Pediatric Emergency Contact Notifications Made Easier  

 By Laura & Janet Greenwald


If you thought handling next of kin notification for adults was tough, try critically ill children!

For the head of the trauma department at one of America’s top pediatric facilities, Chicago’s Lurie Children’s Hospital, having to notifying parents that their children have been the victims of trauma or identify pediatric Jane Does, is an every day occurrence.  But just because they look like they’re handling it well, doesn’t mean that it ever becomes routine.

When a child comes into the emergency department without a parent, it’s usually the result of an accident or traumatic event.  Even though their first priority is to tend to the child’s medical needs, their next priority is to identify the child.  They need to get his parents or guardian down to the hospital, to give consent for his treatment, provide vital medical history and most importantly, to be at their child’s side when he needs them most.

You’d be surprised how often a child is brought into Children’s  without anything pointing to his or her identity.  Many times it’s the result of a car accident, where the parents are injured as well as the child, and are taken to another hospital, while the child is brought to Children’s for specialized pediatric treatment.  Since children don’t have driver’s licenses or checkbooks, identifying them can be challenging.   

Just the other day, three children ranging from 8 months to 3 years were brought into the ED after a serious automobile accident. 

Their parents, who were in bad shape, were taken to another hospital and the paramedics had no clue about their names, ages or medical history.  The trauma team began their medical evaluation, and as they always do when dealing with an unidentified child, opened a trauma pack for each, using a patient number to identify them.  They estimated their ages, did a full physical description including any identifying marks and clothing, then ordered a full set of x-rays, which helps to identify any conditions or injuries that aren’t readily apparent. 

The team’s biggest asset in this situation was the solid relationships that they’ve built with police, fire department, and other local hospitals – as they work together to get the children identified as quickly as possible.  After a major accident like this, the police and fire department were already in the ED coordinating efforts.  With their special emergency landline system they’re instantly linked by phone with any local hospital they need to reach. 

As the team began calling to find out where the children’s parents were taken, hospitals began to call them, to say, “I know you’re looking for the mom and dad of the accident victims. They’re not here,” saving them precious time.  In this case, they found the hospital relatively quickly and found out that even though the children’s parents had been seriously injured, the children’s caregiver who had also been in the accident, was fine.  The hospital sent her over to Children’s and she – and later on the parents – were able to give them all the information they needed to treat the children. 

In the case of a completely unidentified child, especially babies, Children's relies upon their finely honed procedures.   Usually the fire department, police or DCFS dropped the child off, so they are already aware of the situation and have already begun going through the child’s clothing and personal effects to gather evidence and identify the child.  The trauma team will send the police or paramedics right back to the scene to gather additional information, medicine bottles, names, and to canvass the area.  There is almost always someone who saw something. Someone from pastoral care automatically comes down and a social worker will get involved if it looks like any abuse was involved. Together, they take care of figuring out where to go from there, while the team takes care of the child medically. 

If these steps don’t elicit any clues to the child’s identity, the hospital will get media affairs involved.  Children’s will never show the face or reveal the name of any child.  Instead, they photograph the child’s clothing and personal effects and release it to the media along with the child’s estimated age, description and the vicinity in which she was found.  They work closely with detectives and DCFS to give them all the details they need to chase down any leads they get from the public. Many times just calling DCFS or the police will locate parents or bring about an identification.  In the case of severe trauma, abuse or inflicted injury, Children’s always balances treating the child, with carefully gathering as much evidence as possible, to help the eventual police investigation.  They had a young girl a few years ago, whose brutal attacker was convicted mainly on the evidence gathered and catalogued in the trauma room. 

When it comes to providing emergency contact information, kids aren’t always the best source. They have seven or eight year old kids come in everyday, who are sophisticated in every other way.  But get them in a trauma situation and ask them what their mom’s name is and they’ll say it’s “mom”.    In this case, the first thing they’ll do is look at whatever they brought in with them. School-age kids almost always have a backpack. If they don’t find anything there, they’ll check their records to see if the child is in the system and begin to gently probe the child for information.  They ask them where their house is, what their school looks like, information about their friend’s houses, maybe a familiar landmark on the corner like a 7/11 or the name of a park. If you can’t find their contact information right away, try to find the name of their school. Their books will probably have the name of their school stamped inside. 

