Kids and Emergency Care


When it comes to children, a level of unique and specialized care is necessary. “There are a number of considerations in children you have to focus on, whether dealing with an infant, a neonate (less than 28 days old), a child or an adolescent,” says Dr. Pierog. “There are many different features that are obvious, as well as those from a physiological standpoint that determine how their systems function,” says Dr. Pierog.


“Kids are much more prone to have facial and intracranial (brain) injuries than adults because of their larger head-to-body size. Because of their propensity to fall, we see a higher number of upper extremity injuries such as wrist and elbow fractures,” says Dr. Pierog. In addition, because they have a higher hydration requirements, children need two to three times as much fluid than do adults.


“Children require special treatment, not just for their size, but also when it comes to the equipment needed to treat their conditions,” says Dr. Pierog. CHOC’s emergency department has all the bases covered, including master’s prepared child-life specialists who are trained to understand and treat the emotional and physiological needs of little ones. “There are a number of features that pediatric emergency physicians are aware of and prepared to treat, including respiratory, gastrointestinal, and environmental conditions, such as pesticide exposure from children putting items in their mouths.”


For adults, medication dispensing is generalized, but not for children. To ensure parents are giving the right amount, pay attention to the levels. “The dosages of common medications are going to be on a weight-based formula,” says Dr. Pierog.


  • What is the decrease in childrens illnesses because of the use of vaccines: 90%
  • What is the amount of body fluids children turns over: 25%
  • What is the average number of colds an adolescents get each year: 2 to 4


CHOC Children’s contracts with most major public and private health care programs including Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs.) Click here for a list of hospital contracted health plans. You are advised to check with your health plan or insurance network to confirm that CHOC and your physicians are contracted providers. For questions regarding your insurance or eligibility, please contact the CHOC Admitting Department at 714-509-8400. When you choose your physician and medical group, call the office and make sure they refer to CHOC.

Meet Dr. Pierog - CHOC Emergency Medicine Specialist

Dr. James Pierog is the medical director of emergency medical services at CHOC Children’s. He completed his internship in internal medicine and his residency in emergency medicine at the University of Southern California, Los Angeles County Medical Center. He served in the United States Army, achieving the rank of Captain as a General Medical Officer.

Dr. Pierog’s philosophy of care: “Giving cutting-edge care to the children of Orange County. To, protect, nurture, and develop them in an optimal setting.”

University of California, Los Angeles Medical School

Emergency Medicine and Pediatric Emergency Medicine

Dr. James Pierog

Virtual Tour of the Emergency Department

The Julia and George Argyros Emergency Department at CHOC Children’s is exclusively dedicated to the treatment of pediatric patients. Our 22,000‐square‐foot, full‐service emergency department is designed to meet the unique needs of children.

Emergency department lobby

Kids Are Not Small Adults

In this edition of American Health Jounal, Dr. James Pierog, Medical Director of CHOC Emergency Department, speaks about the individiuals who are trained specifcally for the care of children, and how these child specialists are unique to a children’s hospital. Dr. Pierog talks about why it’s important to bring a child to an emergency department designed just for kids. For more information, go to

Health Plans

CHOC Children’s contracts with the most major public and private health care programs including Health Maintenance Organizations (HMOs) and {Preferred Provider Organizations (PPOs.) For questions regarding your insurance or eligibility, please contact eh CHOC Admitting Department at 71-509-8400. When you choose your physician and medical group, call the office and make sure they refer to CHOC.

Mom and son at office visit with physician

Knowledge is the best medicine. Learn more about your child's health in these features from the experts at CHOC.

Kids and Concussions
“The word concussion comes from the Latin word to shake violently. It’s a force that causes a temporary injury to the brain or spinal cord,” says Dr. Taraman. “A lot of times, people may hit their head and don’t realize it was a concussion.”

Kids and Stomachaches
So what causes tummy trouble? It can be as specific as an ulcer, a dietary issue, pneumonia or a sinus infection. Stomachaches are extraordinarily common. Although always a concern, the majority of kids with abdominal pain do not require urgent intervention.

Overscheduled Kids
“There are a number of studies that suggest kids actually do need some unstructured time,” says Dr. Heather Huszti, a CHOC pediatric psychologist. Kids need moments when they can use their imagination, daydream and even goof off a little bit.