Let me preface this post by saying that I have spent the last few weeks working in the pediatric emergency room–and I love it. It’s a well-equipped facility with a team of highly qualified people dedicated to providing excellent care to kids. But it’s not always the most appropriate place for your sick child–here’s why:
So What Should You Do?
Find a pediatrician that you trust. This is the most important step, and it’s one that you should take when your child is healthy. A good pediatrician can identify diseases early, track your child’s growth and development, provide reassurance when that’s all you need, and handle the vast majority of acute illnesses. If–or rather, when–your child gets sick, your pediatrician has access to her records and history, avoiding expensive and unnecessary repeat testing. He/she will understand your personality and perspectives, and your child will be less scared of a familiar face. Look for a doctor that has same-day sick visits, weekend hours, and phone availability even when the office if closed–a lot of ER visits can be avoided by talking through symptoms over the phone.
If your child has a minor illness (runny nose/congestion, cough without difficulty breathing, mild headache, fever without any alarming symptoms, vomiting and diarrhea without dehydration, etc.), stay at home. Use home care measures like saline drops and bulb suction for congestion, offering small amounts of fluids frequently to prevent dehydration, or controlling fevers with over-the-counter medicines (if you must). Call your doctor if you have any concerns, or schedule an appointment to be seen the next day.
If your child has an illness that has been progressing over several days or weeks, but is not in immediate danger, schedule another appointment with your doctor. There are many challenges in diagnosing childhood illnesses, many of which have similar symptoms at the onset, and it may take multiple visits to fully define the problem and best treatment. Many parents get frustrated by this and turn to the ER physician essentially for a second opinion. Because close follow-up and continuity is so important in these cases, this doesn’t tend to be very effective. If you don’t trust your pediatrician, find a new one.
Occasionally children have severe or even life-threatening conditions and need to be evaluated quickly. This is where the ER team shines–especially if you are fortunate enough to have a dedicated pediatric facility nearby. The doctors, nurses, and staff are trained to handle life-threatening situations efficiently. Many pediatric centers will even have a Child Life Specialist, whose job is to make the experience less stressful for your child. They have the equipment needed to handle respiratory problems, traumatic injuries, severe infections, and any other emergency that might roll through the door. They have access to the imaging, specialists, and interventions that are sometimes required to diagnose and treat these problems. If your child has a true emergency, it’s the place to be. And if my kids are really sick, I might beat you there.