When to Visit the ER

Boy in bedIt’s one of the most important questions parents can face: is this bad enough for the emergency room? You ask yourself, “am I neglecting my child by not visiting the ER, or am I overreacting?”

Every year, one in five children require emergency medical care. For families in Denver, Rocky Mountain Hospital for Children (RMHC) has two 24/7 emergency departments — RMHC at Presbyterian/St. Luke’s Medical Center and Sky Ridge Medical Center — that offer around-the-clock access to board-certified pediatric emergency doctors and pediatricians, caring for children and adolescents.

When should a parent make a trip to the ER? Dr. Chris Darr, chief of emergency pediatrics at RMHC at P/SL, recommends immediate emergency care for children who:

  • Have any bleeding that does not stop after applying pressure for a few minutes
  • Have a large or deep cut or one that affects the head, chest or abdomen
  • Have a large burn, especially one that involves the hands, feet, groin, chest or face
  • Have a severe pain that is persistent or worsening
  • Develop sudden neck stiffness, along with a rash and a fever
  • Show any confusion, headache, numbness or dizziness after a hitting their head
  • Have swallowed, or you suspect they have swallowed, common household toxins, including fertilizer, cleaners or insecticides
  • Have gotten into or taken medication that was either not prescribed to the child or the child appears to have taken an excessive amount; this includes over-the-counter remedies and herbal or "natural” products

“Many of the children we see in the pediatric emergency department do not have life-threatening conditions, and many of the children’s conditions may be cared for by the child’s primary care physician,” said Dr. Sue Kirelik, a physician in the RMHC Emergency Department at Sky Ridge. “In many cases, follow up with a primary care doctor will be recommended after the child leaves the emergency department, so we work closely with primary care physicians to provide specialty care in a familiar close to home community hospital setting,” she added.

However, both Dr. Darr and Dr. Kirelik noted there are many illnesses which are best cared for in the pediatric emergency department, including those outlined below.

Flu and Viruses

Most children will weather a stomach virus or common cold with plenty of rest and fluids. However, many parents become concerned and contemplate an emergency visit when they feel that their child has more than “the bug that’s going around.”

“A good way to know if it’s time to go to the emergency department or not is to pay attention to how your child is acting,” Dr. Darr advises. She notes the following are signs that may point to the need for emergency attention:

  • Behavior changes, like lethargy in a normally active kid, not waking appropriately or not interacting as they usually do
  • Any signs of troubled breathing, fast breathing or if you can see your child’s ribs or collarbone outline by skin when he inhales
  • Your child’s belly moves obviously outward with every breath in
  • A fever of more than 103°F
  • A fever, even a low-grade temperature, lasting more than a week, this may be a sign of a bacterial infection

Infants

“The smallest children can present the biggest challenges, since they can’t tell us exactly what’s wrong,” Dr. Kirelik said. To make matters worse, infants often have a harder time fighting off common viruses because their immune systems haven’t fully developed. Kirelik advises a trip to the ER for infants who:

  • Are two months old or younger and have a temperature of 100°F or higher
  • Infants between two and six months old with a temperature of 100°F or higher for more than 24 hours
  • Have a stiff neck
  • Are dehydrated: a dry mouth, no wet diapers for 12 hours, sunken eyes or a sunken soft spot
  • Stop breathing, have blue lips or tongue or have any other signs of breathing difficulties

First Call for Children: Free Advice for Parents When They Need It Most

Rocky Mountain Hospital for Children also offers free advice to every parent in case of an emergency: the First Call for Children hotline. Staffed by experienced pediatric nurses, the hotline provides parents with a trusted source for after hours information about high fevers, allergic reactions, burns, rashes, accidents, illnesses or any other children’s health related questions.

Parents can call 303.563.3300 between 5 p.m. and 8 a.m. on weekdays, and 24 hours a day on weekends and holidays. The nurses can give parents peace of mind and help determine if a child should be taken to the ER immediately, or if it’s best to wait until the primary physician's office opens.

The staff at Rocky Mountain Hospital for Children knows there are few things as stressful as a sick or injured child, so we strive to provide the information and care parents need to make the right decisions for the health of their little ones.

RMHC and its family of locations in every HealthONE hospital brings trusted experience and proven care to you and your children.