Children and emergency medical care

Thursday , July 29, 2010 - 4:00 PM

Catherine McNally - Hilltop Times staff

It's hard for a parent to see their child get hurt, even if it's just a small bump or scratch. Sometimes it can be hard to tell when children need medical attention or when a home treatment will suffice.

Parents know best

Though doctors and qualified medical professionals can provide guidelines on when injuries are serious enough to merit a doctor's visit, it's important to remember that, as parents, you know your child best.

The seriousness of medical conditions can vary from child to child, cautined Maj. Gary Ruesch, a certified pediatric nurse practitioner and pediatric element chief for the 75th Medical Operations Squadron. Things like weight, age and current medical conditions can all factor into any situation, so it's important to realize that the information provided here should be just that -- guidelines.

Although a trip to the Emergency Room may seem like a cure for all injuries, remember that the Emergency Room's primary function is to intervene to prevent loss of "life, limb or eyesight."

"The primary reason for any individual to be evaluated and treated in the emergency department is to preserve life, limb or eyesight," Ruesch said.

"If a parent believes or suspects that failure to obtain immediate medical attention may result in a child's death, loss of limb (arm, leg, fingers or toes to include function of limb not just physical loss) or eyesight they should call 911 or proceed to the nearest emergency department." he explained.

Be prepared

As a parent, it's always better to be prepared. It's basically impossible for any child to never receive an injury, so having information and supplies on hand is important.

Parents should know where the closest medical facility is, including Emergency Care and the doctor's office. Here at Hill, patients have access to an urgent care clinic by appointment only -- there is no Emergency Room at the clinic.

"For a true emergency go to any hospital ER," Ruesch said. It's better to quickly get your child medical care if the situation is serious than to worry about insurance and other factors. Ruesch noted that, while a child is being stabilized and receiving care, hospitals can arrange transport to another care facility that accepts the parents' insurance.

It's still important to know how your insurance works. "TriCare Prime patients should contact the clinic during duty hours for same day appointment or urgent care clinic referral," Ruesch explained.

The number for the base clinic is (801) 728-2600, which also works for after duty hours, weekends and holidays. The after care answering service is also available to provide referrals for TriCare Prime patients. The number for prescription refills is 1-800-453-2388.

Along with taking a First Aid class, parents can also be prepared by having emergency supplies on hand. Ruesch recommends the following items:

SBltâÇAcetaminophen (Tylenol) and ibuprofen (Motrin) for fever or pain.

SBltâÇDiphenhydramine (Benadryl) for allergic reactions.

SBltâÇAntibacterial ointment for minor cuts and scrapes.

SBltâÇBand-Aids, gauze, medical tape and compression bandages (ACE wraps) for basic wound care.

SBltâÇParents should also ensure that they have appropriate emergency medical supplies and medications available that may be required if they have a child with a chronic medical condition.

Another resource parents can have on hand is the book "Taking Care of Your Child" by Robert H. Handell, M.D., James F. Fries, M.D., and Donald M. Vickery, M.D. This book is recommended by Ruesch and a copy can be obtained by TriCare beneficiaries by stopping at the base clinic. The book can also be found at bookstores and online at Amazon.com.

If your child has swallowed something poisonous:

"The first thing a parent should do is call Poison Control (at) 1-800-222-1222," Ruesch said. He also stressed the importance of this number being posted in a readily-accessible area, such as by the phone or on the refrigerator.

"The parent or caregiver should have the container of the ingested product in hand when they place the call if available," he added. "The Poison Control operator will instruct the caregiver on the appropriate course of action."

"DO NOT push fluids or attempt to make the child vomit unless instructed to do so." Ruesch said. "The child should be under constant supervision and 911 called (if any emergency symptoms are observed such as) respiratory distress, seizure, loss of conscious, etc."

If your child has a high fever:

Ruesch cautions that this is an area that is not so black and white. "There is no specific elevation in body temperature that requires an ER visit and there are multiple variables that determine the severity of fever," he said.

Such variables include the age of the child, how long the fever has persisted and if other symptoms are present and what those symptoms are.

"A good medical advice book can be invaluable in sorting out these factors and making an appropriate choice," Ruesch added.

If your child has cut themselves:

According to Ruesch, this is another gray area.

"Most cuts affect only the skin and the fatty tissue beneath it," the book "Taking Care of Your Child" says. "Usually they heal without permanent damage."

However, it may be difficult to determine whether a cut is serious or not. In this case, the book instructs parents to keep an eye out for signs such as "numbness, bleeding that cannot be controlled with pressure, tingling or weakness in the affected limb."

If your child has bumped their head:

"Every child will experience a bump on the head sometime in life and many children seem to bump their heads every few days," says "Taking Care of Your Child." "Many of these injuries will be minor ..."

Still the book cautions that all head injuries can potentially be serious and says that careful observation is the most valuable tool.

"Observation of your child begins with the accident," the book says. "If the child was knocked unconscious or cannot remember the events immediately before or after the accident (then) he or she has a concussion and you should take the child to the doctor."

It's also important for parents to keep watch to see how their child is acting after the injury. Signs such as increased lethargy -- including alternating between stages of alertness and lethargy, unresponsiveness and repeated vomiting could be signs of a more serious injury.

Also important is to note how your child looks. "Bring the child to the doctor if he or she appears persistently pale, sweaty or weak," the book instructs.

Still, diagnosing a head injury can be complicated. "In a typical minor head injury, a bump may develop immediately," the book says. Minor head injuries can also induce sleepiness (due to the excitement) and even vomiting.

If your child has burned themselves:

Burns can also be complicated, Ruesch warns.

The most serious burns, "Taking Care of Your Child," says, are third degree burns where the affected area is painless (because nerve endings have been destroyed). Also serious are burns that are extensive or affect the face, hands or genital areas.

Again, all parents know their child best and it is up to them to decide whether or not their child should see the doctor or go to the Emergency Room.

As Ruesch and "Taking Care of Your Child" both say, "You know your child best; do not hesitate to follow your own judgment as to when to seek professional assistance."

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