Should I Take My Child to the ED or Urgent Care?

Author

Richard A. Kauff, MD

What should you do and who should you call when when your child is sick or injured? This is a question faced every day by parents. Do I call the pediatrician? Do I bring my child to an urgent care facility? Should I go directly to the Emergency Department (ED) or call 911?

First of all, trust your instincts as a parent. If your child has what you think may be a life-threatening condition, then the ED is the place to be.

Examples include:

  1. Head trauma with more than very brief loss of consciousness
     
  2. A seizure (with or without a fever)
     
  3. A systemic allergic reaction, sometimes with generalized swelling, difficulty breathing or swallowing, or change in speech
     
  4. An obvious broken bone with a deformity
     
  5. Severe difficulty breathing
     
  6. Marked change in mental status, such as garbled speech, sudden confusion, or significant change in personality
     
  7. Severe bleeding from a very large or deep wound
     
  8. Anything else you feel is immediately life-threatening

For most, if not all, of the above a call to 911 is warranted. Remember, we have great emergency response teams and ambulances in our region, and they are there to help in these circumstances.

For most other problems it almost always makes sense to call your pediatrician’s office. It is so important to establish care in advance with a pediatric or family practice office you can trust, not just for the all-important primary care and immunizations, but so you have someone to call if your child is hurt or ill. Every pediatric office has trained staff to answer your call, give advice, and schedule an appointment. Often, this advice can ease your mind and save you a visit.

Most offices have extended hours to handle the great majority of urgent needs. Some primary care offices—like South Shore Medical Center where I practice—have full x-ray and lab capabilities and extended hours, so they are able to handle a lot of problems that you might have thought needed ED care. Then your child can be cared for at a facility by providers who know you and your child, can view the full electronic medical record, and, if needed, can keep in touch with you after the visit to make sure everything turns out well.

Sometimes parents may still choose the convenience of a pharmacy-based or free-standing urgent care site. These can be reasonable alternatives for simple problems like earaches, sore throats, and colds. It's important that you are aware that these facilities are often limited in their lab and x-ray capabilities. Also, the documentation of what is done is not automatically included in your child’s ongoing medical record. Most importantly, there is no guarantee that you will see a provider specially trained in the care of children, as you would at your primary care pediatric or family practice office.

In closing I want to bring back the same sentiment I expressed earlier in this blog because it’s so important: trust your instincts and also have trust in your choice of a pediatric practice.

Dr. Richard Kauff is a pediatrician at South Shore Medical Center. He sees patients in our Norwell and Kingston offices. Learn more about him and other South Shore Medical Center pediatricians who are accepting new patients. If you’d like to register yourself or a family member as a new patient, call 781-681-1686 or request a call from a new patient registration specialist.