WHEN TO GO TO EMERGENCY ROOM
As parents, most of us constantly worry about our children’s well being. When they get sick, we often need guidance on when we should worry or when we should let the illness takes its course. Most of the time, the cause of such illnesses would be viruses, and even though there will be some medications that may help alleviate the symptoms, it will take some time for the body to heal, most of the time without any medications.
We turn to our physician, or in this case, our child’s pediatrician for guidance. St. Junipero Children’s Clinic will try our best in accommodating our patients for same day appointments, and perhaps in some cases within 48 hrs. In the case of after business hours, week end and holidays, we hope that some of these advices will help parents decide with what they should do.
· The most important rule when it comes to sick children is “how they act”. If they still act “normal”, playing, even though it’s “on and off”, likely they can wait until the next morning to be seen in our office. They may look sick and whinny at times, but after a dose of ibuprofen or acetaminophen (see dosing tab), their condition likely improves temporarily. This is an indication that emergency service may not be necessary.
· FEVER: this is what keep most parents worry and awake at night. How high is “TOO” high? Fever is your body’s response to foreign agents. Most of the time it’s normal to have fever when you’re sick, even though it may return after a few hours with “fever” medication. It is NOT normal, however, to continue having fever more than 5 days, or higher than 105 F. It may be an indication for you to seek help, although it may or may not mean a trip to emergency room.
· RESPIRATORY STATUS: This is another big one. When should you worry about your child? How bad of a cough before you need IMMEDIATE attention? RETRACTIONS, persistent FAST BREATHING and WHEEZING (without resolution after albuterol treatment in asthma patients) may warrant a trip to the doctor’s office or emergency room. To most people who don’t know, retraction means your child is working hard trying to move air to his/her lungs, frequently to the areas between ribs, underneath the ribs and/or above neck. If you have albuterol and need to use it more often than every 4 hours, you may also need immediate attention. All these symptoms could indicate that your child may have more serious conditions such as pneumonia or asthma exacerbation.
· Abdominal pain: Another symptom that often makes parents worry. Severe abdominal pain that last longer than 2 hours could indicate more serious problem. Otherwise, most abdominal pain is non specific, and can be taken care of in pediatric office during regular hours instead of in the emergency room. Other abdominal pain, especially if it’s been going on for a while, should not be ignored and be brought to your pediatrician attention for a work up.
· CRYING: For non verbal children (under 2 years old), crying can also be concerning to a lot of parents. Generally, you may be able to look at it the same way you do with abdominal pain. If they cry non stop over 2 hours, we want to see what is going on, and that means to seek for help. Otherwise it could mean a lot of things, ranging from needing diaper change, to being hungry, in pain, or even just lonely….
· Although the guidance I describe above would fit most after clinic hours situations, there will always be some exception to the rule and/or some situations that might not be covered by it. Your instinct as a parent is a powerful tool that should not be ignored. When you think your child is in danger or very sick, you will still need to seek help appropriately.
Steve Darmawan, MD, FAAP
We love our patients, so feel free to visit during normal business hours.
333 Abbott Street, Ste C Salinas, California 93901, United States