The chief of pediatric emergency services at New York Methodist Hospital explains how he and his team treat children in innovative ways that address their illness, pain, and fear simultaneously

by Megan Schade • Photos By amessé photography

“Children aren’t just little adults,” said Christopher Kelly, M.D., chief of pediatric emergency services at New York Methodist Hospital (NYM). “They have a unique set of illnesses and present unique challenges to caregivers in the emergency room (ER).

“Feeling pain, seeing that parents are upset, or hearing the noises and sounds of the ER may be very scary for children, who may not be able to communicate what hurts or how they are feeling,” said Dr. Kelly. “Having a dedicated pediatric emergency unit means providing a quiet, child-centered environment, separate from the main ER, that is staffed by professionals specially trained to meet the unique needs of children. And because we only see infants, children and young adults, the wait time is usually minimal, which means a lot when your child is sick.”

More than one third of all medical emergencies nationwide involve children, and studies have shown that children treated in a dedicated pediatric emergency room receive faster, more effective care. Located within the main Emergency Department, New York Methodist’s pediatric emergency room is a self-contained area staffed by physicians certified in pediatric emergency medicine.

“Although we are separated from the main emergency room, we all come together as a team,” said Dr. Kelly added. “If a child comes in with a critical illness or injury and there is a physician in the main ER who has special expertise, he or she assists us with the case, and vice versa. We have a tremendous amount of knowledge in our Emergency Department and when it comes to helping our patients, there is no division.”

To illustrate, Dr. Kelly recounted the case of a teenager who was showing signs of cardiac distress, “and within seconds, an ultrasound specialist had performed a bedside cardiac sonogram that showed she was experiencing a massive sudden heart attack. She was immediately sent to surgery and the cardiothoracic surgery team was able to save her. We are here for stitches, but we are also here for life-saving, advanced procedures. We are a calm, kid-friendly oasis housed in a cutting edge, world-class hospital.”

The pediatric emergency program was started nearly 20 years ago by Robert Van Amerongen, M.D., who is now director of the Pediatric Emergency Medicine Fellowship Program. In 2014, more than 26,000 infants, children and young adults up to age 21 were seen in NYM’s pediatric emergency room. There is an attending physician on the floor at all times, supported by a robust staff of specially trained nurse practitioners, residents physicians, post graduate physician fellows and pediatric nurses. “The physical layout of the unit promotes communication among the staff,” explained Dr. Kelly. Each of us knows what is going on in each bed, even if we are not directly involved in caring for the child who is lying there. And that translates into more frequent and consistent communication with the families.”

“Just as children get sick in their own unique ways, no one gets better quite like a kid…They may not be completely healed yet, but when they start to feel even a little bit better, a smile spreads across their face.”

To Dr. Kelly, good communication is good medicine: between doctors but also with the patient and family. To that end, the pediatric ER has a “waiting room-less” waiting area. In general, after the patient is registered, the family is brought directly into the pediatric emergency room, triaged, and introduced to a doctor who then provides an initial assessment. “Knowing that you have been seen, heard and acknowledged goes a long way.”

“‘Will it hurt?’ is perhaps the most common question we hear—from both children and parents. And while explaining very clearly what we are doing can cut down on the fear, we also make every effort to ensure that nothing will hurt more than it has to. For instance, for most lacerations, we can forgo traditional stitches and use an adhesive gel called DermaBond, which glues the cut closed. For those wounds that do need stitches, we use this great gel that thoroughly numbs the area before we stitch. Parents love the gel!’

“I was supposed to be an accountant!” laughed Dr. Kelly. “But when I had the opportunity to observe an operation, I was transfixed; I knew at that moment that I wanted to practice medicine and went on to medical school at SUNY/Syracuse. I never could have imagined my career trajectory, though. I didn’t plan on working with kids, but on my first medical school rotation through pediatrics, I was sold. Never thought I’d do pediatric emergency medicine, but during that rotation, I knew I had found my path.” In 2002, Dr. Kelly finished his residency at Children’s Hospital of The King’s Daughters in Virginia and then completed a fellowship in pediatric emergency medicine at the Children’s Hospital at Montefiore in the Bronx. He joined New York Methodist Hospital in 2005.

“I love the puzzling. I love looking at the clues and trying to figure out what is going on with this little child who can’t even talk. I love the collaboration and brainstorming with my colleagues, like Ilya Bialik, M.D., in pediatrics, Anne Bellin, D.O., in the pediatric intensive care unit, and the other emergency doctors—Dr. Van Amerongen, Sharon Yellin, M.D., Lucia Santiago, M.D.—to determine the best course of treatment for the child. We truly are a hive of specialized knowledge and experience that focuses on specific challenges: and we are very good!” he said with a laugh.

“And just as children get sick in their own unique ways, no one gets better quite like a kid. When they start feeling better, the smile is there, the clouds are parting. They may not be completely healed yet, but when they start to feel even a little bit better, it spreads across their faces. You can’t beat that feeling and knowing that you had something to do with those smiles. And when they smile, the moms smile. Dr. Kelly added. “That’s when you know the child is really feeling better— when the mom starts to smile!”

New York Methodist Hospital
506 Sixth St. / 718.780.3000 / nym.org