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December 2005

Why Are Children Going to the ER?
(It's not what you think!)

Each year, thousands of children in North Carolina end up in Emergency Rooms (ER), but not for the reasons you think. Rather than broken bones, accidents and injuries, the most common reasons for ER visits are ear infections, colds and fever.

"You can always tell it's cold season by who's coming to the ER," says Dr. Kim Gush of Village Pediatrics of Chapel Hill. "From 5 p.m. to 9 p.m., parents come in with children who have a cough and sore throat."

Why the ER?

The convenience of the ER and the difficulty for parents to leave work are two reasons. But the leading reason is that parents aren't sure when to worry or what to do.1 They often simply want reassurance about their child's health.

When should parents worry?

"Unless your child is having difficulty breathing -- that is, your child is struggling to catch their breath or is breathing rapidly -- your child's cold is better off being cared for at home than going to the ER," says Dr. Gush. "We simply don't have effective medicines for the common cold viruses."

"If your child is otherwise healthy, you don't need to see the doctor unless your child's had a cough that has lasted more than two weeks, a fever (100.4° -104° F) that has lasted for one week, or a fever that was getting better and now has gotten worse. Those are signs that your child may have a bacterial infection rather than a viral one. In those cases, an antibiotic may help."

If parents aren't sure, they should call their child's primary healthcare provider or "Medical Home" rather than going to the ER. A Medical Home can be a doctor's office, a community clinic or a local health department. A Medical Home is where the staff knows the child and the child's health history and where parents can get answers to their questions.

What should parents do?

"Our bodies are built with a remarkable immune system. It can't prevent a viral infection, but it can fight one rather efficiently. Fever and discomfort can be treated with ibuprofen (Motrin®) and acetaminophen (Tylenol®), but never aspirin. With rest and plenty of liquids -- such as water, broth or diluted juice -- most children will be able to get rid of their colds, middle ear inflammation and fevers on their own."

However, the best way to deal with viral infections is to avoid them in the first place. Parents can help by reminding children to wash their hands and to cover their nose and mouth when they cough or sneeze. A flu shot for children older than 6 months is recommended and will either prevent the flu or lessen the severity of symptoms.

Click here to view and order free Medical Home related educational materials

1Seton Healthcare Network, Opens in new window"Out of the Emergency Room," July 2002.

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Last updated: December 2005


At a glance
Most Common ER Diagnoses for Children

  • Ear Infections
  • Colds
  • Fever
  • Noninfectious Gastroenteritis
  • Unspecified Viral Infections

* Community Care of North Carolina
January - March 2005

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