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Hello folks! I would like to introduce you to my friend, Dr. Wayne Warrington, an attending physician in the Emergency Department of a busy hospital in Hawaii. Dr. Wayne is an excellent resource for all of us parents and caregivers who are looking for safety advice. In his spare time, Dr. Warrington runs marathons and rides the waves of Oahu's North shore. In addition to his dedication to physical health, Dr. Warrington lent his expertise to us as the medical advisor for the Responsible Family DVD, Care for Kids : The Essential Guide to Preparing Caregivers . We are very fortunate to have him with us, again. Welcome, Dr. Wayne! Thank you for having me. I appreciate the opportunity to work with you again to help educate caregivers. What you are doing is ground breaking.
Thank you! I guess we both strongly believe in the cause here! So, let's get started. When did you realize that you wanted to be a doctor?
Not until I was a junior or senior in high school. Originally, I wanted to be a pilot, like my eldest brother but the constant road travel didn't appeal to me. Then, while in undergrad at USC I was almost sidetracked into another profession after listening to a Med School guidance counselor tell me that I didn't have the grades to get into medical school... Good thing I had two and a half years as a Peace Corps volunteer to realize her advice was total bunk and applied anyway.
What do you like best about working in emergency medicine?
The variety of cases is great. I loved all of my rotations as a med student so the thought of seeing just rashes all day in a clinic would bore me. I also like the lifestyle that EM (Emergency Medicine) allows. I do my 12 hour shifts, which can be exhausting, but when I am done I can relax. I haven't carried a pager since residency!!
Do you see many children in the emergency room?
Yes, here at HMC West we see all patients, adult to pediatric. There is no separate Pediatric ER like when I was in residency. So, we have to be prepared for patients of all shapes and sizes.
What are they brought in for?
Everything from fevers to drownings, seizures, cuts and broken bones (usually from skate boards, here in Hawaii). If we have kids who need to be admitted to the hospital they would need to be transferred however, as we have no Pediatric floor at our institution.
Are there many kids that are brought in to the ER that do not need to come in? Do you have any advice for parents on this?
I think the low grade fever at 3 AM is probably the most frustrating. First episodes of fever in kids who appear to be well with a generic reason to have a fever (cough, runny nose, etc.) can usually be treated with tylenol or motrin at home and watched. Kids with unrelenting fevers, changes in mental status, inability to take fluids or if your child appears to be in any distress or if the parent is really concerned should seek medical attention.
Are there times when it is better to call 9-1-1 rather than rush to the ER?
In any chance of a spine or neck injury, if you are alone with the child and he/she needs urgent care (cpr, airway support). Remember EMS is able to perform or administer most treatments that are urgently necessary and they can usually get to you before you can navigate to the nearest emergency department. If in any doubt, call 911.
If there was one thing you could tell parents about keeping kids safe, what would it be?
Avoidance of potentially harmful or dangerous situations. Remember an ounce of prevention is worth a pound of cure.
If there was one thing you could tell kids about being safe, what would it be?
Listen to your parents, what they are telling you is often for your own good. Playing in dangerous areas, running with sharp objects, wearing a helmet, avoiding certain foods are repeated for good reason.
How many caregivers do you feel are uneducated about medical emergencies?
That depends on the level of comfort you are looking for. Most parents know when their children are sick and we take the parents opinion very seriously. A lot of babysitters and relatives who are not parents themselves do not have the same know-how as parents. Parents have instincts that other caregivers might not. Parents know when their child isn't themselves and can let the doctor know why. Other caregivers might not know what signs and symptoms to look for, unless parents communicate this beforehand.
Aside from taking CPR courses every year, what other steps can parents and other caregivers take to keep themselves prepared to provide the best care?
I think the Care for Kids video is the most clear and concise resource for delivering the most important tips and instructions on what to do if you find yourself in a childhood emergency. It is important to stay updated on current practices and educated about the best ways to respond in emergency situations. When your child does run into a problem and you are seen by a medical professional, ask questions. Most of the time you will find us more than responsive to your eagerness to prepare yourself for the next event.
Prevention is key, but we can't always prevent accidents. Knowing what to do once an accident occurs can mean the difference between life or death. Thanks so much for your wonderful and very helpful tips, Dr. Wayne! Again, we are very fortunate to have an insider's expertise to help make us aware of the real issues that are involved with child safety. We hope you will join us again to share your stories and pointers. If you would like more information on CPR and first aid courses, here are some resources: The American Red Cross
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Communication 
