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20 Things You Need to Know Before Taking Your Child
to the ER
by
Pamela Kramer
Parents, March 2006
Not only do you have a
sick or injured child who's scared--but you're
probably freaking out yourself. Here are 20 ways to
take control, stay calm, and get top-notch care.
1. Pick a child-friendly E.R. "Children's
hospitals and hospitals with pediatric E.R.s have
specialists on staff 24/7," says Louis C. Hampers,
M.D., medical director of the emergency department
at the Children's Hospital, in Denver. They also
have child-size equipment, specialists to help
reduce anxiety and pain, and toys to entertain your
child. Before your child gets sick or hurt, talk to
his doctor about where you will go in an emergency.
2. Call your pediatrician before you go. The
doctor's office will help you decide whether your
child needs to get to the E.R. right away or can be
treated in the office. If the doctor agrees that you
should go to the hospital, he can call ahead to say
you're coming.
3. Try to keep your cool. Take a few deep breaths,
and tell yourself that you need to stay calm for
your child's sake. Don't let your mind jump to a
scary diagnosis until you have all the facts. "If
you're worried or upset, your child will pick up on
your emotions and become even more distressed," Dr.
Hampers says.
4. Bring your child's health history. In a small
notebook, keep an up-to-date record of her previous
illnesses, immunizations, allergies, chronic
conditions, and any medications she's taking (know
when she took her last dose). Always keep it with
you in your purse or diaper bag, or grab it on your
way out the door to the hospital. And make sure that
your child's health-insurance card is in your wallet
at all times.
5. Go ahead and treat his fever. "Some parents
think they shouldn't give their child a fever
reducer before going to the E.R. because the doctor
won't believe that he's really sick, but that's not
the case," Dr. Hampers says. "It often makes the
examination process a lot easier because the child
feels better and we don't have to wait 45 minutes
for the ibuprofen to kick in."
6. Leave siblings at home, if possible. "You need
to be able to devote your full attention to your
sick or injured child," says Robert Luten, M.D.,
professor of pediatrics and emergency medicine at
the University of Florida Health Science Center, in
Jacksonville.
7. Prepare for a wait. Patients receive treatment
based on how sick they are, not in the order they
arrive. Bring your child's lovey and a quiet toy.
"If you've been waiting and are concerned your child
is getting sicker, you should ask to have her
reassessed," says Cheryl Jackson, M.D., medical
director of the pediatric emergency department at
University of North Carolina Health Care, in Chapel
Hill.
8. Stay by her side.
The E.R. can be a frightening place, and your
presence will comfort and reassure your child.
"Studies show that when parents remain in the room
during exams and procedures it reduces the level of
stress for both children and parents," says Leslie
Zun, M.D., chairman of the emergency-medicine
department at Mount Sinai Hospital and Children's
Hospital, in Chicago. Of course, if you feel as if
you might pass out while your child is getting poked
or sewn up, let the nurse or doctor know.
9. Hold off on food and drink. A full stomach can
delay the doctor's ability to operate on or sedate
your child. "Sometimes we have to sedate kids for
routine procedures, such as CT scans and blood
tests," Dr. Hampers says.
10. Tell your child what to expect. Let him know
that a doctor (not his regular one) will examine him
and, depending on what's wrong, either clean his
cut, take X rays, or run special tests. "For many
kids, the anxiety about what's going to happen is
worse than the actual pain," says Dr. Zun.
11. Give the doctor the facts. Explain how and when
the accident happened, and where your child has
swelling or pain. If she's sick, describe each of
her symptoms, and when each one first appeared.
Precise information will help doctors diagnose and
treat your child more quickly. If your child
swallowed something poisonous, bring the container
with you.
12. Be honest with your child. Don't tell him that
a procedure won't be painful if you know it will be.
"Lying will make the rest of the visit more
difficult," Dr. Luten says. If your child asks
whether a shot is going to hurt, for example, gently
tell him the truth, and point out a positive: "It'll
probably hurt a little, like a pinch or a bug bite,
but then it will stop."
13. Ease your child's fears. Hold her in your lap,
and speak in soothing tones. Remind her that you
won't leave her, and that the doctors are going to
do everything they can to help her feel better soon.
"Try to shield your child from any disturbing sights
and scary instruments, such as suture trays and long
needles," suggests Dr. Jackson.
14. Inquire about "ouchless" options. If your child
is going to have a shot, stitches, or a blood test,
speak up and ask to have numbing cream applied to
the location as soon as possible, advises Dr.
Jackson. These products usually take about 20
minutes to work. In the case of minor cuts, ask the
doctor whether skin tape or glue might be an
appropriate alternative to stitches.
15. Get his mind off the pain. During uncomfortable
procedures, distract your child by looking at books
or playing I Spy. Deep breathing and visualization
techniques are often helpful for older kids, Dr. Zun
says. Have your child picture his pain swirling down
the drain, or have him flip his imaginary pain
switch to "off."
16. Make her comfortable. If she's cold, ask for a
warm blanket. If the room is too bright, ask to dim
the lights. If your child's pain medication has worn
off, let someone know. "You must be the advocate for
your child," Dr. Jackson says.
17. Don't be afraid to ask questions. "Doctors and
nurses get busy, and information isn't always shared
like it should be," says Dr. Luten. If you're not
sure what the plan is for your child or why he needs
a particular test, politely ask for an explanation.
"Parents often feel that it's not their place to
interrupt a busy doctor, but answering questions is
a doctor's job," Dr. Luten says.
18. Bring change for the pay phone. Cell phones
aren't allowed in many hospitals. Coins will also
come in handy if you want to get a snack or drink
from a vending machine.
19. Get clear
discharge instructions. Make sure you know how to
care for your child's injuries and what to do if his
pain or symptoms don't improve or if they worsen at
home. And ask for clarification if you don't
understand the purpose of the medication or dosage
instructions. "It's better to ask when you're there
than to call and try to get information later," says
Dr. Zun.
20. Follow up with
your pediatrician. After the E.R. visit, call to let
your child's doctor know what the diagnosis was so
it can be noted in her medical file (many E.R.s will
send a report to your pediatrician if you ask them
to). Check to see whether the doctor has any
further recommendations and whether your child needs
to be seen for a follow-up exam.
"What I Wish I'd Known..."
Have another adult come with you to stay with your
child while you fill out forms or take a much needed
break.
-Kristine Brown, Point Pleasant, N.J.
Ask for a day's supply of medication in case you
can't make it to the pharmacy right away.
-Robin Nolan,
Carson City, Nev.
While you're waiting for the doctor, jot down any
questions you have so you don't forget them.
-Eric Yaverbaum, New York, N.Y.
If you're not satisfied with a diagnosis, don't be
afraid to ask for additional tests or to get a
second opinion.
-Shannon Connors, Mount Airy, Md.
If your child gets a cut on her face, ask if there's
a plastic surgeon available to do the stitches.
-Sally Lee,
Editor-in-Chief, Parents
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