down in the Diet section, it recommended ''clear liquids'' for 2 days, offering those same two items as examples of what you SHOULD give. (most recent recommendation is actually to give your child rehydration fluids plus a more or less normal diet as he can tolerate; there is NO reason to starve your poor child if he or she feels like eating).. I think most ERs these days suffer from insufficient staffing and overcrowding, largely as a result of our ridiculous, dysfunctional, fragmented so-called health care system. It is very clear that the money is going to profits (CEOs and shareholders), not to providing quality care. Still, I think a childrens' hospital ER would probably be better bcs there are likely to be more potential advocates for your child to help you negotiate system and who understand kids' unique needs. P.
Unfortunately, my child has been to the ER at ChildrenC-s Hospital far more than I can count-for minor and life- threatening issues and each time I think to myself how lucky I feel to live so close to such a phenomenal place. Sometimes the ER waits have been long, other times she was seen immediately. I have never felt like she was being ignored or was in danger when we have had to wait. Every doctor and nurse has been extremely patient and caring and they have all worked very well with my daughterC-s outside pediatrician when necessary. She has been admitted to the hospital a couple times and had to stay several days. Again, her care was always fantastic and the staff made sure I felt as comfortable as I could. The team of doctors and specialists has been really great and I never questioned her care. Aside from an occasional surly security guard, I canC-t think of anything even remotely negative about my childC-s 15+ experiences here. In fact, there is a fund raising group of C,Grateful ParentsC. that are so happy with the care their kids received that they work hard at giving back however they can. I think that says a lot. Grateful Mom
Hello- First, I must say that I work for John Muir Health. But first and foremost I am the mom of an active 2.5 year old son who has visited more ER's than I care to remember. He comes first. Period. That said, we had a horrible experience at Sutter Solano in Vallejo last month. I would actually drive to avoid them if possible.
In the last year, my most enjoyable (odd, I know) experience has been at John Muir in Walnut Creek. I was a new employee, careful to not wear my ID badge, and everyone was very nice. They have ''ED North'' where kids with peas in their noses, strains and in our case, a head laceration, go for quick care, so they are not waiting around for hours and hours. We were in/out in under two hours, which is pretty impressive to the 8.5 we spent at Sutter Solano for a deep finger laceration.
Remember though...that John Muir is the regional trauma center, so you may get a wait if a serious accident or helicopter comes in. But you also get access to all the medical know-how too. mom to a clutsy little guy
We experienced both Alta Bates and Childrens' Hospital with my son (croup and broken arm) With no doubt Children's Hospital was the best. At Alta Bates we waited about 3 hours and that's not a child friendly ER - or adult friendly, really. Lot's of homeless people, drug addicts. Not dangerous, but very uncomfortable. At Children's Hospital it's all about children. Nicer waiting room, attentive and responsive care - they have bottles, sippy cups, etc.... Whatever insurance I get, I make sure my kids' doctor is affiliated with Children's Hospital.
We had a good experience recently with my 3 year old at the Children's Hospital ER. It was very clean and cheerful, and the staff were very attentive, caring, and knowledgeable. It wasn't an easy experience, but they helped in every way they could. Mom of other active kids
we've been to Childrens ER twice for very different problems. once a cut that needed stitches and once for an asthma exacerbation - both with kids under one year old they're great children's hospital fan
I'm so sorry to hear about your unpleasant experience with Kaiser's ER. I'm afraid that most ER's are that way today as a result of the state of our health care. The burden has shifted to the ER, to pick up the tremendous overflow of those uninsured or with little to no access to healthcare. With that being said, I have had adequate results at Childrens in Oakland and John Muir (although that sounds too far for you). I have not been to Alta Bates ER. Children's Oakland has top docs but the wait can be excruciating depending on how busy they are.
