When should we use the emergency room?

Dear Editor,

Part of my job as the nurse here at Southwest Nebraska Public Health Department is to follow up on emergency room visits of children (primarily newborns thru age 19 yrs) to ERs in our department's five hospitals. Educating people to make appropriate choices for health and making sure everyone has a primary or regular doctor, dentist, and vision specialist is the goal.

Making the decision to visit the ER is instead of going to a regular doctor or clinic for treatment ultimately is because of inaccurate information and/or lack of education on the definition of "emergency."

* 75 percent of all visits to the hospital ER are not emergencies

* Hospital emergency room visits increase health care costs.

* A visit to the ER costs more than a visit to your doctor's office

* Incorrect use of the ER increases insurance costs for everyone

According to the American College of Emergency Physicians, nearly 100 million people go to the emergency room each year.

Note: Many parents do not know if a condition can wait until the clinic opens. They may have "heard" of someone with similar symptoms who died or had serious consequences; or they may have "read" about it happening. Or they may think they are being a "good" parent by having their child seen "immediately." Some may have had symptoms for more than one or two days but did not think of calling for an appointment at the clinic when it was open. Some developed symptoms and became ill on a day their clinic was not open (perhaps a week end or holiday).

The following information was taken from the American Academy of Pediatrics publication "When Your Child Needs Emergency Medical Services"

It is rare for children to become seriously ill with no warning.

Depending on your child's symptoms, you usually should contact your child's doctor or health professional for advice. Early recognition and treatment of symptoms can prevent an illness or injury from getting worse or turning into an emergency.

What is an emergency?

According to the American Academy of Pediatrics, an emergency is when you believe a severe injury or illness is threatening your child's health or may cause permanent harm.

Emergencies can result from medical (or psychiatric) illnesses or injuries.

If your child shows any of the following signs it is likely an emergency.

* Acting strangely or becoming more withdrawn and less alert

* Less and less of a response when you talk to your child

* Unconsciousness or lack of response

* Rhythmic jerking and loss of consciousness (a seizure)

* Increasing trouble with breathing

* Skin or lips that look blue, purple, or gray

* Neck stiffness or rash with fever

* Increasing or severe, persistent pain

* A cut or burn that is large, deep, or involves the head, chest, or abdomen

* Bleeding that does not stop after applying pressure for 5 minutes

* A burn that is large or involves the hands, groin, or face

* Any loss of consciousness, confusion, headache, or vomiting after a head injury

Many emergencies involve sudden injuries. These injuries often are caused by the following:

* Bicycle or car crashes

* Falls

* Burns or smoke inhalation

* Choking

* Near drowning

* Firearms or other weapons

* Electric shocks

* Poisoning*

*Call the POISON CENTER at 1-800-222-1222 at once if your child has swallowed a suspected poison or another person's medication, even if your child has no signs or symptoms.

A final note: Be ready for emergencies. Know what defines an emergency.

For non-emergency conditions, ask your doctor during a regular office visit what you should do if a medical problem occurs after clinic office hours. If your child has signs of illness, call your doctor or medical provider to schedule an appointment to be seen before a serious problem arises.

Bev Powers, RN

Public Health Nurse