It’s parent’s worst nightmare. It’s midnight. Your child is sick or injured. The decision needs to be made — go to an emergency room or wait until morning to see your regular pediatrician.
Dr. M. Greg Thompson, a pediatrician with PeaceHealth Medical Group in Bellingham, said there are some guidelines to follow to help parents rest easier when trying to decide if an illness is serious enough for a trip to the hospital ER.
How to evaluate whether a child needs immediate emergency care
Thompson said parents of children with ongoing or chronic illnesses, including those with immune deficiency, should speak frankly with their doctors before an emergency to know when their child will potentially need immediate care. If your child is otherwise healthy, the decision may be murkier.
Thompson said in his practice it’s often best to talk to your doctor’s nurse triage phone line first if it is not clear that the child is in a life-threatening or imminent emergency.
When in doubt, getting in touch with the doctor on-call through a pediatrician’s message service or insurance company’s “nurse-advice” line is a the best way to determine whether your child is in a true emergency.
Going to the emergency room isn’t always the best option, even just as a safety precaution, Thompson said. If a child is not truly in need of immediate care, you and your sick child could wait for several hours to be seen by a doctor as they take the most serious cases first, Thompson said. And, bringing an ill child to a hospital could expose your own child to other illnesses in the waiting room as well as leave others exposed to a the bug from which your child is suffering. There’s also a hefty price tag on emergency care and potentially frightening scenes for children as people are brought into the ER in for traumatic injuries, intoxication or out-of-control behavior.
Thompson offers some advice in the case of several common medical concerns:
Physicians need to rule out potential illnesses like meningitis, a kidney infection or sepsis, Thompson said. It’s often confusing for parents dealing with older children who are feverish, or vomiting, or generally unwell.
“If they are older than three months and have a fever, but are eating and drinking normally, breathing comfortably, and don’t appear lethargic or dehydrated, we usually don’t need to see them that quickly,” Thompson said. If they seem lethargic — which Thompson said means they are not responding or have trouble waking up — they should be seen immediately to rule out more serious issues. Symptoms of dehydration can include cold hands and feet, not urinating at least three times in a day, or a sunken in spot on an infant’s head.
In his own practice, Thompson said the only patients who would need to be treated in the ER are those who need surgery or sedation to set the bone. If you are unsure if an injury is a sprain or break, it’s not necessarily a problem to wait a few hours until your regular pediatrician’s office is open before getting treatment. But if a bone or limb seems misshapen or is protruding from an injury, an emergency room visit is necessary.
Headaches can also be a concern if the pain of the headache continues to intensify and is not relieved with over-the-counter medication. Vomiting persistently in association with the a headache or unrelenting pain may require a clinic or emergency room visit, particularly if they do not have a history of migraine headaches.