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,  "Out of the Emergency
Room," July 2002.
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