When should I take my kid to the ER? The experts at CHI have the answers

Wondering if that high fever warrants a visit to the ER? The experts at CHI give the lowdown...

When your precious little bub is in pain, it’s tough not to panic. Whether it’s because of a high fever or a deep cut, our first instinct (especially as first-time parents) is to reach for our phone and call our trusty family doctor or rush our kid to the emergency room (ER). That’s why it’s important to know the difference between a true emergency or an illness or injury that could easily be treated at home or by a GP. Lucky for us, the good folks over at CHI have put together a handy guide to help us make that all-important decision:

What are the symptoms that can be handled by a GP?

A GP or family doctor is trained to handle a wide range of common outpatient symptoms. In fact, most GPs are adept at dealing with a few minor emergencies as well, such as small cuts requiring a few stitches or tissue glue application. If your kid is alert and active, is still able retain food or fluids, and his or her ailment does not fall within the lists of warning signs/emergency conditions below, he can most likely see a GP. Some of these minor conditions include:

• A fever
• A cold or cough
• A sore throat
• Ear pain
• Vomiting and/or diarrhoea
• Mild abdominal pain or colic
• Constipation
• Headache
• Mild dehydration
• Rashes and skin problems
• Mild wheezing
• Sprains or strains
• Minor bumps, cuts and scrapes

CHI’s well-baby clinic has paediatric doctors and nurses with a midwifery background to support you and your baby in your journey of parenthood.

What are the warning signs we should look out for?

Look out for these signs and take your child to the ER early if there is:

• Fever in an infant less than three months old
• A bulging or sunken fontanelle (soft spot) in infants
• Severe vomiting with an inability to retain fluids; vomiting blood or greenish vomit
• Severe diarrhoea, blood in stools or black foul-smelling stools
• Signs of significant dehydration, such as dry cracked lips; a dry tongue/mouth and/or decreased urination
• Sudden problems with movement or sensation, especially after an injury
• Significant or worsening pain
• A possibility that he has taken an unknown amount of medication or poisonous substance (even if he currently looks well)
• Eye injury or object(s) in the eye
• Trapped object(s) in the ear or nose
• Swallowed or inhaled object(s)
• Sudden change or blurring of vision
• A serious burn
• A gaping wound

When should we call 995?

If a rare life-threatening situation does occur, you’ll need the help of trained paramedics to ensure that the emergency is taken care of on the way to the hospital. Call 995 immediately if your child has:

• Major trauma (eg. Drowning, fall from height or road traffic accident)
• Injury to the neck or spine
• No signs of breathing
• Breathlessness or uncontrolled noisy breathing
• Is unconscious and unable to rouse (eg. After head injury)
• Is unusually limp or weak
• Drowsiness, confusion or disorientation
• Intolerable pain (eg. Abdomen, head)
• Fever with a purplish rash and/or neck stiffness
• Pale, blotchy, blue or grey skin
• A fast or irregular heartbeat
• A seizure/fit
• Choking
• Serious allergic reaction with swelling of the face, lips and eyes
• A broken bone (fracture) that sticks out through the skin
• Taken an unknown amount of medication or poisonous substance, and is now hard to rouse
• Profuse bleeding from a large wound that is not stopping with direct pressure after 15 minutes

Do you have any advice for common conditions that could lead to a trip to the ER?

Fever

Go straight to the ER if your infant is less than 3 months old – at this age, a fever may be the only sign of a serious infection. Otherwise, most children will still appear well even with a high fever. Do not focus on what the thermometer says but rather on your child’s appearance and how he or she is acting. How high your child’s temperature is does not correspond to the severity of the underlying illness. Try giving fever medication such as paracetamol or ibuprofen, encourage them to drink plenty of fluids and dress them in light clothing. See your family doctor if the fever lasts longer than three days or if there are accompanying symptoms such as sore throat, earache, vomiting, diarrhoea or painful urination.

Head injury

Bumps and bruises on the head are extremely frequent in children under four years old and are one of the most common reasons for ER visits. Most are minor with no long-lasting effects. However, go to the ER if there is loss of consciousness (regardless of duration), amnesia, severe headache, persistent vomiting, balance problems, blurred vision, worsening dizziness, a seizure, drowsiness or confusion. Also check for bruising under the eyes or ears, fluid or blood from the ears or nose. Otherwise, once your child stops crying, you can place an ice pack wrapped in a cloth over your child’s bump and monitor your child closely over the next 48-72 hours for any new symptoms.

Instead of panicking, we should take a deep breath, relax and focus on managing the situation. Although it’s easier said than done, it’s definitely faster (and less expensive) than rushing to the ER for every little emergency. But listen to your instincts; bring bub to see your family doctor for peace of mind. And don’t worry – with time, you’ll be a pro at dealing with your child’s health problems. You’ve got this!

Need more health advice for bub? Check out our website for more information.