The doorbell rang around 10 p.m., announcing the arrival of my brother's family for a weekend visit. But they greeted us with "Where's a hospital?" Their 18-month-old had screamed in apparent pain for most of the five-hour drive, so they bolted to the ER. There, distracted by the commotion, the baby cheered right up. A doctor diagnosed a garden-variety ear infection, and the parents chastised themselves for jumping the gun.
I kept this incident in mind when my own daughter, at about the same age, woke up wailing and breathing hard. I calmed her easily, chalked up her symptoms to a virus, and waited until morning to see a doctor. Our pediatrician checked her oxygen level and quickly administered inhaled medicine to open her tight airways. As he briefed me on wheezing, noisy breathing that indicates a struggle for air, he said sternly, "Next time, don't wait -- we don't want her turning blue." I was mortified that I'd failed to recognize something serious.
Children ages 4 and younger account for about 10 percent of the 115 million emergency room visits a year. The most common reasons: respiratory illness and fever, followed by injuries and vomiting/diarrhea.
Most new parents eventually face the scary question "Should we go the ER?" And often, in hindsight, they regret their decision, forgetting they did what seemed wisest at the time. "People go to the emergency room for a reason: something exceeded their threshold for concern," says Joseph Luria, MD, emergency department medical director at Cincinnati Children's Hospital Medical Center. Meanwhile, other parents may talk themselves down from worry when their child really does need attention -- fast. So how do you discern a real or impending emergency from a case better handled at home or at your pediatrician's office? Here, guidance from emergency room experts.