You are the best person to evaluate the state your child is in. You know how he usually is so you can easily see some signals that can reveal that something is wrong. For example, the body temperature can vary a little bit (between 36.5 °C and 37.5 °C) depending on people and if a child can be feverish at 38°C, another will have no symptoms.
Nevertheless, in paediatrics, three cases out of four treated in the emergency room are not truly urgent. “The results reveal that more than 70% of the respondents consult either a paediatrician or a family doctor but 16% of them find it difficult to have an appointment. They then go one time out of two to Sainte-Justine hospital or, in 29% of the cases, in a clinic”, it is said in an article published in April 2003.
With the influenza A (H1N1) wave, visits multiplied so much that hospitals had to repeatedly issue notices reminding them to stay away from the emergency room if their children presented normal flu-like symptoms. Yet, nothing seems to be enough to change the parents minds, even the latency. The idea that a paediatrician, “THE specialist in childhood diseases”, will see their child is more important to them. According to Dr Sylvie Bergeron: “It is essential to develop parental confidence in family doctors who are in a better position to offer support and advice in many paediatric cases”.
Emergency
Do you have an emergency kit at home to provide first aid should an incident occur?
Fill out a form with all the emergency contact numbers and keep it within easy reach, next to the phone or on the refrigerator.
Would you know what to do in an emergency?
By social concern and also to avoid clogging the emergency rooms, it is preferable to consult your family doctor, a walk-in clinic or a CLSC in your area to seek medical advice and possibly receive treatment for these common conditions:
- Contagious diseases
- Colds or flu
- Ear infections
- Eczema or skin problems
- Cough
- Sore throat, tonsillitis and pharyngitis
- Bronchiolitis
- Upper respiratory tract infections (URTI)
- Gastroenteritis,
- Diarrhea.
Some signals should not be overlooked
- Skin paler than usual.
- Heavy breathing, breathing sounds.
- Your child is half-asleep and unusually lethargic. He can also be clingy.
- Your child answers poorly or oddly to your questions. You notice slurred speech.
- Your child does not respond as usual to certain stimuli (visual or auditory) or he finds it hard to pick up things that he usually picks up easily.
- You child is not hydrated (has little saliva, no tears and urinates less often)
Be prepared!
On arrival, the emergency staff will ask you a few questions and you must be able to explain why your child is not his usual self.
You must tell the nurses if your child is on medication, the doses he took and when he took them.
If you have his vaccination records, you will not have to try to remember the last vaccines he received.
Tell the staff if your child is allergic to anything, what he recently had to eat or drink, everything you noted about his state. Tell them everything that they should know quickly.
Cuts - Bites
On a deep wound that bleeds abundantly, wash the wound, use a pressure bandage and call your doctor. Call a health line to find out if you should see a doctor for an examination or for stitches, butterfly bandages or tissue adhesive to heal the wound.
If an animal has bitten your child, wash the wound under running water, and soap for several minutes. Rinse and cover the wound with a dry bandage if it’s bleeding; otherwise leave it uncovered. Most bites don’t break the skin. Teeth marks and bruises aren’t considered broken skin. If the skin is broken, you should go to the nearest clinic to find out if your child should receive a vaccine.
Fall
A baby less than a year old falling off the changing table or the bed is always a looming threat to parents. Even if he seems in good shape, it is better to take your baby to see a doctor where he will make sure that his neck and his head are not wounded. If your child is older, assess his condition and watch him over to see if he is half-asleep, if he vomits or if he is overly tired. In any of these situations, it is important to see a doctor.
Electric shocks
Even if no burns are visible on the skin, it is impossible to know if the electricity caused a serious internal burn. Call 911 to find out what to do and who to see.
Car accident
Whatever the force of impact, a doctor should always see you and your children.
Mouth wound
Be cautious! Don’t panic too quickly because there can be a lot of blood when the mouth was hit. It often takes a bit longer to heal because the mouth is wet and moving. On the other hand, if the palate is hurt, go to the emergency room.
Injury to the teeth
A baby tooth that falls or that is broken or shifted requires care. If you can’t see a dentist, call a doctor or go to the emergency room. The guide “From tiny tot to toddler” suggests keeping the fallen tooth in cold milk until you find a specialist.
A small object in the nose
If you can’t remove the object, you will have to go to the emergency room. Be careful! If you try to remove the object, you can push it further into his nose. If your baby is less than 18 months old, you shouldn’t try to remove the object because your baby can’t keep his head still.
Burn
From hot liquid or from fire, don’t remove the clothing, get the burn into cold water and go to the emergency room!
Choking
If your baby chokes, cannot cough and cannot breathe, call 911 immediately.
Insect bites
Allergic reactions to insect bites can affect a person at any age. If, after a bite, you notice an extending swelling or if your child has difficulty breathing, call 911.
Poisoning
If you find your child unconscious next to medication, quickly call for help. If your child swallowed a hazardous product (or if you suspect him) or if he took medication, quickly call the poison center or 911 and they will transfer you. Don’t make your child vomit and don’t give him anything to drink unless a specialist recommends it.
Drowning
If you saved someone from drowning or if you see someone in danger (in a lake, in the sea or in any other water), call 911. If you know the Cardiopulmonary resuscitation (CPR) technique, administer it.
Contagious diseases
Contagious diseases rarely require a visit to the emergency room. Call your health professional or visit a family doctor first.
Allergies
In case of an important allergic reaction affecting breathing, call 911.
Unconsciousness - fainting
A sudden pallor, excessive sweating, dizziness or nausea may precede a loss of consciousness. The St-John Ambulance says, “The cause may be as simple as a lack of fresh air or as complex as an underlying medical condition”. They suggest checking the breathing and the pulse, placing the person on his side and patting him gently to see if he reacts. If you see no reaction, call 911.
Asthma crisis
If the symptoms of asthma become so important (excessive difficulty breathing, blue lips, difficulty to walk or talk, whistling breathing at rest, drowsiness, etc.) an emergency treatment is necessary.
Gastroenteritis
Note the signs of dehydration mentioned in the “From tiny tot to toddler” guide.
- Drowsiness;
- Dry mouth, thirst;
- Sunken eyes;
- Sunken fontanel;
- Urinating very little;
See a doctor.
What about the fever?
The Montreal Children’s Hospital clearly states that fever is “not necessarily harmful, nor is it always evidence of an illness”. Being attentive to changes in the child’s general behaviour is the best way to assess his condition.
Because fever is usually the only symptoms of a sick child less than 6 months old, it is better to see a doctor. Except if your child has spectacular temperature rises or a fever that cannot be controlled by analgesics such as acetaminophen (Tylenol or Tempra) or ibuprofen (Motrin or Advil), there is no need to go to the emergency. A doctor should see a child whose temperature lasts for more than three days regardless of age.
WARNING! Do not give aspirin (acetylsalicylic acid) in case of fever!
Go to the emergency room if, in addition to fever, your child ...
- Is drowsy, lethargic, irritable or cranky;
- Has difficulty breathing or a suspicious cough;
- Is over 39°C (102°F).
Useful links
Sources : From tiny tot to toddler, CLSC, Montreal’s Children Hospital
