Time for a Trip to the ER?

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Most childhood symptoms and incidents that require emergency care are obvious: serious injuries, major bleeding and unconsciousness are a few.

"People often call their primary care doctor’s office to see if they should go to the ER," says Marie Lozon, M.D., director of children’s emergency services at the University of Michigan Health System. But that isn’t always your best bet. The nurses who screen calls "aren’t going to take any chances," she says, and they can’t physically see your child.

Lozon, who runs the emergency department’s pediatric section, suggests using the following objective indicators to help you decide whether or not to go to the ER. If you’re unsure, though, "it’s better to be safe than sorry," she says. "If you’re becoming frightened, it’s always best just to call 911. The paramedics will come and help you out."

You should seek immediate medical care if your child:

  1. Has labored breathing, audible wheezing or difficulty getting breath.
  2. Is not interacting with his or her environment; does not smile, interact or respond to you.
  3. Has cold extremities at normal temperatures, seems to have poor circulation or has a gray or bluish color.
  4. Has vomited or had diarrhea to the point where he or she is listless and cannot take small amounts of clear liquid for rehydration.
  5. Has dark green or bloody vomit, or if stools are bloody.
  6. Has severe abdominal pain, especially if localized to one area.
  7. Has been injured and seems to have a deformity of an extremity.
  8. Has repeated bouts of vomiting after a head injury; or seems confused or loses consciousness after a head injury.
  9. Swallows an object and is gagging or choking.
  10. Has ingested any type of poison or chemical.
  11. Is having an allergic reaction with rapid swelling around the face or neck, or has labored breathing or wheezing.
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