HEALTH MATTERS: Pediatric emergencies: What to do, where to go

By Alicia Brennan, M.D. Special to The Packet
    Seconds count when dealing with pediatric emergencies, but how do you determine what warrants a trip to the emergency department and what can be handled with a call to your pediatrician?
    The American Academy of Pediatrics explains that an emergency is when you believe a severe injury or illness is threatening your child’s health or may cause permanent harm. If this is the case, your child needs emergency treatment right away.
    At University Medical Center at Princeton, children receive special care from board-certified emergency physicians, as well as pediatricians from The Children’s Hospital of Pennsylvania (CHOP).
    If your child requires emergency care, you can turn to UMCP’s expert, board certified emergency physicians, as well as pediatricians from The Children’s Hospital of Philadelphia (CHOP), who are on-site 24/7 to provide consultation whenever it is needed or requested.
    In most cases, children do not become seriously ill without any warning. Knowing your child and recognizing when something is not quite right, is critical to knowing when to take action.
When to Seek Help.
Fever. While most fevers don’t require emergency care, there are times when a fever could indicate a more serious, rapidly deteriorating situation. Seek immediate care if your child is younger than 2 months old with a fever of 100.5 degrees or higher.
    Additionally, head to the emergency department if your child has a high fever and one or more of the following symptoms:
    • Is unresponsive/ difficult to waken; confused.
    • Is limp and excessively weak.
    • Has a stiff neck.
    • Has difficulty breathing.
    • Has a rash with purple spots. /
    Call your pediatrician if your child has a high fever for more than three days.
Asthma Attack. Asthma is a potentially fatal illness and a severe attack that requires emergency care can come on quickly. Signs that an asthmatic child may need emergency attention include:
    • A flare up requiring medication more than once every four hours, or that is not relieved after a few treatments.
    • Not being able to speak in full sentences.
    • Noticeable contracting of the chest, ribs or belly when breathing.
    • Unusual anxiety or restlessness.
    • Change in skin color.
    • Increased pulse.
    • Sweating.
    • Decreased levels of alertness.
Poisoning. Poisoning is one of the most common childhood injuries, especially among children between eight months and six years old, according to the American Association of Poison Control Centers. If you think your child has swallowed something poisonous — including medication — call the Poison Control Center immediately at 800-222-1222.
Sudden Injuries. Bicycle accidents, falls, and near- drownings are just a few of the many pediatric emergencies involving sudden injuries. Call 9-1-1 if your child shows any of the following symptoms:
    • Any loss of consciousness, confusion, headache or vomiting after a head injury.
    • Bleeding that does not stop after applying pressure for five minutes.
    • A cut that is large, deep or involves the head, chest or abdomen.
    • A burn that is large and/or involves the hands, feet, groin, chest or face.
In Case of Emergency.
    Knowing how to react in an emergency is critical. The American Academy of Pediatrics offers these guidelines:
    • Stay calm.
    • Start rescue breathing or CPR if your child is not breathing.
    • Call 9-1-1 if you need immediate help. Most cell phones can reach 911, but be prepared to tell the operator where you are.
    • Apply continuous pressure with a clean cloth to any site that is bleeding.
    • Place your child on the floor with their head and body turned to the side if they are having a seizure. Do not put anything in their mouth.
    • Do not move your injured child unless they are in immediate danger.
    • Stay with your child until help arrives.
    Remember to bring any medication your child is taking with you to the hospital. Also bring any suspected poisons or other medications your child may have taken. Make sure you tell the emergency staff at the hospital the name of your child’s pediatrician.
    Moreover, every parent — and anyone caring for your child — should be prepared for an emergency. Keep emergency phone numbers posted near your phone and program them into your cell phone. Additionally, learn CPR and basic first aid.
    No one knows your child better than you. If you notice your child is exhibiting signs and symptoms that are unusual and cause for alarm, contact your pediatrician and don’t hesitate to seek emergency care.
Find Out More.
    Find out more about what to do and where to go when your child is having an emergency during my live Web- chat hosted by Princeton HealthCare System on Thursday, April 14, at 7 p.m. To participate, simply go to the UStream Channel at www.ustream.tv/channel/ princetonhealth. To pre-register visit www.princetonhcs.org or call 888-897-8979. Basic computer requirements for the chat are a PC or Mac with Adobe Flash Player installed and a broadband Internet connection.
For more information about CHOP Newborn and Pediatric Care at UMCP visit www.umcpchop.org. To find a pediatrician with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Alicia Brennan, M.D., is Medical Director of the Children’s Hospital of Philadelphia Pediatric Care at University Medical Center at Princeton.