The glass in your hand disappears as you awaken abruptly at 2 a.m. from your dream of an idyllic Caribbean vacation – your 18-month-old daughter is screaming. After shaking off your dream and focusing on reality, you remember that she has been coughing all day. She now has a fever of 102, and while you are concerned, you still don’t want to get your other children out of bed to go to the emergency department. Maybe you could give her some ibuprofen and see if she improves? But then, other thoughts start racing through your mind…what if you don’t take her and she worsens? You would never be able to forgive yourself! So, you package her up, gather the other two kids, load them in the car, and make your way to the hospital. Once you get to the emergency department, you register your daughter and the nurse measures a temperature of 102 and gives her ibuprofen at triage. Your uncompromising twins are irritable and hungry. You are simply exhausted. Having to go to work in 4 hours, you have no clue how you will survive.
After three hours of waiting, whining and bickering by your now very awake children, your daughter’s name is called. She is brought back into a room and her temperature is 98.6. And yes, she is smiling and running in circles, Cheetos dust coating most of her face…though with an occasional cough. After approximately 30 seconds of evaluation, she is diagnosed with an upper respiratory illness…otherwise known as the common cold. You groan. Why did you go to the Emergency Room?
This story is fictional, but probably echoes with some truth for many. So, how is one to know when it is important to go to the Emergency Department? Some simple advice may help.
First, different ages trigger different concerns from your doctor. Doctors subdivide children into neonates (under 28 days), young infants (one month-3 months) and older infants and toddlers (3 months-3 years). One good idea is to gather information ahead of time from your primary care physician on what complaints are of concern for each stage of development.
Most doctors want to see babies younger than four weeks if they are ill. A fever to be concerned about under 3 months is 100.4oF, and for children over 3 months, 102.2oF.
Toddlers often look ill when their fevers spike, but after medication with either Tylenol or ibuprofen, they seem to miraculously recover. If their fever does not go down or the child still appears ill after an hour or so (the exception rather than the rule), then proceed to the emergency department.
Any injury, burn or serious stomach illnesses are reasons to visit your emergency center.
It is very important not to take on the burden alone. Call your primary care doctor. Even if it is the middle of the night, there will be someone on call. Or, call the Denver Health nurse line, a free phone consult service for Denver Health patients. Many symptoms worrisome to parents are common complaints that require only supportive home care, like ibuprofen or help for dehydration. These on-call medical professionals will gather enough information about your child’s condition to advise you on home versus hospital care. If after using these resources, you are still unsure, err on the side of caution, and bring your child to the emergency department. We would much rather see a few children with a common cold than have the medical care postponed for a potentially critical child. We want to support your child’s health and wellness.