When Should Your Child Go to the Hospital?

Test Your ER IQ

1. A child who vomits through the nose has a serious gastrointestinal problem.
The passage from the nose goes into the throat, so this vomiting is normal. A true emergency: A baby has green vomit, which signals an abdominal obstruction that may require surgery.

2. Your sick child has a blotchy rash on his tummy -- but that's no reason for extra worry.
Red bumps and blotches are common, from easily recognizable problems such as diaper rash to more mysterious breakouts that often accompany a mild viral illness. One important exception: flat red pinpoints or purplish spots. "If the rash doesn't go away when you press on it -- most will turn white for a second or two -- and your child has a fever, it could signal a serious illness such as meningitis, which demands immediate attention," says Dr. Shaw.

3. Your toddler fell on her head and acts fine -- but that egg-size lump needs a CAT scan.
A big bump alone isn't cause for panic. If she hasn't vomited or acted dizzy or disoriented within four hours of her fall, she should be okay. It's also a common misconception that a child shouldn't sleep after bumping her head. Don't force a tired child to skip a nap, but do rouse her within two hours of going to sleep to make sure she's fine.

4. Avoid giving your child a pain reliever before going to the ER -- it could mask symptoms and delay diagnosis.
"Knowing how a child reacts to medication helps us decide what to do; otherwise we have to wait and see how the child responds to the medication she receives at the hospital," says Dr. Gorelick. Newborns are an exception: In infants under 3 months, it's important to document the severity of an actual fever. Once a doctor has seen the baby, medicine is fine.

5. Spiking a fever higher than 104 degrees F. won't cause brain damage.
"Fever is the body's way of fighting infection, and harmful effects are very rare," says Dr. Luria. The brain is unscathed, except in the unlikely situation of a prolonged temp above 107.6 degrees F. (such as with untreated heatstroke). An untreated illness-related fever rarely tops 105 degrees F.

Copyright © 2008. Used with permission from the May 2008 issue of American Baby magazine.

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