When to Take a Child to the ER
By Sydney Sallabanks

Having to make a snap judgment on whether or not to rush a child to the emergency room can be a parent’s worst panicky moment. Every child gets sick or hurt, but picking the best course of care can be a quandary for parents. They can choose to handle the situation alone, call a pediatrician or family practitioner, go to an urgent care facility or emergency room, or call 911.

Determining which level of care requires an assessment of the situation. “Clearly there are certain situations that are best handled at the ER, yet some people do go there with non-emergencies,” say Michael Minas, MD, Board Certified in Family Medicine, of River Medical Family Medicine in Eagle.

Nationwide, the most common reasons for ER visits are chest pain, abdominal pain, and fever. With children, parents are more often concerned about fever. Minas recommends immediate care for an infant under three months old who has a fever of 104 degrees or higher or for a three-  to six-month-old with a fever over 100 degrees. If an older child has a fever, assess additional symptoms such as abdominal pain, vomiting, or dehydration. “We see a lot of sick kids when flu season hits the Valley,” says Minas. “It’s better that they are seen early to help avoid more serious complications later on.”

The nationwide trend of increased ER visits is partly due to insurance, explains Minas, “Many people are braving it alone without health insurance.” Further, others are not established with a primary care physician. When a health crisis arises, these people don’t have the option of first calling their family doctor. “Not having a primary care physician can be a real barrier,” says Minas, who recommends that each family member be established with a physician before a health crisis hits. “Primary care physicians are there to help orchestrate and manage your care. They advocate for you in the realm of medicine. They know your history and where to refer you.” Typically your child’s physician will be able to advise you what to do in a situation of concern.

Minas says the there’s a nationwide push toward “open access” in family medicine. His practice and many others in the Treasure Valley schedule open blocks of time during the day so that patients can come in on a same-day basis.  They can bypass a trip to urgent care or the ER. “This helps free up the ER and results in enormous cost savings,” explains Minas.

Urgent care facilities are also good options when a child has an issue that is not life-threatening, yet needs medical care the same day. They often have extended hours and are open on evenings and weekends. “The access can be good and quick,” says Minas.  “They can take care of a sinus infection, sore throat, even a broken arm. But for something such as a head trauma or open fracture, you need the ER.”

If you have a concern about your child’s health, don’t go it alone, call your doctor, advises Minas. “Always err on the side of caution.”

When to Go to the ER
Take your child or infant to the emergency room if he or she has:

•  Difficulty breathing or shortness of breath

•  A change in mental status

•  A deep cut or wound that won’t stop bleeding

•  A stiff neck with fever

•  Ingested a poisonous or toxic substance or too much medicine

•  A rapid heart beat

•   Severe bleeding or head trauma

•   Coughing or vomiting blood/blood in stool

•   Persistent or severe pain

•   Limited mobility or limping

•   Fractures/bone injury

•    A severe allergic reaction

•    Chest pain

•    Severe dehydration

•    A seizure

•    A loss of consciousness

•    Electrical injury

•    A serious burn

Sydney Sallabanks works in media relations for the University of Idaho, and lives with her family in Eagle.