Your Child and the Emergency Room
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.
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
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
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
* 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
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
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
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
* 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
* 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
About the Author:
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
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