I have learned over the years that when it comes to health care, particularly ER's, you should be kind and courteous to the check in people. But you also have to really let them know that your medical situation is most serious. Be kind, but aggressive. It's like you are jockeying for position and the squeaky wheel gets the grease. Sorry to sound so calice but that is the reality of health care today, regardless of where you go. ER mom
We've tried Alta Bates (the worst) Children's (the best because that's what they are there for, with usually the longest wait), and John Muir in Walnut Creek. As an alternative for non-life- threating but serious medical issues that just cannot wait the weekend or overnight, I strongly encourage you to make the trip to Night Owl Pediatrics, 425 Gregory Lane, in Pleasant Hill. Tel. (925) 288-3600. They take most insurance, it's only 15 mins through the tunnel, and is staffed by Pediatric ER physicians. They are amazing, and I cannot speak highly enough of them. We have taken both kids (3 y.o. and 16 m.o.) there several times. The youngest had been coughing for several weeks and I had been told by my regular pediatrican that it was just a ''lingering'' cough that would go away eventually. At Night Owl they immediately saw cause for concern and did a chest x-ray right there and found serious pneumonnia, which my regular pediatrician had been overlooking for a couple of weeks. I did change my peds doc right away after that, by the way! They have excellent staff and facilities, open M-F 5 pm - 11 pm, Sat & Sun 1-11 pm. Here is their website: http://www.nightowlpediatrics.com/ A No-ER, No-Ambulance Mama Anymore!
Why are you choosing your health care based on the Emergency Room? No emergency room is going to be a really fun experience, especially in any kind of city environment. Did you know that you can get same day urgent care appointments at Kaiser? Do you like your pediatrician? You should not have to use the ER except in a situation where you really are not going to care how ''kid-friendly'' it is. I have never had to bring my child to Kaiser Oakland ER but have been there several times for myself or my husband, and while the waiting room is not exactly the lobby of the Ritz, the care has been appropriately prompt and the medical care area has been appropriately clean. I am interested to hear if anyone has been to Kaiser and another ER and found them very different. Learn to use your Kaiser
I'm sorry, this sounds like a bad experience for your poor son. I also have Kaiser and we go to the ER at Oakland. It is more staffed, and seems to better handle the larger volume of patients. So that's lesson #1 for you. Lesson #2 is feel free to offer pain relief at home ASAP for any situation where your child is in pain if you feel it's warranted. There is a LOT more hesitancy around pain medication in hospitals in the past 10 years regardless of patient age, in my experience. I believe this is due to misuse of pain relief meds (although obviously there's not a black market for advil, yet!). I can't say if it's common to get codeine in this situation (having not been in this exact situation) but I would be surprised if it were presented as a choice. Lesson #3 is something I struggle with myself, but it's essentially to be a LOUD voice in this situation and assume you have to advocate for everything (start shouting for pain relief the second you were checked in, for example). Again, none of this is your fault (or even Kaiser's, we weren't there), but lessons I would take away for next time.
I agree 100% with Anonymous - we've had to go to the ER several times in the past 2 years and Oakland is by far the most efficient local Kaiser.
Also agree about the pain med hesitancy and being a squeaky wheel - like anything else with Kaiser you need to be your own best advocate, even in the ER.
All that said, I'm sorry it happened to your son, and hope he's healing well. If it's any consolation, we self-pay way more than double your costs for a family of four. Since you are paying so much take full advantage of all the programs and services they have to offer, some of which (like health education) have been great.
I had to take my dad to the ER at Summit two weeks ago. There was a woman in the waiting room holding her arm and just rocking and sobbing in pain. As far as I could tell, they wouldn't give her anything until she had gone through triage and was in an actual ER bed. I felt for her - she seemed so miserable. My dad was experiencing pain in his lower leg caused by an enormous hematoma, and they didn't give him any pain meds until he was officially set up in an ER bed. So no, unfortunately I don't think your experience was unique to Kaiser.
I am so sorry you went through this (it’s always hard seeing our kids in any discomfort) and that you are second guessing your decisions / actions. I am sure that you did amazingly and your son is lucky to have you advocating for him and proactively considering his needs
I would be surprised, in any situation, if they would offer codeine first. I imagine typical protocol would be to try to get it assessed first (so that you can more effectively pinpoint the location and type of discomfort) and then offer treatment. I would also assume they’d start with mild pain relief and then escalate if needed. That said, you know your son and his pain tolerance best so could probably advocate for medication sooner and at higher dose / treatment if you felt it was warranted.
