Going to the Emergency Room

When your child is sick or injured, it's natural to want to head straight for the emergency room (ER). You know that you can get care, no matter the time, day, or severity of your child's injury.

In some cases, it is a true medical emergency and the ER (also called the emergency department, or ED) is the right place to get care.

In other cases, the illness or injury can be handled at an urgent care clinic or whenever your child's doctor can see you.

When the ER is the right place to go, it's important to know what to expect once you get there.

When Should We Call 911 for an Ambulance?

In some situations, you should call 911 to get an ambulance instead of taking your child to the ER yourself.

Call 911 if a child:

• has trouble breathing and is turning blue
• was in a car accident and is unconscious or seriously injured
• is having a seizure
• loses consciousness (passes out) or is not responsive
• might have a neck or spine injury
• has a head injury with a loss of consciousness, keeps vomiting, or is not responding normally
• has a lot of uncontrolled bleeding
• has a possible poisoning and is not responding normally or has trouble breathing. For any possible poisoning, call the Poison Control Center (1-800-222-1222) for expert advice. They may direct you to the ER.

How Can We Plan Ahead for ER Visits?

Talk with your child's doctor about what to do — and which ER to go to — before you might need to visit one. Your doctor may direct you to an ER that's close to you or one in a hospital where they regularly see patients.

Should your child go to an ER at a children's hospital? Because they're dedicated to caring for kids, children's hospitals probably have the most pediatric staff, specialists, and facilities. So if it's an emergency and a children's hospital is nearby, consider going there.

Otherwise, the community hospital nearest you can give the medical care needed. If for any reason the hospital can't treat your child's specific condition, the doctors there will arrange a transfer to a facility that can.

It's also important to know your child's medical history. Consider preparing a medical history now so it's handy during the chaos of an emergency. Keep a copy available at home so that anyone caring for your child — such as a babysitter or grandparent — will have it in case your child needs to go to the ER.

To prepare a medical history, include:

• medicines your child takes
• any allergies
• history of previous hospitalizations
• any previous surgeries
• chronic conditions or illnesses
• relevant family history
• immunization history

Include the name and number of your child's primary care provider, and the name and number of the pharmacy where you usually get your prescriptions filled.

How Should We Prepare to Go to the ER?

When you go to the ER, it's important to know the details of your child's current problem, including:

• when the problem began (the time of injury or how long your child has been sick)
• the symptoms of the current illness or injury
• treatments and medicines you have already tried
• when your child last had anything to eat or drink

If you go to the ER because your child ingested a particular medicine or household product, bring the container of what they ingested. That will help the doctors understand what kind of treatment is needed. If your child swallowed an object, bring an example of that object, if possible.

What Should We Expect at the ER?

Expect to Wait

At any ER, except in the most serious emergencies, be prepared to wait. If you have time before you go to the ER, consider bringing something to do while you wait, such as a book or magazines. You also may want to bring pen and paper to write down any questions you have for the doctor. If your child is not too ill, bring things for them to do as well, such as crayons, books, toys, and comforting objects, like stuffed animals. If you think there's a chance that your child might have to be admitted to the hospital, you may want to grab a change of clothes and toothbrushes for you and your child.

There's no way to predict how long you'll have to wait to be seen at the ER. If your child has a severe medical problem, be assured that the doctors will provide whatever care is needed right away.

Because doctors attend to the most severe injuries and illnesses first, there's a good chance that if you are there with a minor injury, you'll have to wait longer. Even if the waiting room is empty, you still may have to wait if the exam rooms are filled or many doctors and nurses are attending to a particularly serious case. If your child's condition becomes worse while you are waiting to see a doctor, tell the medical staff.

Triage and Paperwork

Soon after arriving at the ER, your child probably will be seen by a nurse, who will ask about symptoms, check vital signs, and make a quick assessment. This evaluation, also called triage, will prioritize your child's medical needs based on the severity of their condition.

You'll also go through a registration process where you'll be asked to sign consent for treatment forms. And if you have health insurance, be sure to have your member card with you.

Other things to know:

• Most ERs have some translation services or someone who can help translate. If you do not speak English well, consider bringing along a family member or friend who can help you translate.
• In some situations, your doctor would prefer your child has nothing to eat or drink. Before offering any food or drink to your child, make sure to ask the medical staff if it is OK.
• A specialist might not be on-site if you go to the ER on the weekend or at night, but if needed, one will be called in. If surgery is needed, a surgeon will be contacted.

Reassuring Your Child

While you wait, there's a chance that you — and your child — may see some very sick and injured people come into the ER. The sights and sounds of those who are seriously hurt or sick can be scary. So assure your child that the ER is the best place for the hurt people to be and that this is where the doctors can help them feel better. You might even give an example of a time when someone you know was injured and, as scary as it was at the time, all was fine after the doctor's care.

Some hospitals have child life specialists. They can help children cope with the stress of being in the ER, help prepare them for procedures, and give them non-pharmacological pain management techniques even at very young ages.

Things to Keep Track of

When you're in the ER, try to write down important information that you hear, such as:

• the names of the doctors
• what they say about the illness or injury
• any medicines or treatment they give your child
• any directions for follow-up or care at home

What Happens When We Leave the ER?

If your child is discharged, make sure you understand the home care instructions and ask questions if you don't.

In many cases, the doctor who treats your child in the ER will contact your primary care doctor afterward. If your child is admitted to the hospital, the emergency room doctor will let your doctor know.

Some ERs provide written or electronic documentation of the visit and others dictate and then send the report to the primary care doctor. Carry a copy of the papers you get when your child is discharged to share with your doctor at any follow-up visits.