By Holly Owens, M.D., and Ramana Jones, M.D.
Spring brings many things besides flowers and showers. When the weather warms up, kids ride bikes, start new sports, and bid adieu to the flu. Spring also signals a rebirth of sorts–plants flower, trees bloom, bunnies take over as Easter nears. But that doesn’t mean we should be in a rush to welcome all that’s new and fresh.
Childhood illness and injury, infants born too soon—here’s how to determine what can and can’t wait: whether you can ride it out at home or should ride the road to an emergency room.
Holly Owens, M.D., Pediatric Emergency Medicine
When illness or injury strikes, it can be hard to know what to do. If you’re ER-bound, consider a pediatric emergency department. Children are not mini-versions of adults – they don’t get the same diseases and their bodies don’t react the same way to illness, injury or medications.
Breaks, Sprains and Strains
Whether sports-related or play-associated, swelling and pain can be the result of a break, sprain or strain. A pediatric ER has the necessary equipment for a physician to make the correct diagnosis, provide short-term treatment and, if necessary, refer the child to a pediatric orthopedist.
If there is a loss of consciousness or bleeding, head to the ER immediately. If you choose to stay home, watch closely for confusion, memory loss, nausea, blurred vision, balance problems and slurred speech—these symptoms may appear over 24-48 hours and range from mild to severe, but definitely warrant a pediatrician’s attention.
Cuts, Scrapes and Scratches
Excessive bleeding and gaping skin are pretty good indicators that stitches are in order, so this isn’t the time to ride it out. Surface cuts can be treated at home with a good washing, OTC antibiotic cream and bandages. Watch for infection over the next couple of days and, if you’re concerned, follow up with your pediatrician.
Fever and Vomiting
A lot of people bring their kids to the ER because of fever or vomiting. If a child is less than two months old and has a fever of 100.4 or higher, that is an emergency. For older children, the number on the thermometer isn’t as important as their demeanor—if they’re lethargic or listless it’s an emergency. If they’re drinking well and playing a little, they’re probably fine. You can treat the fever at home with OTC meds, or try to ride it out until he or she can be seen by the regular pediatrician.
Kids vomit for many reasons, but if it’s so much that they can’t hold down fluids, even a sip, that’s an emergency. Children become dehydrated quickly and will need to be treated with medication and IV fluids. Signs of dehydration include dry mouth, sunken eyes, crying without tears and decreased urination.
Breathing problems are almost always an emergency. It wasn’t a very harsh winter, which means asthma is going to be a big player this spring. Wheezing, coughing, shortness of breath and tightening of the chest should be assessed by an emergency room pediatrician.
Holly Owens, M.D., sees pediatric patients at Children’s Memorial Hermann Memorial City in the newly expanded pediatric ER, now open 24/7, 365 days a year.
Ramana Jones, M.D., Laborist
A healthy pregnancy lasts approximately 40 weeks, but there are several things that can compromise what is supposed to be a happy time. When something goes wrong, we need to care for both mother and baby, which is why top-notch pregnancy care should include emergency access to obstetricians 24-7.
Labor that begins before 37 weeks is considered pre-term and requires immediate medical attention. Recognizing early labor is critical to stopping it.
Head to the OB ER if experiencing:
- abdominal cramping
- regular contractions, at least six to eight within one hour
- increase or change in vaginal discharge
- constant, dull low backache
- pelvic or lower abdominal pressure
- rupture of membranes
What to expect when you get there:
- physical examination
- monitoring of the fetus and uterus
- possible ultrasound
- lab analysis as needed
If pre-term labor is confirmed, treatment begins. There are several medications that will relax the uterus and decrease the frequency of contractions, but they will not guarantee a full-term delivery. These meds basically buy time to allow for additional medications that will improve fetal lung maturity should pre-term delivery occur.
It’s still a medical mystery as to what causes a woman to go into labor when she’s full term, never mind pre-term. But if moms learn to recognize the symptoms and doctors provide immediate, specialized care, babies have a fighting chance.
Ramana Jones, M.D., and her colleagues in the new OB ER at Women’s Memorial Hermann Memorial City see pregnant moms 24/7, 365 days a year.