When to take your toddler to the emergency room

No matter how careful a new parent – or even a not-so-new parent – is, when toddlers are involved, accidents happen. So do illnesses. Most fevers, sniffles, bumps, and bruises can be treated without having to venture further than your own medicine cabinet, but every once in a while, something comes along that needs a little professional help. What can be difficult, though, is figuring out whether that help can be a doctor’s appointment next week, or if it has to be an urgent care drop-by, or an emergency room visit.

Unless there’s an urgent emergency that needs immediate medical attention, calling your pediatrician’s office to talk through the problem is generally a pretty good place to start. Some parents worry about seeking medical help for a health problem that turns out not to be very serious, but healthcare professionals understand that it’s not always easy to tell what to worry about, and it’s always better to have something checked, even if it’s found to be just fine, than to not get something treated that turns serious.

What counts as an urgent, emergency situation?

Most of the time, the best way to start figuring out what kind of care your child needs is to call their pediatrician, but some situations are urgent enough that it’s best to skip that step, and move right on to a quick drive to the emergency room, or even calling 911 (for those in the US) or your local emergency number. Situations that fall into this category include:

  • Breathing problems: Choking, stopping breathing, or turning blue are all signs to call 911 or your local emergency number. Trouble breathing, from asthma, swelling, an allergic reaction, or for any other reason should prompt a trip to the emergency room right away. The one exception to this is trouble breathing from a stuffy nose, if the blockage can be sucked out with a nasal aspirator. But when in doubt, it’s better to be safe.
  • Head or neck injury: Injury to the neck or spine should be handled by calling 911 or your local emergency number, since a healthcare provider should give the okay to moving someone with an injured neck or spine, to make sure not to cause more damage. A head injury where the injured person is unconscious or passes out, vomits, or has uneven pupils should also receive medical care as soon as possible.
  • Blood: Bleeding that can be stopped with pressure and elevation may be less urgent, but heavy bleeding or bleeding that parents are having a hard time stopping should receive quick medical attention.
  • Potential poisoning: Children who may have swallowed something dangerous should get immediate medical care from poison control and either 911 or your local emergency number.
  • Anything you suspect might be a broken bone: Urgent care clinics don’t generally handle broken bones, and broken bones should be looked at as soon as possible, so the emergency room or 911 are generally the way to go. Rapid swelling and an inability to move the hurt body part are pretty solid signs of a fracture.
  • Dehydration: Signs of serious dehydration like dry mouth, crying with no tears, no wet diapers or urination for 18 hours, or a sunken-in fontanelle (soft spot) should receive medical attention as soon as possible.
  • Less common symptoms: Other, less common symptoms that should lead to a 911 call or emergency room visit include difficulty waking your child, a high fever that doesn’t respond to medication, serious burns, coughing or throwing up blood, unusual and serious headache or chest pain, a fast heartbeat that doesn’t slow down again, or sustained throwing up or diarrhea.

Emergency room or urgent care?

If your child is hurt or sick, it can seem like heading straight for the emergency room is the only responsible thing to do. But for more minor injuries or illnesses, an emergency room visit can actually cause as much harm as good, between the exposure to germs in the emergency room and the fact that a doctor in the emergency room is not your child’s pediatrician, and may not be as familiar with their medical history.

There’s a reason that, for less urgent illnesses and injuries, it’s a good idea to start by calling your doctor. By waiting to come in for urgent care hours in your child’s pediatrician’s office, you’re more likely to find a healthcare provider who is experienced treating children, and one who has access to your child’s medical records. Urgent care is also often cheaper, and may mean less of a wait.

  • Elana Pearl Ben-Joseph. “Is It a Medical Emergency?” Kids Health. The Nemours Foundation, April 2013. Web.
  • “Urgent Care Versus the ER: A Pediatrician Offers Tips on Making the Right Choice.” Hopkins Medicine. The Johns Hopkins University, The Johns Hopkins Hospital, and The Johns Hopkins Health Center. Web.
  • “When to use the emergency room – child.” Medline Plus. U.S. National Library of Medicine, November 20 2014. Web.

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