Being sent to the ER or hospital by your child’s physician can be a scary experience. You may be unsure of what to expect, how long of a stay, what all your child’s medical care and course will entail. As a brief guide, I wanted to mention a few pointers to families. Let's first start with before an overnight stay, and if you first get sent to the ER.
If you are going to the ER:
- Ideally, child friendly or pediatric ER’s are best, but if it’s truly an emergency (for example, an allergic reaction or anaphylaxis or bleeding emergency), go to whatever ER is closest. ER doctors, even those who don’t have specific pediatric training, do know how to stabilize a pediatric patient and can transfer to a children’s hospital or ER if needed.
- Contact your pediatrician before you go to the ER. They can make doctor to doctor calls to facilitate the handoff and fill in gaps on history. I do this firsthand for my families and wish more pediatricians did because it does help provide some background information, clinician to clinician.
- You may have a long visit ahead of you. It’s not because we’re lazy or bad at managing time. ER docs are actually fabulous at managing time. There are just a lot of things (procedures, discharges, re-evaluations, etc) going on. Patients receive treatment based on how sick they are, not in the order they arrive. Care is based on acuity.
- That being said, you can 100% speak up and say that you’re worried about the wait and may need your child re-assessed. Nobody will mind.
- You can request to stay overnight and be admitted to the hospital if you are uncomfortable with your child being sent home.
Let’s say you do end up needing to stay the night or be admitted for a longer period of time.
If you are in the hospital:
- In rare occasions, we admit directly in patient, or to the hospital floor, bypassing the ED. Your pediatrician will review this with you if that is the case.
- You may have more than one doctor. Often times, large hospitals are teaching institutions. That means your medical team can consist of medical students, interns, residents, and attendings. Final decisions in patient care are made by physicians, not medical students, but medical students are an important part of the team.
- You can participate in rounds. That means if they discuss the number of wet diapers, the consistency of stools, the labs and/or X-rays done, you have the right to listen in and look at the imaging yourself alongside the team.
- You are allowed to ask for more detail. You can ask and should if you have questions, if someone from the medical team can come back later and answer your questions. Sometimes, this might be the nurse, medical student, resident, or attending on the team.
- Your hospital team may, and often should, touch base with your child’s outpatient pediatrician. The outpatient pediatrician (like me, for example), knows your child well. They have a record of your child’s medical history and have seen them more than once-both well and sick. (Side note: See how important it is not to have fragmented medical care?)
Some important points I want to mention, whether your child goes to the ER or gets stepped up to a hospital inpatient admission:
Get clear discharge instructions, whether it’s from the ER or from the hospital. Make sure you know how to treat your child and what to do if symptoms don’t improve or worsen. And ask for clarification if you don't understand!
Lastly, follow up with your pediatrician. Really! We want to know what happened, what was diagnosed. We want to check in and knowing your child’s history, we may be able to provide more personalized medical advice.