Five Signs Your Child May Need to Visit the Emergency Department

As an Emergency Department (ED) physician, I know that a trip to the ED is something that all parents dread. It can mean long waits and you may question whether or not an injury or illness warrants an ED visit.

Below are five of the most common issues we see in South Shore Hospital’s ED and some guidance about how to determine when a trip to the ED is warranted, or if it can wait for an appointment with your child’s pediatrician.

1. Accidents and Injuries at Home 
   Some of the most common injuries we see happen at home are a result of kids falling or running into objects (like hitting their head on a piece of furniture). When it comes to head or neck injuries, it's always better to be safe than sorry. Kids' brains are still developing, so a head injury can have a lasting effect on cognitive development.
   
   If your child has lost consciousness—even for a very short time—isn't walking or talking normally, is having a hard time waking up, or vomits repeatedly after a head injury, it’s time to seek immediate medical attention.
   
   When is it time for stitches? If your child slips, trips, or otherwise manages to draw blood, note the depth of the wound and whether it's bleeding heavily. A laceration caused by an animal bite should always be examined by a doctor due to the risk of infection.
    
2. Fevers
   Fever is another top reason for ED visits for kids ages 15 and under. So when is a fever cause for alarm? For a newborn, a rectal temperature of 100.4 degrees Fahrenheit or higher, and for babies 3 to 24 months old, the critical number is 102.2 degrees Fahrenheit. Watch for signs of dehydration, like sunken eyes, dry lips and mouth, and a lack of urine. If you can’t get into your pediatrician quickly, it’s worth a trip to the ED.
    
3. Upper Respiratory Infections
   Upper respiratory infections (involving the throat, nose or trachea) are frequently seen by doctors in our pediatric emergency department. Respiratory problems can be severe and cause breathing difficulties, or they can be connected to a case of the common cold that is taking too long to clear or is making a child unusually uncomfortable.
   
   So when is it time to worry about a cough? Listen for a whooping or raspy sound when your child inhales or a high-pitched, whistling sound when they exhale. In addition, if your child is having trouble breathing or swallowing, is vomiting, or has a high fever, seek emergency care.
    
4. Digestive and abdominal complaints
   Vomiting, diarrhea or severe stomach pains can be very concerning and it may be hard to determine if it’s a stomach ache or something more severe, such as appendicitis. If your child is old enough to talk, have him describe the abdominal pain. Ask your child to point to where it hurts. Does it hurt more when you press it or when you take your hand away? Watch for abdominal pain that starts at the belly button then moves toward the lower right side of the stomach, that’s a key symptom of appendicitis which warrants an immediate trip to the ED.
    
5. Fainting or Passing Out (Syncope)
   Syncope is a medical term used to describe a temporary loss of consciousness due to the sudden decline of blood flow the brain. In layman’s terms, syncope is commonly called fainting or passing out. If your child suddenly passes out, an ED visit is worth the trip. Each child may experience symptoms of syncope differently and because symptoms of syncope may resemble other conditions or medical problems, it is important to consult with a health care provider for a diagnosis.

Pediatric Emergency Services
Did you know that South Shore Hospital has a pediatric emergency department that is staffed by board-certified pediatric emergency physicians affiliated with both South Shore Hospital and Boston Children’s Physicians Weymouth? Learn more about our pediatric emergency care by visiting our website.