My 6yo daughter broke her arm this summer and we went to the Oakland Kaiser ER. Her arm bone was visibly broken and there was a small wound where the bone had pushed through the skin in the fall. We saw the triage person almost immediately and he offered her a sling and said that he would try to make sure she got seen as soon as possible. We waited in the waiting room for about 20 minutes, after which I asked the triage person if they could give her anything for pain, even over the counter stuff. He said they can't, it has to be prescribed by a doctor. He did manage to get us into a room about 15 minutes after that though (so waiting outside for 45 minutes) while my daughter was hugging her arm and going in and out of crying inconsolably with moments of gritting her teeth and just getting through it. Once we got into a room, it was at least another half hour before she was offered Tylenol, so overall, from the fall to pain medication, my daughter had to wait about 2 hours. Once she was seen by a doctor though, they offered her morphine, but as the Tylenol seemed to take the worst of the pain away, we rejected it. Over the time we were there, we asked for pain medication to be given several times before it was, and kept getting the same answer about a doctor having to see the patient first, which was really excruciating for us. My daughter ended up needing to go under general anesthetic for wound cleaning later though so I guess they also just don't know what the next steps are going to be, so are hesitant to give anything without a consultation with the doctor. I'm still not sure how I feel about the whole thing, but overall, I'm grateful for the care she got, and she healed really well. If something like this happens again, I might just give my kid some Tylenol en route to the hospital and let the doctors know what we administered. I'm sorry you had to go through this with your son and I hope he's healing well, and that you're recovering from this traumatic situation as well.
Sounds about right. I have only been to an ER once in my life and after that I told my family that if anything happens to me I would prefer to just die at home rather than going to one ever again. Not being facetious here. I have been to an urgent care twice in my life many years apart and both times the experience was fine. ER: NO WAY am I going there if I break a bone no matter how bad the pain is.
Unfortunaly having experienced multiple broken arms, we have loved UCSF children's hospital in Oakland. A pediatric ER is amazing and has everything kid-sized, and the doctors and nurses there have been great, even when they are super busy. It's one of the reasons why we wouldn't want to leave the Bay Area. We also always called an ambulance for (clearly) broken bones since the EMTs can properly wrap the injured limb before jostling it around in transport, and it gets you past the waiting room.
In my experience, no ER will offer pain medications to a patient before they have been assessed. They need to make sure as in your case if the patient has any internal issues before so they need to be examined. As for security most ERs are crazy with Security these days. But the best place to take an injured minor is Children’s Hospital Oakland. I assume Kaiser will cover the ER anywhere but not certain
My experience going to the ER with a child and even just myself at Alta Bates has been very good. I left Kaiser a long time ago because of the things you described—needing to advocate for myself constantly. However, my mother in law often goes to Kaiser’s ER in Oakland and says she has a fine experience so maybe it was just Richmond.
I would say this is typical, actually, and not a Kaiser-specific thing. A few years ago, my then 12 year old was bit in the face by a dog in another state. So definitely not Kaiser, and it was a trauma hospital that we went to. It was pretty awful, some puncture wounds plus a 3 inch gash from the corner of his mouth that went all the way through. His face was gaping open, he was screaming in pain. It took over an hour and a lot of pestering by us before a very annoyed nurse told us they don't usually do this, but offered him Tylenol. He didn't get anything stronger until after his emergency surgery a few hours later. And no, I wasn't going to stop by the medicine cabinet at home before rushing my child to the hospital. It's horrible they don't offer pain relief right away for these cases, but it sounds like standard procedure, unfortunately.
So sorry about this experience! But I would echo what everyone says--we have had two good experiences with our kiddo at the Kaiser ER in Oakland. The waiting room was calm, the wait was not long, and everyone seems to be organized and know what's going on. It's also inside, no tents. It's funny because I otherwise hate going to Kaiser in Oakland as opposed to Berkeley or Pinole, but I think their ER is the best. Actually way better than experiences I've had with non-Kaiser ERs in the past.
I just want to explain a bit why they don't give any medication in to the ER (or any other medical setting) before evaluating the patient: We need to make sure the medication is appropriate for the patient, they are not allergic to it and it does not adversely affect them in their current condition (because if we don't, you *will* sue us). And we can only do that after assessing the patient. In addition we need to document any medication or treatments they are given in their file, so if we haven't started a file, there is nowhere we can put that information. And we don't want someone to overdose on any medication because they got some before paperwork was started and then another dose because the treating MD didn't know they had already got some.
ERs often have long wait times and they are triaging the people in the most danger before the people in the most discomfort. So I don't know if there's an ER that is super comfortable right now. Kaiser seems to have weird waiting room security rules - I wasn't allowed to have my partner with me when I had to go to the ER there recently - which I do not believe is the norm in the Bay. But overall I don't think Kaiser is worse than other ERs.
Having said that, you can legally go to whatever is the closest ER even if you have Kaiser (check out the EMTALA law). Recently I had an injury during a strike at Kaiser so went to a Sutter facility. I was treated and charged the same co-pay I would have been charged at Kaiser. I then scheduled my follow up back at KP.
Sorry you had a bad experience.