The Emergency Room:
When Should You Take Your Child?
It’s very important for parents to understand that children are not just “little” adults. Early on in life, their immune systems are less capable of fighting off infections. All medications have to be carefully dosed based on a child’s weight. A ‘minor’ injury to an adult might have serious consequences for a small child. As those of us who are parents know all too well, children’s judgment isn’t always the best. Sometimes they put things in their mouths (or noses) that they shouldn’t or jump off of things we wish they hadn’t. Their bodies have different ways of letting you, and their doctor, know that they are sick. Consequently, doctors and parents have to look carefully for signs of serious illness that might be different than in adults.
There are also some “no debate” areas for infants and children. These are situations where you really must bring your child into the emergency room right away.
They include:
- Fever in a newborn or infant under 3 months of age. Any temperature over 100.4 F could be the sign of a serious infection and must be evaluated right away.
- Neck stiffness with rash, fever or confusion could be the first signs of meningitis.
- Any head injury that is associated with confusion, severe headache, persistent vomiting, change in behavior of level of consciousness needs to be seen by a doctor immediately
Another way to approach this to think about the ABCDEs:
- A stands for Airway. Anything that blocks or interferes with a child’s or infant’s airway could be an emergency. If a child has put an object in their mouth or is choking on something, that is a good reason to call 9-1-1 and get your child to the emergency room.
- B stands for Breathing. If your child is having difficulty breathing, looks or turns blue, has either an unusually rapid or unusually slow breathing rate or is wheezing then they need medical attention right away.
- C stands for Circulation and also for Consciousness. If direct pressure and elevation on your child’s bleeding site can’t control the bleeding proceed to the hospital. A child who is unconscious, confused, limp or hard to arouse need urgent medical care. Infants may be extra fussy, hard to console or won’t stop crying.
- D stands for Disability and also Dehydration. If your child has had an injury and can’t walk or won’t move part of their body; if they have abdominal pain with fever and are vomiting or having diarrhea so that can’t take/keep down enough fluids then take them to the hospital.
- E stands for Environmental Exposure. This includes accidental poisoning, electrical shocks, burns, frostbite, heat-related illness or trauma, any of which could be serious and warrant immediate medical attention.
While the emergency room is certainly meant for emergencies, parents should always trust their instincts when it comes to their children – they know them best.
Mark Melrose, M.D., has practiced emergency medicine for more than 20 years, is board certified in Emergency Medicine. Neal Shipley. M.D., an emergency physician for more than 17 years, is board certified in both Emergency Medicine and Internal Medicine. Melrose and Shipley have recently opened Urgent Care Manhattan, a walk-in emergency medical center located 199 Amsterdam Ave. at 69 St., New York, New York, which is open seven days a week.
