The doorbell rings and the baby is safely playing on the couch surrounded by a mound of pillows. Halfway to the door, a loud thud comes from the room of pillows, immediately followed by uncontrollable whaling. This scary and unfortunate scenario happens more often than we might think. And in moments like these, taking an emergency room visit may seem like the best option–just to make sure everything is alright.
A lot of new parents will at one point or another face the scary question 'Should we go to the ER?' Many parents will take their children to the ER even for things that do not necessarily constitute an emergency.
"People go to the emergency room for a reason: something exceeded their threshold for concern," says Joseph Luria, MD, emergency department medical director at Cincinnati Children's Hospital Medical Center.
Plain and simple, being a parent is scary, and sometimes kids do some really unexpected things that can land them in the hospital. Meanwhile, other parents may talk themselves down from worry when their child really does need attention. So take it from this one mom and a few emergency room doctors on what a trip to the ER is all about and when you should definitely go, without a doubt.
No one is going to think you hurt your little one, much less on purpose. Though many parents fear that doctors and nurses will judge them or that they will have to meet with child protection for every little stitch needed during an ER visit, that is widely not the case.
Although emergencies are just that, if you happen to live near a children's hospital, choose that as your emergency room destination. "Children's hospitals and hospitals with pediatric ERs have specialists on staff 24-7," says Louis C. Hampers, MD. They have child size equipment and toys to entertain your child.
Before your child gets sick or hurt, talk to his doctor about where you will go in an emergency.
As parents, we hate to see our little ones in pain. Unfortunately when it comes to fixing up all the boo-boos doctors may need to do some pretty painful things to make it all better.
Whatever your child's injury, discuss your pain-free options with your doctor. Depending on the procedure a local anesthetic can be used, instead of sedation.
"If your child is going to have a shot, stitches, or a blood test, speak up and ask to have numbing cream applied to the location as soon as possible," advises Dr. Jackson. These products usually take about 20 minutes to work. In the case of minor cuts, ask the doctor whether skin tape or glue might be an appropriate alternative to stitches.
Your little one won't hate you for taking him to the hospital. While we admit, hospitals can be a scary place, not all kids hate hospitals, especially if you explain why they are necessary and treat them to something fun once the visit is over. Just remember while you are there, you know best.
You are the best advocate for your child and the best interpreter of his or her needs. If you think your child is in pain, say so. If you don't think he or she is ready to go home, tell a member of the ER team.
There are a few telltale signs that mean it's really time to head for the hospital. If your child is choking, has a flat rash that does not get lighter with a touch accompanied by a fever, or green vomit or excretions it is time to go to the hospital.
These could be serious signs of serious illnesses that need immediate attention. If what your little one is experiencing does not fall under one of these categories, it can be pretty hard to determine what warrants a hospital visit, especially when you are a new parent.
Just go with your gut, if you truly don't know whether or not to go to the hospital, call your child's pediatrician first, many doctors have after hours.
Wondering when the emergency room is the best option? If your child is choking, then RUN, do not walk to the emergency room, or have someone call 911 while you try to clear the airway.
Parents Magazine advises parents to take a CPR course just to be prepared. Noisy, high-pitched, and rapid wheezing or grunting are other indicators that it's time for an ER trip.
These are signs that a child is struggling for air, according to ER physician Joan Bothner, MD. "You'll see the chest sucking in and the belly moving," she explains. It's an emergency if a baby is taking 60 to 70 breaths per minute, a 1-year-old 40 or more, or an older child taking in 30 or more.
Don't let the fact that your visit is for your child confuse you. Even in children emergency rooms, you might have to wait a long time since only the most important emergencies go first. So make sure to bring something that can help occupy your little one during the waiting period and to help he or she feel more at ease.
If your little one typically feels comfortable with one item, don't hesitate to bring it. Whether it be a toy, blanket, or book. It can really help take your child's mind off the pain and feel less anxious in an unfamiliar place.
One of the most important things parents should do when faced with the nerve-wracking decision to take their child to the emergency room is to stay calm.
Just take a few deep breaths and tell yourself that you need to stay calm for your child's sake.
If you are all tense and stressed out he or she will be too. It is a scary time but try not to let your mind jump to a scary diagnosis until you and your child's doctors have all the facts. "If you're worried or upset, your child will pick up on your emotions and become even more distressed," Dr. Louis C. Hampers, emergency room doctor, says.
One of the most important among the long list of things not to forget when taking your little one to the ER for the first time are the insurance cards. Leaving the insurance cards behind can make that emergency room trip really messy and really expensive.
In addition to helping you cover the bill, having your insurance cards present will help ensure that nurses are inputting your little one's name correctly. Insurance cards can also help doctors to prescribe any necessary prescriptions that fall under your insurance coverage, which can be a huge help that can save you and your family a lot of time and money, later.
If you notice that your little one has decreased urination (fewer than two soaked diapers a day), a sunken soft spot on the head, a sticky mouth, tearless crying, sunken eyes with dark circles underneath, listlessness, paleness, turning blue, or clammy skin it's time for a trip to the emergency room. These are all signs of some pretty serious circulation issues and could mean that your child needs intravenous fluids, according to Parents Magazine.
This applies not only to blood loss from trauma but also to dehydration from vomiting or diarrhea, which prevents blood from properly nourishing the body.
