Your Child and the Emergency Room
By: John Vonhof
This year, one out of every 2.4 children will be seen in the nation's 6000 or so emergency rooms. It may be a cold, an earache, a cut, a broken bone from a fall, or a breathing problem. Whatever the illness or injury, an emergency room visit can be overwhelming and even scary to the parent unfamiliar to the inside of an emergency room.
Before an Emergency
Know where your local emergency room is located, its phone number, and how to get there. If there are several hospitals in the area, find out which is staffed best for pediatric care. Some areas have a children's hospital.
If your child is on any medications, make a complete list for the medical personnel. Likewise, list any known allergies.
If your child is going to be in the care of another relative, babysitter, day care provider, or at school or other activities, make sure all of these have the above information and a Consent to Treat form that authorizes treatment in your absence. Free Consent to Treat and Emergency Information forms can be printed from http://www.footworkpub.com/erconsent.html.
Deciding to Go to the Emergency Room
There are certain situations when it is appropriate to go to the emergency room with your child. Some of these situations include
- When you do not have a pediatrician and you think your child needs emergency medical care.
- When you are out of town and an emergency occurs.
- When you are unsure how serious your child's illness or injury is and you cannot reach your pediatrician.
- When there are life threatening emergencies such as seizures, breathing problems, unusually high fevers, unconsciousness, heavy bleeding, possible broken bones, eye injuries, significant pain that cannot be resolved, and/or a head, neck or back injury. In these emergencies, an ambulance is often appropriate.
Your Pediatrician and the Emergency Room
Your child's pediatrician is typically the first person you should call when an emergency arises. He or she can tell you to come into the office or refer you directly to an emergency room. Some emergencies will necessitate bypassing your child's pediatrician. Illnesses like high fevers, breathing problems, and earaches often require immediate attention.
Parents would be wise to learn basic first aid skills and become certified in infant and child CPR. Check with your local Red Cross, American Heart Association, and area hospitals for available courses.
The Emergency Room
Patients are usually seen in a specific order, based on the urgency of their illness, injury or medical condition. The emergency room is staffed by a variety of care providers. The doctor is in overall control and has the final say over procedures and medications. The nurses are usually the first medical personnel you see. They will make an initial assessment, put you into a room, explain the next steps in obtaining treatment, dispense medications, start IVs, follow the MD's direction in ordering lab work and x-rays, and discharge you and your child when treatment is completed. Additional medical personnel include lab, respiratory, x-ray and emergency room technicians.
The doctor will examine your child, ask questions about the illness or injury and determine a plan of care. This may include lab work, x-rays, medications, wound cleaning, breathing treatments, splints, or other medical procedures. The staff should keep you informed about what tests or procedures have been ordered and the time they will take.
It is your right to understand everything done to your child and have it done to your satisfaction. You must be your child's advocate. If you feel the doctor has not listened to you or has rushed to judgment, take the lead and express your concern.
Younger children can be helped by the use of simplified explanations and language, and simple visual demonstrations of what is going to happen. Older children often will understand and appreciate a more detailed explanation.
Many children will want their parents at their side during treatment—ask if you can stay, but respect their experience with similar situations. If you suspect that you cannot remain calm or may lose control during a procedure, tell the nurse or doctor.
In order to keep your child calm, you must remain as calm as possible. Your child will sense tension and fear—particularly of procedures that make you squeamish.
- Do tell your child that medical personnel are going to help them.
- Do tell the nurse if your child's condition worsens while waiting to be seen.
- Do ask about pain medications if you think they are warranted.
- Do ask about your status if a doctor has not seen you yet or if nothing happens within a reasonable time period after being seen.
- Do understand that lab work and x-rays take time, both for the technicians to do them and for the results to be read.
- Do remember to bring an extra diaper, a favorite stuffed animal, toy or blanket, and a few books to read while passing time.
- Don't ask for water or give your child a bottle unless cleared by the nursing staff.
- Don't tell your child that the medicine is candy.
- Don't tell your child that a procedure will not hurt, particularly when you know that it will. Be realistic and explain that the hurt will only be for a moment.
- Don't let your child crawl around on the floor or play with equipment.
Before Signing Out
Make sure you have a copy of your discharge instructions with any prescriptions. If the discharge instructions are unclear, or if you are unsure about follow-up actions, ask for a better explanation.
When You Get Home
After the emergency room visit spend time at home to reassure your child as necessary, talking about what happened, or answering any questions your child may have. The child's memory for medical procedures plays an important role in their response to subsequent medical events.
John Vonhof is a Prehospital Care Coordinator in Emergency Medical Services. This article is extracted from his booklet A Parent's Guide to the Emergency Room: Managing Your Child's Crisis Without Fear. The booklet is available at www.footworkpub.com.