Do I or Don’t I need to take my child to the ER?

Hospital ER

As a new parent or even a seasoned one, the question of when to take your child to a hospital is often a complex and confusing decision. This is the case especially when it is in the middle of the night and the Doctor’s office is closed and the situation was unexpected.

Parents magazine and other sources have published some guidance that can ease your concerns and prevent anxiety over "do I or don’t I" rush to the emergency room. Guidance will vary based on the age and medical history of the child but here is a summary of their advice.

1 Airway: If the passage to the lungs is blocked - for example, your child is choking.

2 Breathing: Noisy, high-pitched, and rapid wheezing or grunting indicates a child is struggling for air, usually during a respiratory infection or an asthma attack. The chest sucking in and the belly moving. It's just as hard - if not harder - to exhale, as it is to inhale, which means your child's condition will deteriorate fast. Get emergency aid for a baby taking in more than 60 to 70 breaths per minute. A 1-year-old taking in 40 or more breaths per minute. And an older child taking in 30 or more

3 Circulation: This applies not only to blood loss from trauma but also to dehydration from vomiting or diarrhea, which prevents blood from properly nourishing the body.

Signs that your child needs intravenous fluids include decreased urination (fewer than two soaked diapers a day), a sunken soft spot on the head, a sticky mouth, tearless crying, sunken eyes with dark circles underneath, listlessness, paleness, and clammy skin.

4 Disability: Get immediate help for a child who's unconscious or having a seizure that involves going limp or stiffening and jerking, with eyes rolling back or staring.

About 5 percent of young children are prone to febrile seizures. This frightening response to fever is usually harmless, but a child's first seizure should be treated as an emergency to rule out a more serious problem. For subsequent episodes, there's no need to call 911 unless it lasts longer than the typical 5 minutes (but always report it to a doctor ASAP).

5 Fever: If your infant is 2 months or younger and has a rectal temperature of 100.4 degrees F. or higher, he could be sicker than he seems. (One exception to this rule is if your 2-month-old just got his vaccinations and runs a low-grade fever within 36 hours.)

Young babies usually don't show a lot of symptoms, but they can quickly develop a serious bacterial infection because their immune system is still immature, says Sue Hubbard, MD, a pediatrician in Dallas. Parents often assume their baby just has a cold, but colds usually don't cause a fever at this age. A doctor will see an infant with a fever as soon as possible, but if it's the middle of the night, your pediatrician may send you to the ER.

Benjamin Franklin said "an ounce of prevention is worth more than a pound of cure.” Take his advice and discuss emergency processes and preferences with your family doctors. Know when he or she prefers you to call, go to the emergency room (and which one) in advance of a situation suddenly arising. Trust your gut and never regret making a decision to get emergency help, even if it turns out to be an insignificant event. Your child’s life is well worth being embarrassed.


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