Ear infections, high fevers, and long nights of no sleep and upset stomachs are, believe it or not, not reasons to go to the ER, according to the medical staff of Denver Children's Hospital. However, convenience and cost aren't the sole reasons to avoid the ER.
Ultimately, a child who's not in danger is best off waiting to see his regular doctor, who is familiar with his medical history. Emergency rooms also contain a lot of germs and can be dangerous for young children. Even repeated gastrointestinal bouts are usually far more distressing than dangerous; however, as soon as your child can keep liquids down, offer frequent sips of water, diluted juice, or a rehydration solution such as Pedialyte.
During a baby's first 6 to 12 weeks, almost anything out of the ordinary qualifies as a possible emergency, including symptoms considered minor in older children, such as a fever of 100.5 degrees Fahrenheit or higher, difficulty feeding, or a bump or bruise on the head. From 6 to 12 weeks their immature immune system does not fight infection well, so any minor illness can quickly become major.
"Also, conditions such as heart or gastrointestinal problems not identified right after delivery might become evident now," says Kathy Shaw, MD, director of emergency medical services at The Children's Hospital of Philadelphia.
Bottom line: Is your under-12-week old presenting symptoms out of the ordinary? Take them to the hospital.
"Some parents think they shouldn't give their child a fever reducer before going to the ER because the doctor won't believe that he's really sick, but that's not the case," Dr. Hampers, Emergency Room Physician, says. "It often makes the examination process a lot easier because the child feels better and we don't have to wait 45 minutes for the ibuprofen to kick in."
However in infants under 3 months, it's important to document the severity of an actual fever, so one should wait on giving anything at home before coming to the hospital. Once a doctor has seen the baby, medicine is fine.
Everything can seem a bit scary in the hospital, but do not be afraid to ask questions about your child's care.
"Doctors and nurses get busy, and information isn't always shared the way it should be," says Dr. Luten. If you're not sure what the plan is for your child or why he needs a particular test, politely ask for an explanation.
If you still are a bit confused about something, repeat your questions and be patient. You and your child will meet lots of different people. Repeating your story and talking about symptoms and what brought you to the hospital to each doctor can seem redundant, but it is worth it.
No matter how young your little one is, it is never too early to talk things out and explain what's happening for both your benefits.
Talking things out can really help prepare you too, Mom for what's to come. Try letting him know that a new doctor will examine him and, depending on what's wrong, either clean his cut, take x-rays, or run special tests. "For many kids, the anxiety about what's going to happen is worse than the actual pain," says pediatrician Dr. Zun.
Be honest about the potential of pain, not to scare them, but again just so they will be prepared.
When you get to the ER the last thing you want to do is have a less than exact response when medical staff asks you what kind of medications your little one is on. The one that starts with L is not going to be very helpful and can actually be quite dangerous if he or she has to get another prescription.
Therefore it is important to bring with you a list of current medications, including prescriptions, over-the-counter painkillers, homeopathic medicines, vitamins, and supplements, that he or she is taking currently. It can also be very important to know the time your little one last ate.
Is your little one up to date on his vaccines? Are you against vaccinating your child? These things need to be discussed with the medical personnel at the hospital.
When the staff knows whether or not your child has gotten all of his vaccines they can know what symptoms to isolate and which ones to look out for, for signs of more severe, less common, illnesses.
When you take your little one to the hospital you want the best care, so make sure that you are forthcoming with all the information that doctors and nurses could possibly need in order to give your little one the best care.
When you are in the ER, you may get asked a lot of routine questions that can easily be answered with the information you got at your child's last regular doctors visit. Some of these questions might include: How much did he or she weigh? Does she have any previous illnesses?
All in all, it can be helpful to know and have the name of your child's normal pediatrician handy, just in case. This one mom recommends keeping an up-to-date record of everything in a notebook that you carry with you everywhere. In it, list all previous illnesses, immunizations, allergies, chronic conditions, and any medications that she's taking and know when she took her last dose.
Explain how and when the accident happened, in chronological order if possible, and where or if your child has swelling or pain. If he or she is sick, describe each of her symptoms, and when you remember each one first appeared.
Precise information will help doctors diagnose and treat your child more quickly and accurately.
If your child swallowed something poisonous, bring the container with you and explain in detail everything you have done since. It can also be helpful to explain how you took your little one's temperature if you see they have a fever, the amount and timing of meds; and changes in sleeping, feeding, and waste excretions.
Are you worried about everything that's going on around you in a hospital? Chances are your little one will be too, no matter how curious they are, emergency rooms can be frightening places.
So do your best to keep your child comfortable for the duration of time you need to be there. If he or she is cold, ask for a warm blanket. If the tests are taking a really long time but he or she is hungry, ask a doctor for ice chips; if the room is too bright, ask the staff to dim the lights. If your child's pain medication has worn off, let someone know, quickly.
"You must be the advocate for your child," Dr. Jackson adds.
When thinking about your first trip to the ER, many parents rarely think about what happens once they get home. Sure you will ask a lot of questions about the procedure, and maybe even about what will happen during your hospital stay, but after everything is all said and done, make sure you know how to care for your child's injuries and what to do if his pain or symptoms don't improve or if they worsen at home.
Ask for specific instructions on how to give medication and how much.
"It's better to ask when you're there than to call and try to get information later," says Dr. Zun. As always, follow-up with your pediatrician after the ER visit.
References: Today's Parent, New York Times, Parents Magazine, Personal Experience, Interviews with ER doctors