Where to Turn When your Child Needs Medical Attention, STAT

. December 2, 2016.
ER

Sooner or later, all parents face an unexpected medical meltdown: the baby spikes a scorching fever in the wee hours. The preschooler swallows something suspicious. The middle-schooler wrenches an ankle at basketball practice. When faced with a medical emergency—or a situation that could become one—what’s a parent to do? Head straight for the chaotic, costly hospital emergency department (ED)? Or a local urgent care center?

Don’t load your sick kiddo into the car just yet. It’s best not to rush to an ED or urgent care right away.  “The best first move is to contact your child’s pediatrician,” says Dr. Andy Seiler of Liberty Pediatrics in Ann Arbor. With knowledge of your child’s medical history and any existing conditions, your child’s pediatrician is best equipped to steer you toward the appropriate critical-care option, says Seiler. And whatever treatment course you take, notifying your pediatrician allows the doctor to update your child’s medical chart and follow up as needed.  Also, providers who cannot know your likelihood of following up are more likely to do tests and prescribe antibiotics that may turn out to be unnecessary. Sore throats, earaches, coughs, and rashes are much better handled in the office as long as your child can be made comfortable in the morning, again because many children are over-treated in ED and urgent care settings, Seiler asserts.

If a child is an infant or needs a CT scan, IV hydration, care for a broken bone, or surgery of any kind, the child is much better off in a hospital setting, where the required procedure can be performed quickly, and will use minimal radiation techniques, says Seiler. But urgent cares can be great lower-cost options for older children with minor cuts, burns, strains, and sprains.

Urgent care or emergency room?

When might parents want to consider an urgent care center instead of an emergency room? Urgent care centers can be a quick alternative to a regular doctor’s office visit, because patients can be treated for minor cuts, obtain prescriptions, and get basic lab work and X-rays. Another factor is cost: according to insurance provider Blue Cross Blue Shield, the average emergency room visit has a pre-insurance price tag of $1,045, while urgent care treatment comes in at just $130.

But before you write off the ER as too costly, consider this: if your child needs to be transferred to an ER after visiting urgent care, as many do, you’ll end up footing the bill for both. Most insurance plans cover emergency room care, and federal law requires that emergency rooms treat all patients, regardless of insurance status or ability to pay.

The bottom line

Any time parents perceive a life-threatening condition, they should call 911 and take the patient to the emergency room. Conditions requiring a swift ER visit include significant injuries or deformities to limbs, difficulty breathing, ingestion of a foreign body, head injury or concussion, significant trauma or bleeding, sudden severe pain, severe allergic reactions, and dizziness, disorientations, or sudden changes in mental functioning. Questions about fevers, vomiting, diarrhea, and flu-like symptoms should be fielded by a child’s pediatrician, while concerns about possible poisoning warrant a call to the local Poison Control Center. Those experts will advise you on whether your child needs to head straight to the ER or not.