May 20, 2022 11:27:13 am
Infants and young children, unlike adults do not voice out their complaints or discomfort. The commonest and the only presentation can be unconsolable cry and refusal of feeds. Any astute physician can pick up clues while examining a calm child but it becomes difficult when the child is irritable and resents examination. Emergencies related to underlying medical conditions or household accidents can turn life threatening if appropriate management is delayed. Managing sick children on an emergency basis not only requires a physician oriented to pediatrics but a good team for coordination and an appropriate environment.
To quote a few, accidental fall of kids from heights (cot, sofa, stairs) who present only with superficial swellings / injuries can have serious internal injury as well. A detailed examination and watch fullness for clues of severe trauma suggesting the need for a CT is essential in such cases rather than doing a CT in all children with a history of fall.
Accidents at home are common these days with children staying in-doors. Small children are too curious and tend to put everything into mouth or nose. Ingestion of naphthalene or camphor balls can cause seizures and delayed manifestations in the blood (hemolysis and methemoglobinemia). Accidental ingestion of mosquito repellant liquid is also a common occurrence in growing inquisitive kids. These are few of the toxins were vomiting is not induced and stomach wash is not given because they contain hydrocarbons which are volatile and such maneuvers increase the absorption and toxicity further. Expert opinion in such confusing situations can always be provided by your emergency care pediatrician oriented to such emergencies.
Insertion of foreign bodies into nose / ear or ingestion into the gastro intestinal system are far more common in normal healthy children than in adults. Timely removal of button battery from nose and throat is essential to prevent serious long term complications. Suturing of lacerations / cleaning and dressing of scald injuries in children under sedation and analgesia (pain relief) also needs expertise. Safe handling of children during such procedures is a skill learnt with experience.
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Medical problems like wheezing / breathing difficulty, prolonged seizures can worsen during the late hours requiring in-hospital management and observation for response.
Children have unique anatomic, physiological, developmental and medical needs that differ from adults. A well-equipped Pediatric Emergency room has appropriate sized equipment’s like blood pressure monitoring cuffs, instruments used for foreign body removal and orientation of the team to weight based drug dosages. Most of the Pediatric emergency rooms are well supported by Pediatric sub specialties like Neurosurgery, Urology, ENT etc. These are important requirements for safe and successful management of pediatric emergencies. It is important for parents to be aware on how to reach their pediatricians / hospitals with such facilities well before an unanticipated emergency. Such equipped emergency rooms have a direct telephone lines for consultation. Consulting your pediatricians can decrease anxiety, provide more clarity on what to do next in such stressful times than to end up confused and guilty. Plan ahead and get to know your nearest Pediatric emergency room phone number along with details of ambulance services.
Myths about Emergency Room (ER) :
- Myth : ER is a place where first come patients are seen first.
Fact : Sickest patients are seen first. You might have to wait for your turn if your child is found to be stable after the initial assessment on arrival.
- Myth : On ER visit, all symptoms are relieved in a jiffy.
Fact : Depending on the type and severity of illness, your child might get a relief in a short span or might need blood investigation and / or imaging. All this takes some time and patience is needed.
- Myth : If going to ER, you are sure to be advised admission.
Fact : Only children who are sick requiring continuous treatment and monitoring are advised admission.
- Myth : ER is full of trauma patients with blood.
Fact : Pediatric ER has a separate bay for critical children and are transferred swiftly to ICU after stabilization. Unlike adult ER, this place has a child friendly and a safe atmosphere to make the consultation experience a smooth one.
- Myth : People who visit ER, contract coronavirus infection
Fact : No. Patients with suspected covid are received and assessed in a separate place and ER is reserved for non febrile / non respiratory emergencies as per existing hospital infection control guidelines.
24×7 Pediatric Emergency Contact Number – 044-4860 0000
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