Going to the Emergency Room

Finding the Right ER at the Right Time

In certain situations, you should dial 911 to get an ambulance instead of taking your child to the ER yourself. Call 911 if:

• Your child is having trouble breathing and is turning blue.
• There has been a car accident and your child is unconscious or seriously injured. 
• Your child is having a seizure that lasts 3-5 minutes, is having difficulty breathing, or is turning blue.
• Your child loses consciousness or is not responsive.
• Your child might have a neck or spine injury.
• Your child has a head injury with a loss of consciousness, persistent vomiting, or is not responding normally.
• Your child has significant uncontrolled bleeding.
• Your child has a possible poisoning and is not responding normally or having difficulty breathing. In any possible poisoning, call the Poison Control Center (1-800-222-1222) for expert advice and they may direct you to the ER.

Planning Ahead

Talk with your doctor about what to do — and which ER to go to — before you're in a situation where you might need to visit one. The doctor may direct you to an ER that's close to you or one in a hospital where he or she regularly sees patients.

Should your child go to an ER at a children's hospital? Because they're dedicated to caring for kids, children's hospitals probably have the most pediatric staff, specialists, and facilities. So if it's an emergency and a children's hospital is conveniently located, consider going there.

Otherwise, the community hospital nearest you will provide the medical care needed. If for any reason the hospital isn't equipped to treat your child's specific condition, the doctors there will arrange a transfer to a facility that is.

Preparing to Go to the ER

When you go to the ER, it's important to have a good handle on your child's symptoms. It's also important to know your child's medical history — allergies, past illnesses, injuries, surgeries, immunization history, or chronic conditions.

Even if you know the medical history by heart, consider writing it down so it's handy during the chaos of an emergency. And keeping a written record readily available at home will let anyone caring for your child — such as a babysitter — provide it should your child be taken to the ER.

To prepare a medical history, include:

• medications your child is taking
• allergies
• history of previous hospitalizations
• any previous surgeries
• illnesses
• relevant family history
• immunization history

You also might be asked when your child last had anything to eat or drink. You should know the name and number of your child's primary care provider. And it's good to know the name and number of the pharmacy where you usually get your prescriptions filled.

If you go to the ER because your child has ingested a particular medication or household product, bring the container of whatever was ingested. That will help the doctors understand what kind of treatment is required. If your child has swallowed an object, bring an example of that object, if possible.

At any ER, except in the most serious emergencies, be prepared to wait. If you have time before you leave the emergency room, consider bringing something to do while you wait, such as a book, magazines, or bills to pay. You may also want to bring pen and paper to write down any questions you have for the doctor. If your child is not too ill, bring things for him or her to do as well, such as crayons, books, toys, and comforting objects, like stuffed animals.

If you think there's a chance that your child might have to be admitted to the hospital, you may want to grab a change of clothes and toothbrushes for you and your child.

Most ERs have some translation services or someone who can help translate. If you do not speak English fluently, consider bringing along a family member or friend who can help you translate.

What to Expect at the ER

There's no way to predict how long you'll have to wait to be seen at the ER. If your child has a severe medical problem, be assured that the doctors will provide whatever attention is needed right away.

Because doctors attend to the most severe injuries and illnesses first, there's a good chance that if you are there with a minor injury, you'll have to wait longer. Even if the waiting room is empty, you still may have to wait if the exam rooms are filled or many doctors and nurses are attending to a particularly serious case.

If your child's condition becomes worse while you are waiting to see a doctor, tell the medical staff.

Before offering any food or drink to your child, make sure to ask the medical staff if it is OK. In some situations, your doctor would prefer your child has nothing to eat or drink.

While you wait, there's a chance that you — and your child — may see some very sick and injured people come into the ER. The sights and sounds of those who are seriously hurt or sick can be frightening. So assure your child that the ER is the best place for the hurt people to be and that this is where the doctors can help them feel better. You might even give an example of a time when someone you know was injured and, as scary as it was at the time, all was fine after the doctor's care.

Soon after arriving at the ER, your child probably will be seen by a nurse, who will ask about symptoms, check vital signs, and make a quick assessment. This evaluation, also called triage, will prioritize your child's medical needs based on the severity of his or her condition.

You'll also go through a registration process where you'll be asked to sign consent for treatment forms. And if you have health insurance, be sure to have your member card with you.

When you're in the ER, try to write down important information that you hear. It's scary and stressful when your child is in the ER, so it can be hard to remember details you may need later, such as:

• the names of the doctors
• what they say about the illness or injury
• any medications or treatment they give your child
• any directions for follow-up or care at home

If your child is being discharged, make sure you understand the home care instructions and ask questions if you don't.

A specialist might not be on-site if you go to the ER on the weekend or at night, but if the problem requires it, one will be called in. If it requires surgery, a surgeon will be contacted.

Some hospitals even have a child life specialist. They can help children cope with the stress of being in the ER, help prepare them for procedures, and provide them with non-pharmacological pain management techniques even at very young ages.

In many cases, the doctor who treats your child in the ER will contact your primary care doctor afterward. If your child is admitted to the hospital, the emergency room doctor will let your doctor know.

Some ERs provide written or computer-generated documentation of the visit and others dictate and fax the report to the primary care doctor. Carry a copy of the papers you receive when your child is discharged to share with your doctor.

Reviewed by: Yamini Durani, MD
Date reviewed: May 2011