Before You Call 911

When does a child's medical problem require a trip to the ER? LHJ asked top pediatricians.
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Knowing When You Need a Doctor

Your child falls off the jungle gym and hits his head. Does he have a concussion or just a bump? It's Sunday afternoon and your baby is running a temperature of 104 degrees F. Should you go to the emergency room or the medicine cabinet? Your teenager's cut is gushing blood. Does it need a bandage or stitches? Here are some common children's medical problems and when you need to seek help:

1. Burns

The problem: Fires and burns are the third-leading cause of unintentional death in children, according to the National Safety Council. First-degree burns cause redness and swelling. Second-degree burns produce blisters. Third-degree burns appear white or charred and cause damage to underlying tissue.

When to get help: Treat first-degree burns at home with cool compresses, antibacterial ointments and pediatric pain relievers. Use those measures for second-degree burns, but if the burn involves the face, hands, genitalia or feet, take your child to the doctor because it's important the burns heal without scarring. But head for the ER if any burn is larger than your child's hand or the skin appears white or charred. Your child needs professional care and may need pain relief and infection-fighting medication. Also get immediate help for electrical and chemical burns, and for severe burns around the mouth, because your child's airways may have been affected.

2. Fever

The problem: Fever can be caused by everything from benign viral illnesses, like colds, to a serious bacterial infection, like meningitis.

When to get help: A rise in temperature can actually be a good thing because it kicks the body's disease-fighting mechanisms -- like white blood cells -- into gear.

A lot will depend not so much on the thermometer, but on how your child is acting. If your child seems comfortable, is eating, sleeping and even sometimes playing, then you might wait to see if the fever comes down on its own or with a fever-reducer, such as acetaminophen. Call your pediatrician, however, if your child is vomiting, complaining of an earache, severe neck or head pain, has a rash, suffers a seizure or isn't urinating. "Your child's symptoms take precedence over the fever," says William E. Bruno, Jr., MD, chief of staff at the Joe DiMaggio Children's Hospital, in Hollywood, Florida.

Fevers in very young children can be dangerous because they have immature immune systems and become dehydrated more easily. Call your pediatrician immediately if your child is under 10 weeks old and has a rectal temperature of 100 degrees F. or higher. Also call if your child is under two and has a rectal temperature of 101 degrees F. or higher.

3. Cuts

The problem: Cuts or wounds that puncture the skin, causing bleeding and/or damage to underlying tissue.

When to get help: Applying firm pressure for five minutes can stop most cuts from bleeding. However, if the bleeding won't stop after 10 minutes, if the cut is contaminated with glass or metal or is more than 1/2 inch long and 1/4 inch wide, your child will need stitches. Many cuts on the face require stitches to minimize scarring.

Continued on page 2:  Concussion, Vomiting, Poisoning


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