Schools are also a great source for emergency contact information. They’ll often even list alternate people to call in an emergency if the parents are at work or hard to reach.  In an emergency, schools will usually send someone directly down to the hospital with the child’s emergency card and emergency consent forms.  If the injury occurs at school, most schools will send someone from the school along with the child to the hospital, while someone else is calling the parent.  For parents, Children's suggests that every parent name someone else on the child’s emergency card.  Someone who knows the child well and would be able to step in to help out during an emergency if the parents can’t get there right away.  

So once you identify a child, how do you know if the person who comes to the hospital is really his parent or relative?  It’s not always easy. Remember that the parents didn’t expect to have to come to the hospital today, and probably won’t be carrying three forms of ID and their child’s birth certificate. For people that come in and say they’re related to a child who’s been in the media, they get as much ID as they can, be it a driver’s license, pictures or other proof.  With kids, the biggest test is to watch their response when that person goes in the room. Usually you’ll here a resounding “Mom!” or “Daddy!” and you know you’ve got the right person.  If there’s no response from the kid, or if they’re not sure of the adult, it’s probably not the right person. Or worse, the child might recoil from the adult, which could indicate an abusive situation.

Treating kids also means caring for their parents.  When Children’s has to make a notification call they’ll begin by telling the person on the phone who they are and ask them how they are related to the child.  If it’s the mom or dad, they’ll tell them that their child has been brought to Lurie Children’s Hospital.  Of course the parent will immediately ask how the child is.   This is always the hardest part of the call.  If the child is clearly fine, they’ll say “Don’t worry, they’re fine, we just need you to come down here.”    

But if there is a more serious injury, or if the child hasn’t survived, they say that the child has been in an accident, that they need to come down, and if necessary, that they need to get their medical history.  If they refuse to get off the phone until they find out what’s wrong, the trauma coordinator will say that they’re very concerned about their child’s health and that they need to come down right away.  They’ll always try to calm the person down as much as they can – tell them to go and get a pencil and paper to take down the address of the hospital, to take down the hospital’s name and the nurses' direct number.  They tell them to ask for them right away when they get there, so they don’t have to waste any time at the desk and then try to make sure they have someone to drive them over.  And they finish by reminding them that they need to drive carefully and slowly and to make sure that they get there in one piece! 

At Children’s the top priority is the restoration of the health of every child who comes through their door, no matter who they are and where they come from.


Learning how to do Pediatric Notifications is just ONE way to increase patient safety, health and satisfaction while reducing liability.  

We have many more in our book Notify In 7.

Notify In 7 is filled with tools you and your hospital staff can use to facilitate NOK notification, patient identification and communication. 


If you want to create change throughout your entire facility, our Six Sigma based, HIPAA-friendly, “Creating A Next of Kin Notification Program” has everything you need to roll out the Seven Steps facility-wide.  The Program includes patient tracking workflows, tools and training materials, based on Notify In 7.  It provides your Emergency Department staff, managers and Risk Management professionals with comprehensive training, giving you and your hospital a fully operational Next of Kin Notification System in ninety days. 


Support independent publishing: Buy this book on Lulu.

Notify In 7 - Creating A Next of Kin Notification System - Paperback Edition by Laura & Janet Greenwald   $24.95

This includes the spiral bound edition of Creating A Next of Kin Notification System.  

This edition comes with downloadable Chart Pages, Patient Tracking Sheet, work flows and staff handouts, as well as the PDF version of the Notify In 7, Seven Steps System Guide.  

Support independent publishing: Buy this book on Lulu.

Purchase Creating A Next Of Kin Notification System for the special price of $24.95 now!


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Laura and Janet Greenwald, are the founders of The Next of Kin Education Project and Stuf Productions.  The mother & daughter team were not only instrumental in enacting three Next of Kin Laws in California and Illinois, but created the Seven Steps to Successful Notification System, which teaches quick, easy, next of kin notification skills for trauma patients to hospitals like Dallas’ Methodist Medical Center. 


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