Cincinnati Family Magazine

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November 30, 2022

Emergency Room Know-How, Stat!

While you can’t predict when your child might need emergency medical care, you can take steps to help him get the best care possible.


Full2765.jpgWhen Fletcher broke her arm at gymnastics practice one night, her mother got the phone call that every parent dreads: “Mrs. Reynolds, Fletcher fell, and her arm is definitely broken. You need to come down here quickly.”

Reynolds raced to the gymnastics school, carefully loaded Fletcher into the car and sped to the nearest emergency room (E.R.). Though everything turned out alright (Fletcher spent eight weeks in a cast to heal both broken bones), if she had to do it all again, Reynolds says she would have better prepared for the E.R. to save herself the frenzy of the unknown.

Choose an E.R. Before You Need One

Choose your emergency room for your child. “Each case needs to be addressed on an individual basis and reflect the child’s past medical history with the current complaint,” says Tom Abramo, M.D., medical director of the emergency department at the Monroe Carell Jr. Children’s Hospital at Vanderbilt (VCH). “The final decision, though, should be a team effort between the child’s physicians and the parents.”

When making your decision, keep in mind that children’s hospitals, like Nashville’s VCH, are tailored to serve the smallest patients. “They have more specialized knowledge and training for the complex medical issues that occur in children,” says Abramo. “It also has extensive ancillary resources for children in emergencies, like child life services, pediatric surgery, anesthesia and imaging services,” all for the pint-sized patient.

No matter where you decide to take your child, these tips can help you select a good local E.R. before you need it:

  • Consider VCH as the first option. Doctors at children’s hospitals often sub-specialize in certain types of pediatric emergencies.
  • Ask your child’s doctor which E.R. she recommends. Is she an attending physician at an E.R.?
  • Ask whether the doctors at the E.R. are board-certified physicians, which means they’ve received extra training in pediatric emergencies. After you select an E.R., find out how to get there from your home. Most pediatric injuries happen at home, and certain illnesses, such as croup, colic and fever, also tend to worsen at night when you are at home.

Plan Ahead With Your Child’s Caregivers

If others care for your child during the day, make sure they can contact you easily in an emergency. You also need to know how to contact your child’s caregivers after hours if necessary. An E.R. doctor might want to know how your child behaved earlier in the day when he was not in your care.

Make sure your child’s caregivers have the paperwork needed in the case of an emergency. Give all caregivers a signed “consent to treat” form or consider filing one at the E.R. where your child will most likely be treated. This form gives emergency doctors legal permission to treat your child if you are unavailable for consent.

If your child has special medical needs, ask your child’s doctor to fill out an “emergency information form for children with special health care needs.” If your child is healthy, fill out a “personal medical history” form for your child. Keep these forms updated, copy them for yourself, and put them somewhere easy to access. Give copies to all of your child’s caregivers as well. All of these forms are available on the American College of Emergency Physicians (ACEP) Web site at acep.org/webportal/patientsconsumers/medicalforms/.

When a Medical Emergency Happens

If your child has a life-threatening medical emergency, call 911. If your child’s problem is urgent but not life-threatening, call his doctor for advice first. The doctor can often evaluate an urgent illness over the phone. Injuries are more difficult to evaluate over the phone and will most likely be referred directly to an E.R. Depending on the severity, the doctor can sometimes call ahead to expedite your child’s care upon arrival. If you’re worried about your child and can’t reach anyone for advice, trust your instincts.

Before You Leave for the Emergency Room

If you do need to take your child to the E.R., follow these steps to help the doctors provide the best treatment possible:

  • If you child is injured, don’t give him anything to eat or drink in case anesthesia is needed. Anesthesia is safer to administer on an empty stomach.
  • If you think your child swallowed a poison, bring the substance with you.
  • If your child has a fever, offer him Children’s Tylenol or Motrin if you think it will make him more comfortable. Evaluation is much easier if the fever is treated.
  • Try to bring any relevant medical information for your child including medications, medical history forms and immunization records.
  • Try to leave siblings behind with a trusted adult.

What to Expect in an Emergency Room

A visit to the emergency room with your child is very different from a well-child visit. Always keep in mind that an emergency department is not a first-come, first-served place. Patients are triaged (sorted) based on the urgency of their problems. Due to triaging, a patient who arrives after you might be treated before you, so expect a wait: emergency rooms are frequently abuzz with patients.

Emergency physicians work with both the parent and the child during an emergency. “We kind of consider them a unit, because they are,” says Rick Blum, M.D. “Parents play an important role in calming their child, which is really helpful to us.”

Remember to maintain your cool for your child’s sake. It’s also important to be honest with your child, such as explaining whether a procedure might hurt.

Your knowledge as a parent is invaluable in an emergency. Parents are the best source of vital information about a child, such as allergies, past surgeries, medications the child takes and the child’s normal behavior patterns. Ultimately, Blum says, the most important thing you can bring for a kid to the emergency room is the parent.

Remember that you are your child’s advocate in the E.R. If you have any questions about your child’s treatment, be sure to ask. Don’t be afraid to ask about the doctor’s credentials or about treatment or lab tests. And if you don’t understand the discharge instructions, keep asking until you understand. No good doctor is ever going to get mad at you for asking questions.

Laurie Bouch is a freelance writer.


top reasons for E.R. visits

According to Tom Abramo, M.D., medical director of the emergency department at the Monroe Carell Jr. Children’s Hospital at Vanderbilt, the number one reason children are brought to the E.R. is infectious disease-related illnesses. These include fever, vomiting, diarrhea and rashes. “These infectious related visits have seasonal variation,” says Abramo. “In the summer months, we see more stomach bugs, and in the winter months more respiratory complaints like colds and flu.”

The second most common reason for an E.R. visit? Trauma-related events, such as bicycle accidents, falls and sports related injuries.

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