When to take your child to the ER

March 03, 2016 | by Jennifer McNulty, M.D.
Categories: Healthy Driven Moms

When your child is sick or injured, it’s natural to panic. There are some emergencies in which the need to call 911 is clear: your child is having trouble breathing, is badly injured, unresponsive or unconscious.

But many times, the situation is less obvious and parents are left wondering “Should we go to the emergency room?” It can be difficult to distinguish the need for a visit to the ER from something that can wait.

First and foremost, it’s so important to have a primary doctor for your child. You aren’t expected to know everything — that’s what your child’s pediatrician is there for. They are your go-to person, your source for real-time information.

When you have an established relationship with your child’s pediatrician, the doctor gets to know your child and his/her health patterns. You can also discuss ahead of time with your child’s doctor what to do and where to go in case of an emergency.

It is rare for children to become seriously ill with no warning. When it’s a life-threatening emergency, call 911 immediately. But, depending on your child’s symptoms, your child’s pediatrician should usually be your first point of contact. Even if it’s after-hours, the pediatrician on-call can help you to decide whether a trip to the ER is needed.

Many times, I’ve had a parent hold the phone up to their child’s mouth so I can listen to their child’s breathing or cough. I may recommend bringing their child in for an office visit. If it’s after-hours, I may advise going to an immediate care center or walk-in clinic. And if it’s something more serious, I may tell the parent to go to the ER.

When symptoms are recognized and treated early, it can prevent an illness or injury from getting worse or turning into an emergency. Your child may need emergency care when he/she shows any of the following signs:

  • Increasing effort or trouble with breathing
  • Skin or lips that look blue, purple or gray
  • Fever over 104°F along with a stiff neck, breathing problems, vomiting or lethargy
  • Stiff neck or a rash with a fever
  • Persistent, uncontrollable vomiting or diarrhea
  • Signs of dehydration (no tears, a dry mouth, or hasn’t peed in more than six hours)
  • Abdominal pain or bloating/swelling (around the belly button or in the lower right abdomen) with fever, nausea, vomiting or diarrhea
  • Rash - small red or purple non-blanching dots on a widespread area of the skin
  • Hives with lip or facial swelling
  • Persistent bleeding after applying pressure for 5 minutes
  • Gaping wound or serious burn
  • Head injury (especially with any loss of consciousness, confusion, headache, vomiting)
  • Bone fracture or dislocation
  • Persistent bad headache with confusion, blurred vision, vomiting or fever
  • Sudden change in mental state - acting strangely or becoming less alert, unresponsive, listless, disoriented, or not able to speak, see or move
  • Seizure - rhythmic jerking and loss of consciousness

There are situations that call for an ER trip which may not be on this list. Also, even without signs or symptoms, if your child swallowed a suspected poison or another person's medication, call your Poison Control Center at 800-222-1222 at once.

The bottom line is, go with your gut. You know your child best. If something doesn’t seem right with how your little one looks or acts, trust your instincts if you believe they need medical care fast.

Always remember that your child’s primary doctor is there to help. For non-emergency conditions, call your child's pediatrician first. And when you’re in doubt, go to the ER or call 911 — it's better to be on the safe side!

Learn what to do in case of an emergency.

ER, Immediate Care, Walk-in Clinic or doctor’s office? Read our levels of care guide to help you decide.

Learn more about pediatric emergency care at Edward-Elmhurst Health.

Jennifer McNulty, MD is a pediatric emergency medicine physician and medical director of pediatrics at Edward Hospital.

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