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When to Take Your Child to the ER

To a parent, especially a new parent, a child's small cold or knee scrape can seem to call for a trip to the emergency room. For people who don't have medical degrees, it can be difficult to recognize the real signs of a medical emergency. Babies can be especially tough, because they lack any real communication skills to tell you there is something very wrong. Older toddlers present their own set of problems, as they are often more adventurous, and therefore more at risk for serious injury.

So how can you recognize the signs of an injury or sickness so serious that it requires a trip to the emergency room? CBS News medical correspondent Dr. Jennifer Ashton, who is also a mother, gave her insider tips below on how to know when it's time to call 911.


Recognizing when to take your baby to the Emergency room can be difficult. Not only can babies not articulate their health issues, but they are delicate and can react dramatically to anything that affects them physically.

Here are a few tips….

Day-to-day baby habits are important!

• Are there any changes in their eating habits?
Every baby is different and there is no set amount that any baby should eat. The real way to know when your child is finished feeding is when they refuse more. However, on average, a baby from 0-4 months who is just eating formula should be taking in about your baby's weight x 2.5 ounces. Has your baby's intake gone way up or way down? This could be a sign that something bad is happening.

• Are there any changes in their bowel movements or urination patterns?
Babies should be wetting their diapers five or six times a day. A newborn can have as many as eight to ten bowel movements a day, but as long as she is having at least one, she's probably all right. If you notice a drastic change in these basic habits, again, especially if they coincide with changes in eating and/or sleeping, it might be a signal of something more serious.

• Are there any changes in the number of hours they are sleeping?
At 3 months, most babies sleep a total of 12 to 15 hours a day, including nighttime sleep and naps. Typically, by age 3 months or so, babies have started to develop more of a regular sleep/wake pattern and have dropped most of their night feedings. Has your baby stopped sleeping? Or are they sleeping a lot more than usual? Again, these signs, ESPECIALLY a combination of two of the three, or all three is a sign that the ER might not be a bad idea.

• Your baby is inconsolable.
If your baby is younger than 5 months old and cries for more than three hours in a row, it's time to see a doctor. If the level of crying sounds like hysteria, and you would describe it as inconsolable with no times of stopping, then perhaps it's time to go to the ER. According to Reuters, a Canadian study says that only 1 in 20 cases is inconsolable crying a serious matter. According to this same study, the most common serious medical matter associated with inconsolable crying was urinary tract infection, with infants less than 1 month old having the highest rates of infection.


• When your child is in some sort of an accident-CONSIDER the mechanism of injury.

The "mechanism of injury" is a trauma term. The laymen definition: the way damage to skin, muscles, organs and bones happen. Healthcare providers use mechanism of injury to help determine how likely it is that a serious injury has occurred. For instance, a low-speed fender-bender in a parking lot is much less likely to cause a life-threatening injury than a rollover accident on the freeway. Tripping over a loose rug can cause an injury. In that case, the healthcare providers are likely to list the mechanism of injury as a ground-level fall, which is not as bad as a "long" fall (falling from a height three times as tall as the patient).

The same holds true for children and toddlers. When your child fell off the jungle gym, was it from the highest rung? When your child was injured, were they thrown from a moving car or did they fall over on their bike?

Considering how they were injured is an important aspect of understanding the magnitude of their injury.

• Consider the ABC'S
-AIRWAY-Is your child breathing normally? Does their breathing seem halted or blocked? Shallow and too rapid? Normally, children can catch their breath easily after an accident or physical activity. If you find that your child is not getting their breath back, or their breath does not sound normal to you, an ER trip could be necessary.

-BLEEDING-When kids fall, they bleed. But how much blood is too much? If a clot shows no sign of clotting, that can be a sign that something is seriously wrong. Cuts should take about thirty minutes to clot completely. If the wound seems very deep or penetrating, especially if the edges of the wound do not come together by themselves or the wound is more than 1/2 inch long, you should seek medical attention right away.

-COLOR-This indicator is good for young toddlers and babies alike. If your child's color looks abnormal, bluish, grey, a sickly yellow, this can be a serious indicator that something internal is going on.

• Change in Mental Status
Does your child seem delirious? Is he babbling, or has he stopped making sense?

Often, children can begin stuttering at an early age, this can be worked on, or is chronic. Consult your doctor. An ER visit is often unnecessary.

But, if your child has been behaving normally, and begins to speak in an entirely different way, or babbles incessantly, it could be a sign of a more serious problem like high fever or meningitis.

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