Wednesday, December 28, 2011

::kids tips from the ER::

My son Max in January 2010, age two. 

I am still loving working the ER.  Its wonderful.  As the only nurse that likes peds in a mostly adult oriented unit, I take care of lots of the kids that come in.  The hospital I work at is not a pediatric hospital, but people bring their kids in all the time.  One of the biggest issues I run into is parents who do not understand illness in their children.  Here are a few little tips about some of the most common educational needs I see -

Fever - kids get fevers.  If your child is under age one any fever is something that your pediatrician (NOT A DR IN AN ER) needs to know about.  Your pediatrician knows your child and knows you.  They will advise you as to if you should go to an ER, urgent care, or treat your child at home.  If your child is over one, then you need to treat your childs fever and understand that fevers are part of life.  Treatment can include Tylenol and/or Motrin to get the fever under control.  Alternate between them to get the best coverage.  Call your pediatrician for exact dosing and timing.  Don't bring me your kid that you have not given an medicine to in 6 hours, because the first thing I am going to do is give them some and send you home.  But the process will take three hours plus and your insurance is going to be mad.  Don't forget less aggressive fever treatments in addition to medicine, such as luke warm (not cold) wet wash cloths on the chest, forehead, and arms.  Change those cloths out frequently to keep them cool. 

On any given day I could have a kid come in via ambulance with fever related seizures and a temp of 104.  Give us 20 minutes, a dose of Tylenol, and a basin of room temperature water with wash clothes and that same kid will have a temp of 100.  20 minutes later and that kid is up, playing, and asking for ice cream.  Seizures are dangerous to your child - don't passively sit by and let the poor kid burn up.  Keep that fever under control.  Be proactive about your childs health. 

Do not think that you should let the fever build before you come see me so I will take you seriously about your kid being sick.  I will simply think that you are too ridiculous to treat your childs fever.  TREAT THE FEVER AT HOME - if your pediatrician agrees.  I have no greater medicine than you do to treat a common fever - Tylenol and Motrin.  You wouldn't let your self suffer with the aches and discomfort of a high fever, don't let your kid. 

Now scardy cat first time parents - if you freak the crunk out and are in a state of panic  - come to me.  But don't be shocked that I am not going to be able to fix your kid any better than you can.  I will gently educate you on how to take care of this yourselves next time, but if you come back in two days I will not be so gentle.   

Sore Throat - Call your pediatrician!  Please.  Because you don't belong with me.  I can't fix this.  I understand that work and school can get in the way of your child's doctors office hours.  That is exactly why you need to know what local urgent care takes your insurance before you need them.  If your child has a sore throat and your can't get ahold of your pediatrician, than take them to urgent care.  They will test for strep with the exact same test I have and they will write the exact same antibiotic script that we will give you.  But the cost to the health care system is a fraction as much.

Ear Ache -  This one just makes me mad.  Don't bring your kid to me for a flipping ear ache.  Go to the urgent care down the road.  This is what they do.  You should be embarrassed to take up the resources of an emergency room with an ear ache.  I promise you, that you will be waiting a long time because you are the very bottom of my priority list.  The heart attack next door will be getting all my attention and you will have to wait.  GO TO THE URGENT CARE~~~  Do it. 

Reasons to come see me: any kind of trauma (near drowning, choking, car crash), ANY issues with breathing, if you went to urgent care but they don't you to come to the ER, or if your childs doctor told you to come. 

Please understand - if you bring your child in the ER you need to mean it.  You needs to feel that they are so sick that it is worth it.  They may get stuck with needles.  They will be scared and uncomfortable.  They may scream every time I try to touch them.  We may miss their IV on the first stick and have to stick them a few times.  We don't want it to be that way, we don't enjoy hurting your child.  But we will if it is the best treatment for the child.  Don't blame me for this fact, you brought them to me to treat and I will.  
Now if you do really need to go to the ER, pack up a bag of toys and your cell phone charger and be prepared to spend at least 3 hours with me.  I promise I will be nice to you and do everything I can to make this easy for you and your kiddo.  

Last tip - take your child to a pediatric hospital.  If you were having a heart attack wouldn't you have them take you to the best heart hospital?  Do the same with your kid.  If you really think they are sick enough to go to the hospital, than you want them at a peds hospital.  You want a place that is set up for kids and has staff that is used to working with children.  We have two amazing children's hospitals in Indy.  USE THEM!!!!


  1. It is amazing how many parents are absolutely ignorant of these facts. Thanks for clearing them up.

  2. I was laughing and screaming AMEN the whole way through this!

  3. I love how you clarify what type of malady belongs where.

  4. I am retired from medical transcription. I transcribed a medical report once where a patient came to the ER c/o of a headache and hadn't even taken anything for it at home. And it wasn't a child !! Pitiful! :) Chris

  5. You are featured on New Nostalgia's Anti-Procrastination Tuesday! Thanks for linking up!!



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