As parents, it’s a scenario we wish was less common: It’s 1 a.m. and your child’s screams wake you. You take her temperature and realize it’s sky high, her skin hot to the touch. What do you do?
When this happened at our house just a few days ago, my daughter’s temperature was 104.3 degrees. I held the now-burning-up thermometer in my hand while my husband and I looked at each other, each of us contemplating our next steps. The emergency room? The on-call pediatrician? Give her Tylenol, put her in the bathtub and see if it decreases the temperature before deciding?
We chose the last option, and I’m grateful we did. Our daughter’s temperature thankfully subsided to a more palatable 102 degrees, and alternating between Tylenol, ibuprofen and baths seemed to do the trick.
What do you choose?
That split-second decision we as parents sometimes are forced to make, though, is never an easy one. What’s the right call when your child is injured or very sick?
Dr. John La Count, a pediatrician with St. Elizabeth Physicians’ Florence office, said parents should follow the ABCs.
Here are some of the conditions that warrant emergency room treatment:
Airways or breathing
If your child cannot breathe or is having significant trouble catching his or her breath, “it’s an automatic do-not-pass-go and head to the emergency room,” La Count said. “If you live too far from the emergency room to safely transport your child by car, it is better to activate the EMS system and make sure you get the child to the emergency room as fast as possible while receiving basic stabilization treatments.”
Circulation
If your child is experiencing significant or uncontrollable bleeding, apply direct pressure to the area involved, but go immediately to the nearest emergency room.
Delirium (change in mental status)
If your child has experienced head trauma that results in a loss of consciousness, he or she should be evaluated in the emergency room. If he or she has an altered mental state from something ingested or from substance abuse, you also should go to the emergency room for evaluation and support.
“Some drug effects initially are confusion, or change in mental status, but can end in death if not dealt with immediately,” La Count said.
Electrical injury
There can be significant life-threatening injuries from electricity, with few external manifestations.
Fracture
If your child experiences trauma resulting in obvious deformity, he or she should immediately be seen in the emergency room.
Gunshot wound
Head injury
Especially an injury that results in an altered mental state
Infection
A fever in a child young than two months of age, or a fever associated with an altered mental state, requires additional evaluation and workup.
Beyond the “ABCs”
Some conditions, however, are less clear, La Count said, such as a burn ““ whether from a fire, chemical stove, etc.
“If the burn is severe or large in size, you should head to the emergency room for treatment and to make sure your child isn’t dehydrated and won’t require additional care (from Shriners Hospital for Children ““ Cincinnati, a hospital dedicated to the treatment of pediatric burns, for example),” he said.
In the case of fevers, unless your child is running a very high temperature and acting confused or lethargic, only a phone call to the pediatrician’s office is warranted, La Count said. If your child is running a significant temperature and acting in an unusual manner, though, take him or her to the emergency room right away.
Finally, La Count said, many parents take their children to the emergency room because of a rash, and that’s typically not necessary.
“Many times, unless you to go a children’s hospital, the doctors in the ER aren’t going to know what the rash is and will refer the child to his or her pediatrician,” he said. “You can save yourself money and time by calling your pediatrician first when it comes to rashes. If there is a concern, your pediatrician can recommend evaluation in the ER or office based on the appearance of the rash and its progression.”
