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A pediatric ER doctor explains: Symptoms you shouldn’t ignore
September 05, 2023
Girl with cast on her arm talks to nurse in CHoR emergency department

    Symptoms you shouldn’t ignore

    Injuries and illnesses happen. But how do you know what requires a trip to the emergency room and what can be healed with some TLC at home? Dr. Rashida Woods, pediatric emergency medicine physician, explains when immediate medical attention is important.

    A child should go to the emergency room in these circumstances

    • Broken bones

    It’s not always easy to tell if a bone is broken. Signs of a broken bone include pain, swelling or redness, an usual shape or deformity at the spot of the injury, or inability to bear weight on or use the extremity (arm or leg). If there’s any concern that a bone is broken, have it assessed as soon as possible. Though not common, a bone will sometimes break through the skin. This is called an open or compound fracture and requires immediate medical attention to avoid infection.

    • Difficulty breathing

    If your child is breathing heavily to the point you can see their ribs, is breathing more quickly than normal, or has a blue color around their lips or face, they should be seen by a medical professional. Wheezing, gasping and flaring nostrils are also indications that a child is struggling to get enough oxygen. If you think your child is having an asthma attack or acute allergic reaction with difficulty breathing, go to the emergency room right away.

    • Head trauma

    An injury involving the head can be scary. A child who is otherwise healthy, doesn't lose consciousness, and is feeling and acting normally has probably just experienced a minor bump. It’s still important to keep a close eye on them for 24-48 hours. If they’re showing any signs of concussion, they should see a doctor. These signs include headache, nausea, vomiting, dizziness, balance problems, vision problems, sensitivity to light or noise, feeling foggy or groggy, appearing dazed and answering questions slowly, among others. A child exhibiting any of these symptoms immediately after injury should be seen by a health care professional right away. 

    • Lacerations or deep cuts to the skin

    Many cuts can be cared for at home by cleaning well, patting dry and applying antibiotic ointment. Wounds that are deeper or longer than ½ inch, have ragged or gaping edges, are caused by a dirty object or animal bite, are located close to the eye or over a joint (like a knee or elbow), or will not stop bleeding with light pressure should be addressed by a health care provider. It’s best to have them cleaned and stitched as quickly as possible for optimal healing.

    • Persistent high fever

    A fever is a sign the body is fighting infection and in general isn’t cause for alarm, especially if your child is still eating, drinking and acting normally. A fever higher than 100.4F rectally in infants younger than 3 months, or higher than 102.2F rectally for more than three days in children older than 3 months warrants medical evaluation. You’ll also want to seek medical care if your child’s fever is accompanied by severe headache, neck pain or abdominal pain, or if they’re lethargic or not able to keep fluids down.

    • Severe dehydration associated with persistent vomiting or diarrhea

    Babies and children are more susceptible to dehydration than adults. If your child is experiencing vomiting or diarrhea, keep an eye out for signs of dehydration including peeing less or having fewer wet diapers than usual, few or no tears when crying, sunken eyes, dry mouth, drowsiness or crankiness. Babies should continue to drink breastmilk or formula and children should have small sips of water or rehydration solution, such as Pedialyte. Seek medical attention if they’re not able to keep this down or their symptoms aren’t getting better.

    • Unrelenting abdominal or stomach pain

    The most common reason for tummy discomfort in kids is constipation, but lots of things can cause stomach pain. Seek medical care if the pain is in the lower right side of the abdomen, the pain radiates to the back or groin, the pain is accompanied by excessive vomiting or fever, they’re severely bloated or there is blood in the stool. Abdominal pain that is so severe they don’t want to move is another reason for a visit to the emergency room.

    Your family’s pediatrician is an excellent resource

    If the situation isn’t urgent, you can call your pediatrician for guidance. They’ll ask questions and determine if they can provide care in their office or if a trip to the ER is needed.

    Signs of some health conditions will appear over time. If you notice changes in sleep, appetite, weight, bathroom habits, etc., mention it to the pediatrician so they can keep a close eye on it and provide treatment if needed.

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