This week on On Call for All Kids, Joe Perno, M.D., vice president of medical affairs at Johns Hopkins All Children’s Hospital, shares information for parents about dealing with emergency situations and when you should seek help from your pediatrician or a hospital.
In the unfortunate event your child is involved in an emergency situation, what should you do first?
First and foremost, you need to remain calm (easier said than done) as you will play a key role in the treatment of your child. If you are not with your child and you are being called about the emergency, you want to be clear on what is expected of you. Should you proceed to your child or is you child being transported to a hospital? If the child is being transported, you will likely be speaking with paramedics. You want to be clear on where they are taking your child. Also they may need basic information such as medical problems and allergies.
If the child is clinically stable, they may ask you which hospital you prefer. This is something you want to have thought about before you are in this situation.
Lastly, as you proceed to your child, try to remain calm and drive safe, as your child is in the hands of qualified medical professionals. If you are involved in a motor vehicle crash on your way to the hospital, you are not helping your child.
How do you know when to call an ambulance and when to drive your child to the Emergency Center?
Anytime there is significant injury, significant pain, breathing problems or alteration of their mental status (awareness), you should call 911. I tell parents all the time that if you feel it is an emergency, you should call 911 rather than driving. The paramedics are able to begin care before arrival in the hospital.
Also, driving like a crazy person to get to the hospital with one eye on the road and one eye on your child is not safe for you, your child and others on the road. However, if your child is not in any distress and you are calm, driving the child to the Emergency Center may be appropriate. If you call 911 and they do not feel it is necessary for them to transport, they will give you the option of driving yourself.
Once the child arrives in the Emergency Center, what are some of the things the EC physician may need?
Similar to the paramedics, the EC physician will need to know about any significant past medical history such as asthma, diabetes, seizure, etc. They will need to know about any medication your child takes daily. They will need to know about any drug or food allergies. They will want to know any details about this emergency. This may be what you witnessed or what was told to you by the school or bystanders.
Unlike the paramedics, the EC physician will be more interested in recent events over the preceding days. They may ask about recent illness and any symptoms. If the emergency involved any injury, they will likely ask about when was the last time the child ate or drank.
Lastly, they will likely want to know when you think you will arrive at the hospital. It is important that you keep your cell phone handy, in case something changes and the treating physicians need to reach you before your arrival.
Is it an emergency or a pediatrician visit?
This can be an emergency if the child is less than 4 months old and the fever is greater than 100.4. For older children, if they can be made comfortable with anti-fever medication they can be monitored at home and seen by their pediatrician. If there is any change in behavior such as lethargy or difficult breathing with fever, then they should be seen in the Emergency Center.
Swallows an object
If the child swallows an object and is having any difficulty breathing, swallowing, speaking or drooling, they should be seen in the Emergency Center immediately. If they have no symptoms and can drink and eat, they can safely be monitored at home. If there is any suspicion that they swallowed a flat button battery, they should be seen immediately regardless of symptoms.
Swallow chemicals or medication
This should prompt an immediate call to the Poison Control Center at 800-222-1222. They can help guide whether or not the child can be managed at home or needs an Emergency Center visit. If the child is having any symptoms such drooling, change in mental status or breathing problems, you should be seen in the Emergency Center immediately.
On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report.