Emergency Room Essentials

One situation that all parents dread, but know is almost inevitable, is an emergency room visit. Sometime, somewhere, there will be a bump or illness that needs immediate attention, or that happens while the pediatrician's office is closed.

Emergency room visits can be scary and extremely stressful for both parents and children. From knowing whether to rush to the hospital or not, to coping with an agitated child who is stuck waiting for an hour, the process is incredibly difficult. Over the past five years, and in the process of dealing with hospital visits too numerous to count, I've come up with some ideas and suggestions that may make these unpleasant trips a bit less emotionally painful.

Naturally, you should avoid going to the emergency room whenever possible. A good first aid kit and a first aid course (check your local Red Cross chapter or ask at your doctor's office) can make it easier to recognize whether a bump or cut truly merits a hospital visit.

If at all possible, the emergency room should not be used for diagnosis of a cold, ear infection, or other common ailment. Rather, call your regular doctor; most will offer same day appointments, or have certain hours where walk-in patients are welcome.

If you are part of an HMO, you may have the option of visiting an urgent care center. (In many cases, non-life threatening situations MUST go to such centers.) This center is staffed with physicians who are trained to deal with emergency situations, as well as common colds.

Some situations definitely merit an emergency visit. The following is a brief list; ask your family doctor for a list of other situations which would mean that your child should be brought to the emergency room:

Allergic reactions which cause breathing problems should always be treated in an emergency room. Even if you have administered an EpiPen, you should seek follow-up treatment. If you cannot treat with an EpiPen at home, do not drive to the hospital--call 911 and have an ambulance come and get you.

Falls which result in a loss of consciousness should always be treated. If the child revives quickly, you should be able to call your pediatrician and see if he prefers that you go to his office or the hospital. If a child does NOT immediately regain consciousness, call 911. Do NOT move the child yourself!

Suspected broken bones should be examined at the hospital.

Unexplained seizures should be checked.

In infants, extreme high fevers (ask your doctor for a threshold number) should be checked immediately.

The most important thing to remember is that no matter how scary an emergency room visit may seem to you, it is undoubtedly even more frightening to your child. Try to remain calm.

If you have time, pack a small bag to bring with you. It should include:

• health insurance information and card
• any current medications your child is taking
• contact information for your family doctor
• change for phones, soda machines, etc. (It may be a long wait, and many hospitals do not allow cell phone use within their buildings)
• extra diapers if your child still wears them
• easy-to-dispense snacks (dry cereal, granola bars, crackers, etc.)
• any favored comfort item - blanket, stuffed animal, favorite toy
• a few books or other quiet playthings; it could be a long wait.

When possible, try to avoid going to the emergency room in the early evening (6 to 8 pm). This is often the busiest time, as people who had problems during the day often wait until after dinner to come in to be checked.

Check with your local hospitals to see if one has a pediatric emergency room. This has been a lifesaver for us! Our local hospital has a completely separate pediatric emergency center, staffed by pediatricians and set up to be more comforting for children. This is a far more comfortable place for anxious children than the regular emergency room, where all sorts of horrific accidents and injuries may be seen at any given time.

Once you are home, be sure to follow-up with your doctor. Even if the entire illness or injury was taken care of, your doctor will want to know what happened, so the information can be added to your child's chart. Set up any recommended follow-up appointments as soon as possible.

While the major trauma may seem over once you've left the hospital, your child may still be affected. She may become afraid of doctors, or unwilling to repeat the types of behaviors that resulted in the initial injury. Be patient, and help her work through the situation. Sometimes play-acting with dolls or toys can help; let your child be the doctor, and the toy a "patient." By taking control of the situation, your child should be able to work through any fears and stresses related to the hospital visit.