Dr. Werner Gerntholtz uses an iPhone to do a preliminary vision check on a seven-year-old boy brought to Surrey Memorial Hospital’s pediatric emergency department with an apparent eye injury.

CARING FOR KIDS: Surrey’s kids-only ER sees 100+ children per day

SMH's Pediatric Emergency Room – the largest of its kind in Canada – treats patients age 16 and under.

As the designated Regional Pediatric Centre in the Fraser Health region, Surrey Memorial Hospital offers specialized and unique care to babies, children and youth from Burnaby to Hope. The Leader provides an inside look at how B.C.’s second-largest hospital has grown and adapted to treat its youngest and most vulnerable patients.

It’s mid-morning on a Tuesday and there’s something wrong with seven-year-old Alfred’s eye.

It’s red and looks irritated, so his dad has brought him to Surrey Memorial Hospital’s Pediatric Emergency Room to have it checked out.

Alfred’s father explains that he and his wife noticed the inflammation the day before, but don’t remember him poking or injuring it. It had been hot outside, so they speculated perhaps he’d got sunscreen in his eye.

The doctor on shift is Dr. Werner Gerntholtz. Wearing blue scrubs with a stethoscope slung around his neck, he takes a look at Alfred’s eyeball – but can’t readily detect if there’s any damage. He explains he’s going to put dye in the boy’s eye and useCaring for Kids logo an elaborate microscope to examine it more closely.

“This is going to make your vision orange,” he tells the boy.

“Whoah,” Alfred says as he glances, wide-eyed around the room.

With the lights turned out, Gerntholtz peers into the eye again and says he can see a small scratch. It’s not serious, but he suggests the dad monitor it and follow up with an eye doctor.

On this particular morning, Gerntholtz is the only physician working the department. It’s not considered a busy time in the ER, unlike from 3-11 p.m., when things can get hectic. Then, there will be two doctors on shift.

Still, there’s a steady stream of kids coming through the doors.

Down the hall, another boy is with his mom. Gerntholtz reviews a chest X-ray with her, noting some “fluffiness” in the picture of the nine-year-old’s lung. He explains the fluffy appearance indicates there’s fluid present.

“It’s nothing to be worried about,” assures the doctor, motioning toward the alert child, “because he looks very, very well.”

Though already on antibiotics, he says the boy needs a higher dose.

“The most important thing is, if he has a fever again or starts to have trouble breathing, bring him in,” he adds before sending mom and son on their way.

The two boys are among at least 100 youngsters – from newborns to 16-year-olds – who will visit Surrey’s pediatric ER that day.

The unique facility, which opened in 2013, is the largest of its kind in Canada in that it’s not part of a children’s hospital. At 5,500 square feet, it’s intended to better serve the Fraser Health region, where 40 per cent of B.C.’s children live.

And while health care workers and officials knew it was needed, they underestimated how well-used the space would be. Within the first full year of operation, 31,000 young patients visited the pediatric emergency department, well beyond the 24,000 anticipated.

Now, there are between 100 and 120 young people brought to the department daily.

“That’s a 20-per-cent increase over last year,” says Ron Bate, Patient Care Coordinator at Surrey Memorial Hospital (SMH).

The emergency department at SMH is distinct in that when you enter the main doors, there are two areas: one to the right where adults are triaged, and secured doors to the left where only babies, children and teens are treated.

Mandip PahalBate explains that kids and youth are given a score upon admission, ranging from 1 (critical, requiring active CPR) to 5 (minor, could be seen at a clinic).

Regardless of need, he says, patients are treated a timely manner, with more than half seen by a doctor within 30 minutes of walking in the door.

There are 12 beds in the pediatric ER area – two fast-track for minor illnesses or injuries, three acute care for patients requiring closer attention, four for those with respiratory or cardiac needs, one low-stimulus area for children or teens with mental health concerns, one seclusion room for anyone deemed a danger to themselves or others, and a trauma room for the serious or critically injured.

All rooms have closing glass doors for privacy and all beds in the rooms automatically measure the weight of the young patients so they don’t have to be moved unnecessarily. The equipment, such as ventilators and intubators, are all designed for use on children and youth, and children’s blood tests results can be returned in less than five minutes if required in acute cases such as cardiac arrest.

“There is also a pediatric psychiatric nurse on call 24 hours per day, seven days a week,” Bate says.

Kid-friendly touches, such as colourful murals and an entertainment area, are also reminders you’re not in the regular ER.

At the far end of a corridor, Mandip Pahal (left) is doing her best to keep her active two-year-old daughter Jannat happy, distracting her with anything she can until it’s her turn with the doctor.

The curly-haired toddler, she tells Gerntholtz when he arrives, throws up whenever she eats or drinks. It’s been happening several times a day for about four days, the concerned mom explains.

“She is hungry but just vomiting? Poor girl,” the doctor sympathizes, listening to Jannat’s chest and looking in her ears.

The little girl had a fever the night before, indicating she’s fighting some sort of infection. The doctor orders further tests for the child before heading to consult with another toddler who’s been brought in with a chest infection.

All the while, a baby cries inconsolably in another area – a common sound in the pediatric ER, a nurse says.

And Dr. Gerntholtz has darted away once again. With just one of him and dozens more young patients bound to show up, it’s always an emergency.

ON FRIDAY: SUPPORT FOR ABUSED AND NEGLECTED YOUTH

Other stories in this series:

• Bringing Joy to the world

• Shelter from the storm

• ‘Something right happens here’

• ‘I think of it as putting them back together’

• ‘They’re saying that our youth matter’

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