I'm not the only one, am I? It was only recently that I realized I should think in advance about exactly where I would take my kids in a medical emergency. Of course I'd thought about where the closest hospitals are, but it hadn't occurred to me that there might be major differences among emergency rooms.

Thankfully, this realization was not brought on by a crisis but by a wonderful resource, The City Parent Handbook, by Kathy Bishop and Julia Whitehead. Among the advantages of city parenting cited in the book is the selection of medical care, including pediatric emergency facilities.

Some of it can be chalked up to that late pregnancy mania that wakes one up nights with infinite variations on the theme of "if I don't do this right now it'll have to wait until at least kindergarten!" But in the light of day, two statistics in The City Parent Handbook really got me motivated to investigate local emergency facilities. First, that "there are more than 31 million child and adolescent emergency room visits a year - that works out to 41 visits for every 100 kids." Second, that "ninety percent of the physicians staffing emergency departments have training in Advanced Cardiac Life Support, but less than two-thirds have completed an equivalent course in pediatric resuscitation." ER visits are hardly a remote possibility, and neither it seems, is the chance of a doctor treating my child like a mini-me.

I'm glad I checked, because my knee-jerk reaction would have been wrong. I probably would have headed for the University of Washington Medical Center ER, logic being that our pediatrician practices at a UW clinic - plus I know how to get there easily. When I called the pediatrician's office, they said that the UWMC doesn't really deal with kids because Children's Hospital is so close. OK, time to plot the course to Children's (I always get twisted around back of University Village) and consider the other contingencies.

But what if its rush hour, plus a Huskies game day, plus a rainy mess? Is it still best to go to Children's, or should we head to Swedish Ballard or Northwest, or maybe hightail it downtown to Pill Hill where there are so many hospitals that one would have to be a good bet for kids?

When it comes down to that moment, we'll each have to make the call. While the ERs in our corner of the city are not pediatric facilities, they seem pleasant and adequate for the basics. Northwest has nurses with pediatric training in the ER, according to their website, although the triage nurse on duty when I stopped by said they encourage anyone with "anything major" to go to Children's. Still, it felt like a place that wouldn't inspire further trauma; calm, clean, with a kids' corner in the waiting room by the window. Swedish Ballard was likewise calm and pleasant, but their biggest advantage (besides proximity) seems to be connection to a system that does include more pediatric specialists. Dr. Greg Sorensen, director of pediatrics for Swedish, told me that staff at their various campuses, including Ballard, receives training from Child Life and other specialists at First Hill. They too have nurses in the ER with pediatric training. As for hightailing it downtown - shouldn't be necessary because 1) a pediatric patient admitted at the Ballard ER would automatically be taken to the First Hill campus, and 2) Harborview is the only other pediatric resource to speak of, and their specialty is "level 1 trauma" - the sort of thing that usually involves an ambulance anyway.

That being said, let's get back to plotting that route to Children's. I'd never been there before last week, except to get my car seat installation checked in the parking garage. I still need to fine-tune it, but even my less-than-perfectly-direct route from Greenwood was 5 miles, accomplished in 15-20 minutes. On arrival it all seemed worthwhile.

My first impression of the emergency department at Children's was that you'd never know it was an ER if it weren't for all the special equipment. It's not garishly lit, there's no PA system in use. Staff spoke like they were in a library. I loved the scale of the place - hallways were short and wide, the waiting room cozy, not cavernous. The nurses' station seemed more like the info desk at (again) the library - visible, approachable. And that's just the feel of it, of course; there are measurable differences as well.

Just for a start, at Children's you can be sure that the staff - doctors, nurses, social workers, and specialists - is trained in pediatrics. ER doctors, for example, must complete an extra thee years of pediatric emergency medicine. Child Life specialists are also involved the emergency department (unfamiliar with this program? I was too - check out www.childlife.org, or 'support services' at seattlechildrens.org.) There's special attention paid to minimizing wait times. Dr. Tony Woodward, head of the Emergency Dept., told me that aside from those who don't wait at all due to the urgency of their situations, their emergency patients generally wait less than thirty minutes. Then of course there's the child-scaled equipment and supplies. Everything from blood pressure cuffs to defibrillators and breathing tubes is different for kids, to say nothing of doses of medicine and anesthetics.

All of this does not mean that the other ERs are cavalierly going to shove a giant tube into our kids' lungs. As Dr Woodward was quick to point out, Children's is a regional resource, and they work with and consult with all the general hospitals to provide the best pediatric care possible for every patient, no matter where they are seen.

Phew. Okay, I think I can sleep tonight.

If parents (and other devotees) of kids of all ages want to share ideas or comments with Alouise, send an email to Bnteditor@robinsonnews.com with 'parenting' in the subject line.