The ER and Your Child
What you need to know before you go.
by Jourdan Crouch

PARENTGUIDE News October 2006

We all agree that there’s nothing fun about taking a trip to the emergency room. The long hours, bright lights and noisy people can be incredibly draining for you and agonizing for your sick child. But, the trip doesn’t have to be as dreadful as you think. Dr. Ruth Borgen, director of the Pediatric Emergency Room at Hackensack University Medical Center, offers a few helpful tips for anxious parents in need of expert advice.

How do you know if you should go?
1. Call your family pediatrician. Most family physicians have some sort of phone service for patients who need to reach them at night.
2. If your child is experiencing any sort of respiratory distress, do not hesitate to take him to an emergency room. Call 911 if you think the situation is life threatening.
3. If your child experiences a change of mental status, such as seizures, loss of consciousness, confusion or trouble waking, don’t wait to take him in.
4. The best way to judge if your child needs immediate, professional care is to be observant. Don’t always go by the temperature you see on the thermometer. If he has a fever but is acting normal and alert, he is probably okay. However, if he has a low fever but is acting strange, it is best to take him in.

Where should you go?
If your child is experiencing respiratory distress, take him to the nearest hospital. Once he is stabilized, feel free to ask if he can be transferred to the hospital of your choice. Contact your pediatrician for advice, and be honest about your preferences. You should never feel locked into one hospital. Also, find out where the closest pediatric emergency room is located in relation to your home. These centers are child-focused, have child-appropriate equipment and are staffed with doctors and nurses trained in pediatric care. You won’t have to worry about your child getting thrown in with adult patients, and you should expect him to be treated with tenderness and patience.

What should you expect when you arrive?
You and your child will first be seen by a triage nurse who will take down a quick history and check the vital signs of your child before making an educated decision on the immediacy of his situation. Often, parents expect to be seen right away because they have a child. But, as we all know, that just can’t be the case. Because it is their child, parents are sometimes very emotional and impatient. It’s hard for them to see that other children might need more immediate attention. After a child is registered with the triage nurse, he or she is seen by the physician and treatment is rendered.

How long should you expect your visit to last?
It depends on a variety of factors. In a pediatric ER, afterschool, weeknights and weekends are the busiest times. Fevers go up at night, so that prompts many parents to bring their children in at that time. Also, pediatricians’ offices are closed at night. If you are in and out of a pediatric ER in two hours, you should be thrilled. It’s all based on your expectations. If you expect it to be a quick visit and you have to wait for your child to undergo tests and receive treatment, you’ll think it was a long visit. However, if you go into the situation thinking it might take some time and then leave rather quickly, you will be pleasantly surprised.

What should you bring for the trip?
First of all, you should always carry your pediatrician’s number and insurance information with you. Pediatric ERs are great because they are stocked with great books, age-appropriate toys and TVs to keep kids entertained while they wait. Most offer goody bags full of cool treats, and some even have mazes in the room. If your heading to a regular emergency room, it’s definitely smart to bring activities for your children. Their favorite games and books will keep them distracted, and many parents bring portable DVD players. Bubbles are also great to pack for the trip.

What about food and drinks?
Always ask the nurses before you give your child anything to eat and/or drink. If a surgery or intensive treatment is required, it is important that the patient has an empty stomach. Pack snacks for yourself and your other children (if you have to bring them in with you). Then you won’t have to spend money at the vending machine or run out to get anything.

What is the protocol if you are taking in someone else’s child?
You should always have a letter of consent if someone else’s child is staying with you. Before the other parents leave their child with you, ask them to write up a letter for you in case of an emergency. You also should be aware of allergies, current medications and dosages.

Any final advice?
The key is that you stay calm. Children can sense when their parents are anxious, which can make them anxious as well. Sometimes I see parents walk away from the situation when they start to tear up or become jittery, and I think that’s a smart thing to do. Also, try to bring support if you can. Grandparents, aunts, uncles and your spouse can all provide much needed help. Try to leave your other children with supervised care while you are gone so that you can focus on the child at hand. Finally, never hesitate to ask questions! If you don’t understand what’s going on or don’t think that your child is receiving the best care, please let your concerns be known.

Jourdan Crouch is an assistant editor.