20 Things to Know Before Taking Your Child to the ER

Not only do you have a sick or injured child who's scared -- but you're probably freaking out yourself. Here are 20 ways to take control, stay calm, and get topnotch care.

Tips 1-10

Not only do you have a sick or injured child who's scared -- but you're probably freaking out yourself. Here are 20 ways to take control, stay calm, and get topnotch care.

1. Pick a child-friendly ER. "Children's hospitals and hospitals with pediatric ERs have specialists on staff 24-7," says Louis C. Hampers, MD, medical director of the emergency department at the Children's Hospital, in Denver. They also have child-size equipment, specialists to help reduce anxiety and pain, and toys to entertain your child. Before your child gets sick or hurt, talk to his doctor about where you will go in an emergency.

2. Call your pediatrician before you go. The doctor's office will help you decide whether your child needs to get to the ER right away or can be treated in the office. If the doctor agrees that you should go to the hospital, he can call ahead to say you're coming.

3. Try to keep your cool. Take a few deep breaths, and tell yourself that you need to stay calm for your child's sake. Don't let your mind jump to a scary diagnosis until you have all the facts. "If you're worried or upset, your child will pick up on your emotions and become even more distressed," Dr. Hampers says.

4. Bring your child's health history. In a small notebook, keep an up-to-date record of her previous illnesses, immunizations, allergies, chronic conditions, and any medications that she's taking (know when she took her last dose). Always keep it with you in your purse or diaper bag, or grab it on your way out the door to the hospital. And make sure that your child's health-insurance card is in your wallet at all times.

5. Go ahead and treat his fever. "Some parents think they shouldn't give their child a fever reducer before going to the ER because the doctor won't believe that he's really sick, but that's not the case," Dr. Hampers says. "It often makes the examination process a lot easier because the child feels better and we don't have to wait 45 minutes for the ibuprofen to kick in."

6. Leave siblings at home, if possible. "You need to be able to devote your full attention to your sick or injured child," says Robert Luten, MD, professor of pediatrics and emergency medicine at the University of Florida Health Science Center, in Jacksonville.

7. Prepare for a wait. Patients receive treatment based on how sick they are, not in the order they arrive. Bring your child's lovey and a quiet toy. "If you've been waiting and are concerned your child is getting sicker, you should ask to have her reassessed," says Cheryl Jackson, MD, medical director of the pediatric emergency department at University of North Carolina Health Care, in Chapel Hill.

8. Stay by her side. The ER can be a frightening place, and your presence will comfort your child. "Studies show that when parents remain in the room during exams and procedures it reduces the level of stress both for children and parents," says Leslie Zun, MD, chairman of the emergency-medicine department at Mount Sinai Hospital and Children's Hospital, in Chicago. Of course, if you feel as if you might pass out while your child is getting poked or sewn up, let the nurse or doctor know.

9. Hold off on food and drink. A full stomach can delay the doctor's ability to operate on or sedate your child. "Sometimes we have to sedate kids for routine procedures, such as CT scans and blood tests," Dr. Hampers says.

10. Tell your child what to expect. Let him know that a doctor (not his regular one) will examine him and, depending on what's wrong, either clean his cut, take x-rays, or run special tests. "For many kids, the anxiety about what's going to happen is worse than the actual pain," says Dr. Zun.

Next: Tips 11-20

Tips 11-20

11. Give the doctor the facts. Explain how and when the accident happened, and where your child has swelling or pain. If she's sick, describe each of her symptoms, and when each one first appeared. Precise information will help doctors diagnose and treat your child more quickly. If your child swallowed something poisonous, bring the container with you.

12. Be honest with your child. Don't tell him that a procedure won't be painful if you know it will be. "Lying will make the rest of the visit more difficult," Dr. Luten says. If your child asks whether a shot is going to hurt, for example, gently tell him the truth, and point out a positive: "It'll probably hurt a little, like a pinch or a bug bite, but then it will stop."

13. Ease your child's fears. Hold her in your lap, and speak in soothing tones. Remind her that you won't leave her and that the doctors are going to do everything they can to help her feel better soon. "Try to shield your child from any disturbing sights and scary instruments, such as suture trays and long needles," suggests Dr. Jackson.

14. Inquire about "ouchless" options. If your child is going to have a shot, stitches, or a blood test, speak up and ask to have numbing cream applied to the location as soon as possible, advises Dr. Jackson. These products usually take about 20 minutes to work. In the case of minor cuts, ask the doctor whether skin tape or glue might be an appropriate alternative to stitches.

15. Get his mind off the pain. During uncomfortable procedures, distract your child by looking at books or playing I Spy. Deep breathing and visualization techniques are often helpful for older kids, Dr. Zun says. Have your child picture his pain swirling down the drain, or have him flip his imaginary pain switch to "off."

16. Make her comfortable. If she's cold, ask for a warm blanket. If the room is too bright, ask to dim the lights. If your child's pain medication has worn off, let someone know. "You must be the advocate for your child," Dr. Jackson says.

17. Don't be afraid to ask questions. "Doctors and nurses get busy, and information isn't always shared the way it should be," says Dr. Luten. If you're not sure what the plan is for your child or why he needs a particular test, politely ask for an explanation. "Parents often feel that it's not their place to interrupt a busy doctor, but answering questions is a doctor's job," Dr. Luten says.

18. Bring change for the pay phone. Cell phones aren't allowed in many hospitals. Coins will also come in handy if you want to get a snack or drink from a vending machine.

19. Get clear discharge instructions. Make sure you know how to care for your child's injuries and what to do if his pain or symptoms don't improve or if they worsen at home. And ask for clarification if you don't understand the purpose of the medication or dosage instructions. "It's better to ask when you're there than to call and try to get information later," says Dr. Zun.

20. Follow up with your pediatrician. After the ER visit, call to let your child's doctor know what the diagnosis was so it can be noted in her medical file (many ERs will send a report to your pediatrician if you ask them to). Check to see whether the doctor has any further recommendations and whether your child needs to be seen for a follow-up exam.

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