Transcription:

Prakash Chandran (Host):  If your child is feeling sick, a trip to the doctor is usually in order. But what about more serious conditions or injuries? And when should you take your child to the Emergency Room? We’re going to talk about it today with Dr. Russell Homan, a Pediatrician at Capital Regional Medical Center.

This is Helmet of Health, the podcast from Capital Regional Medical Center. I’m Prakash Chandran. So, first of all Dr. Homan, this is extremely relevant for me right now because on Sunday, I actually just took my four month old to the ER. There was like a slight scratch on the head and I was like oh my gosh, what am I going to do? There’s nothing else that’s open. So, I had to go to the ER because she was crying more than I had really ever seen before. But then when I got there; they were like you know this is nothing, not even close to raising a red flag for us. Don’t worry everything is going to be fine and everything was fine. But I’m curious about what you see as some of the more common conditions that children are treated for at the Emergency Room.

Russell Homan, MD (Guest):  Right, yes, thanks for having me. And I think like you are saying, the most common conditions we see in the Emergency Room revolve around whether a parent is worried that the child needs immediate medical attention, or they will be like permanently damaged. And those mostly revolve around large cuts that we can’t get to stop bleeding. It sounds like your child was on the smaller side. Also trouble breathing. Like a child who is really struggling to breathe, cannot talk, looking anxious or a child who is just acting funny like someone who hits their head and then they are like not making sense, they don’t know what the date is, they don’t know the season, they don’t know what they just did. Those are the common reasons people would really like people to come. But then we also see people come that maybe could have called their pediatric office first. Because most pediatric offices are open after hours, in the evenings, 24 hours a day and the doctors are prepared to guide you on whether you need to come or not.

But really, if you are worried about immediate problems, then definitely the Emergency Room is the place to be.

Host:  Got it and it’s a slippery slope because as a new parent, first time parent myself, you think that anything outside normal in your world is something that is potentially dangerous. So, I’m curious as to your thoughts around when an adult should take a child to the Emergency Room. Like clearly like maybe a fever might not be something to take them in for, but when do you really want to see parents? You talked about potentially like the child acting a little funny or things that won’t stop bleeding, but what are some of the other circumstances that a child might want to come in?

Dr. Homan:  Yeah, the main one in kids I think is breathing trouble. So, if we’ve all seen and had coughs ourselves and fever and body aches like someone would have with the flu. But when almost anyone not even just a kid should go to the ER is when you start seeing them start to breathe kind of heavy and they are breathing hard and you can like see their ribs pulling, their shoulders are moving up and down and then a lot of times they can’t even speak in sentences. They will be like I’m having trouble breathing like that’s definitely a time someone should go to the Emergency Room.

Another one is if there’s just a lot of pain or irritability. Which is why you shouldn’t fee too bad about taking your child in because your child sounds like was just crying and irritable and you couldn’t console her. So, that’s the same thing, if the kid can’t be consoled and they are really irritable and just crying and the pain seems like it’s out of control; that is something that should be checked in the ER as well.

And then the other thing like I was saying, is children acting funny after they hit their heads or kids can act funny when they have a fever too. They might be – if a kid has a fever and is pretty lethargic and kind of out of it; they should be checked out as well.

Host:  I’m curious about something that happens quite often with our youth, a suspected sprain or a broken bone. Is that a scenario where parents should bring their children to the ER?

Dr. Homan:  You know every – most kids do have a medical home and every medical home has different comforts with injuries and most people probably know how their pediatrician handles injuries. So, most pediatricians will handle like sprains, some even might handle small fractures and bruises. But if your child has a bone injury where the bone is obviously broken; you can see it broken; that would be a reason to go to an Emergency Room. Or if there’s a bone or ankle or joint injury and the pain cannot be controlled. If it’s pain that can’t be controlled, it would be great to call your pediatrician first. They might have help that they can give you. Or if there’s any kind of break with bleeding like an open fracture that should definitely go to the Emergency Room.

Host:  Okay, that makes a lot of sense. But what about the case of a flu, like let’s say the child is expressing a very high fever, or vomiting a little more than normal; is that a scenario where you would like to see a parent bring their child in?

Dr. Homan:  Well also if you had like the flu with runny nose, cough, congestion, you could have vomiting, diarrhea, body aches, thankfully things don’t usually suddenly get worse though sometimes they do. So, like I said before, it’s always good to call your pediatrician for guidance on that if you can. But that being said, if a child has had flulike illnesses like we talked about, starts to breathe heavy, that would be a good idea to go to the ER then. If the child has a flulike illness and then does start to have lots of pain that can’t be controlled; if you feel like it’s too urgent to call your pediatrician; then a trip to the ER would be reasonable.

Host:  And finally, just in wrapping up here, what do you wish that more parents knew before they came to the ER? Like for a parent like me, I’m a new parent, I came in with something that is potentially not ER worthy, so I’m sure that you see this quite often. I’m curious as to if you have thoughts around a framework that parents should follow or just understand before bringing their child in.

Dr. Homan:  I think the thing I wish parents would think about but in the heat of the moment I understand they don’t. Is just to give their pediatric office a call even on an after hours time because most offices are open in the evening and a night.

Host:  All right Dr. Homan, I really appreciate your advice today. That’s Dr. Russell Homan, a Pediatrician at Capital Regional Medical Center. Thanks for checking out this episode of Helmet of Health. Head to www.capitalregionalmedicalcenter.com to get connected with a provider. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.