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Docs’ Advice on ER Visits and Kid’s Common Wintertime Illnesses and Injuries

It’s one of the most important ques-tions parents can face: is this badenough for the emergency room? Youask yourself, “am I neglecting my child by not visitingthe ER, or am I overreacting?”

Every year, one-in-five children requires emer-gency medical care. For families in Denver, RockyMountain Hospital for Children (RMHC) has two

24/7 emergency departments — RMHC at Presby-terian/St. Luke’s Medical Center and Sky RidgeMedical Center — that offer around-the-clock access to board-certified pediatricemergency doctors and pediatricians car-ing for children and adolescents.

Now a service of all HealthONE hospitals: The Medical Center of Aurora, North Suburban Medical Center, Presbyterian/St. Luke’s Medical Center, Rose Medical Center, Sky Ridge Medical Center and Swedish Medical Center.

December 2010

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But when should a parentmake a trip to the ER? Dr. ChrisDarr, chief of emergency pediatrics atRocky Mountain Hospital for Chil-dren at P/SL, recommends immediateemergency care for children who:

Have any bleeding that doesnot stop after applying pressurefor a few minutes.

Have a large or deep cut orone that affects the head, chestor abdomen.

Have a large burn, especiallyone that involves the hands,feet, groin, chest or face.

Have a severe pain that ispersistent or worsening.

Develop sudden neck stiffness, along with a rashand a fever.

Show any confusion,headache, numbness ordizziness after a hitting theirhead.

Have swallowed (or you suspect they have swallowed)common household toxins,including fertilizer, cleaners orinsecticides.

Have gotten into or takenmedication that was eithernot prescribed to the childor the child appears to havetaken an excessive amount. Thisincludes over-the-counter reme-dies and herbal or “natural”products.

“Many of the children we see in thepediatric emergency room do nothave life-threatening conditions, andmany of the children’s conditionsmay be cared for by the child’s pri-mary care physician,” said Dr. SueKirelik, a physician in the RockyMountain Hospital for ChildrenEmergency Department at Sky RidgeMedical Center. “In many cases, fol-low-up with a primary care doctorwill be recommended after the childleaves the emergency department, sowe work closely with primary carephysicians to provide speciality care ina familiar close-to-home communityhospital setting,” she added.

However, both Dr. Darr and Dr.Kirelik noted there are many illnesswhich are best cared for in the pedi-atric emergency room, includingthose outlined below.

Flu and VirusesMost children will weather a stom-

ach virus or common cold withplenty of rest and fluids. However,many parents become concerned andcontemplate an emergency room visitwhen they feel that their child hasmore than “the bug that’s goingaround.”

“A good way to know if it’s time togo to the emergency room or not is topay attention to how yourchild is acting,” Dr. Darr advises.She notes the following are signs thatmay point to the need for emergencyattention:

Behavior changes, likelethargy in a normally activekid, not waking appropriately ornot interacting as they usually do.

Any signs of troubledbreathing, fast breathing or if you can see your child’s ribsor collarbone outline by skinwhen he or she inhales.

Your child’s belly moves obviously outward withevery breath in.

A fever of more than 103°F.

A fever, even a low-grade tem-perature, which lasts morethan a week. This may be asign of a bacterial infection.

Infants“The smallest children can pres-

ent the biggest challenges, since theycan’t tell us exactly what’s wrong,”said Dr. Kirelik. To make mattersworse, infants often have a hardertime fighting off common viruses be-cause their immune systems haven’tfully developed. Dr. Kirelik advises atrip to the ER for infants who:

Are two months old oryounger and have a temperatureof 100°F or higher.

Infants between two and sixmonths old with a tempera-ture of 100°F or higher formore than 24 hours.

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Have a stiff neck.

Are dehydrated: a dry mouth, no wet diapersfor 12 hours, sunken eyes or a sunken soft spot.

Stop breathing, have blue lips or tongue orhave any other signs of breathing difficulties.

First Call for Children: Free Advice for Parents When They Need It Most

Rocky Mountain Hospital for Children also offersfree advice to every parent in case of an emergency:the First Call for Children hotline. Staffed byexperienced pediatric nurses, the hotline provides par-

ents with a trusted source for after-hours information about high fevers,

allergic reactions, burns, rashes, accidents, illnesses or any other

children’s health-relatedquestions.

Parents can call 303.563.3300 between 5 p.m. to 8 a.m.on weekdays and 24-hours a day on weekends and hol-idays. The nurses can give parents peace of mind andhelp determine if a child should be taken to the ERimmediately or if it’s best to wait until the primaryphysician office opens.

The staff at Rocky Mountain Hospital for Childrenknows there are few things as stressful as a sick or in-jured child, so we strive to provide the informationand care parents need to make the right decisions forthe health of their little ones.

Rocky Mountain Hospital for Childrenand its family of locations in every HealthONE hospitalbrings trusted experience and proven care to you andyour children. For information on parenting, healthtips and more, visit www.ParentPages.com orwww.RockyMountainHospitalForChildren.com.

Sue Kirelik, MD, (right) is medical director of pediatric emergencyservices and chair of the pediatric department at Sky Ridge Medical Centerin Lone Tree. She is a graduate of George Washington University School ofMedicine in Washington, DC. She followed with a residency in pediatrics atChildren's National Medical Center, DC and a fellowship in Pediatric Emer-gency Medicine at Children's Hospital in Oakland, CA. Dr. Kirelik is a foundingmember of CarePoint and is board certified in pediatric emergency medicineand pediatrics.

Christine Darr, MD, (left) is the medical director for the pediatric emergency department at RockyMountain Hospital for Children. She is also the medical director for the pediatric division of CarePoint, PC, anemergency physician private practice in the Denver metro area with 23 pediatric physicians. She is a graduate

of Rush Medical College School of Medicine in Maryland. She followed with a pediatricresidency at the University of Chicago hospital. Dr. Darr is board certified in pediatricemergency medicine and pediatrics.

RockyMountainHospitalForChildren.com

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Rocky Mountain Hospital for Children after-hours advice line

First Call® for Children ...Our nurse advice line has the answers to your after-hours questions

303.563.3300(Out of Denver area call toll-free 1-877-647-7440)

For medical emergencies ALWAYS call 9-1-1 Open Mon-Fri 5:00 pm - 8:00 am | 24 hours weekends and holidays

For after-hours questions about your child’s health,there’s First Call for Children every night and everyweekend and holiday:

FREE pediatric advice and information line

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Based on national illnesses and injuries guidelines

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