In the last two months alone we have had two emergency department visits, a surgical procedure, 5 other hospital visits, x-rays, blood tests, consults with GPs, OTs and specialists. Luckily I only have two children. People ask me how we do it but I kind of think dealing with doctors and hospital is now my mum super power. In reality having a child with a disability and medical issues has made us familiar with medical appointments and the hospital environment. For less familiar families a visit to hospital, particularly the Emergency Dept can be a scary experience.
So today I have joined with my sister Lauren who is an Emergency Department nurse (and often the nurse in charge) to give some expert tips. She works in one of the countries busiest trauma Emergency Departments in the country and has been there for over a decade. Unfortunately she has seen it all when it comes to trauma, emergencies and families. I hope these tips help you if you ever need to take your child into the emergency department.Let’s talk about vomiting and the ED
Vomiting and taking kids to Emergency
I hate gastro and seeing your child with a nasty vomiting bug is horrible for any parent. Lauren says You do not need to bring your child to the ED after they have one vomit or one loose bowel motion. You can attempt to encourage oral fluids at home, preferably clear fluids (water apple juice orhydralite). Do not worry so much about food in the first few hours but hydration is key. If your child has blood in their stools or vomit, always get checked. Encourage your child to have small frequent sips opposed to large gulps which are easily re vomitted.
So the key here is try to ride it out at home, offer small sips and lay off the food. If the vomiting occurs for a long period of time and they can’t keep fluids down, or their tongue looks dry then take them in.
Fevers may not always be a bad thing
When talking about temperatures Lauren shared that so many parents focus on a number. Your child may have a high fever and be running around playing as normal, or have a normal fever and be very unwell. Go by how your child is behaving. Treat the fever with panadol and or nurofen before you come to hospital and see if it responds. If your child has a fever and a rash then bring them into Emergency.
I absolutely agree that children can feed off our worries. It can be upsetting seeing your child in pain but it is important that we help them to be as calm as possible for medical staff to do a correct assessment. Lauren says Keep calm. Your child will be watching your reactions and feeding off your behaviour. Keep calm and relaxed for them, getting upset will make them more distressed and can then make it hard to assess their actual physical distress.
Hold off feeding your child
When my daughter broke and badly dislocated her thumb recently she did it at the end of the day. When we went to the Emergency Department we had to hold off food and cope with a ‘hangry’ child till it was decided if she would require surgery or not. Kids need to be fasted before an anaesthetic. Lauren says Keep the food and drink away until they see the doctor. Your child will not starve in the time it takes to wait and see the doctor.
Know your child’s medical history
I could share in a concise manner my child’s medical history in my sleep. I have become an expert at it. We have given up on the small blue book and have a larger folder. Being able to share a full medical history gives treating doctors a more accurate picture. Lauren says Bring the childs blue book, or be able to tell the childs history to any medical professionals. Also if your child has been in the hospital before and you know the childs medical number bring that or tell staff that too.
Nurses are there to help
I can’t imagine parents sharing any other message with their kids but Lauren says this is an issue nurses see time and time again. Lauren says The nurses and doctors are not “mean”. We do not give needles to “naughty” children. Please do not tell them that. We are there to help them get better, we don’t need them to be any more frightened of us.
Work with staff, not against them
I can relate first hand to this. Raffy has at times had procedures that were uncomfortable and he didn’t like them eg blood tests, learning to tolerate his CPAP machine. However these procedures were necessary. I listened to the nurse and while it was upsetting to see Raffy crying we stuck with the CPAP machine. Within the day he had learnt to tolerate it which meant we could go home. In the bed next to me the parents took the machine off every time the nurse left. Lauren says We are there to help your child, if it is deemed necessary that a procedure needs to take place then please try to help the staff. Eg: if a child requires and oxygen mask or nasal prongs, not many children enjoy having it applied for the first few minutes. Do your best to soothe your child and try to prevent them pulling it off. It is for their benefit and the excuse of “they don’t like it” becomes very frustrating, remember we are trying to help your child.
Expect to Wait
Fortunately for most of us we will take our children to the Emergency Department and they will be well enough to be required to wait. You see in the Emergency Department being triaged and not flown straight through to the Resus bay is actually a good thing. No medical professional wants a child to be in pain or distress longer than necessary but the nature of the Emergency Dept means that the biggest emergency is going to be treated first. And this is just the way I want it to be. I am happy to wait because I have been the parent of a child rushed straight through an Emergency Department. Lauren It is an Emergency Department. We understand your child is the most important thing in your life however your version of what is an emergency is not always ours. Your child will be seen in due course but there can be unexpected delays come into the department due to the nature and unpredictability of the ED.
Bring a Distraction
What I love the most about the ED at Melbourne Kids Hospital is the gigantic fish tank which can keep kids occupied for ages. If you have the time and forethought then grabbing a screen device such as an ipad (and the charger) can be a lifesaver. Lauren says Bring your childs favourite book or toy to help keep them occupied and feeling safe.
As parents it is our job to ask questions and at times advocate for our child. As long as you choose the right time and aren’t aggressive I have found staff more than willing to answer any questions I, or the kids, may have had. Lauren says If you have any questions then ask, we will try to explain to you as clearly as we can however if you don’t ask please ask for clarification. This is an important point. If you don’t understand then don’t feel stupid. Medical terminology can be complicated. Ask for it to be explained again, ask if they have a pamphlet or if they can draw a picture. Also if you need an interpreter then tell staff as early as possible.
Have a great GP
Our GP is invaluable to our family. I occasionally send her flowers to say thank you. Sometimes I think I should have frequent flyer points because we both know we are keeping her practice going. A good GP knows your child, can often help your child avoid an Emergency Dept visit, can hasten appointments with specialists when required and can provide you with a letter to give to ED staff if they feel a hospital visit is needed. Lauren says Make sure you have a good GP. Many trips to ED are for things which could have been dealt with by a GP. Coming to ED for minor things makes the wait times for yourself and others longer. You will also need a GP to liaise with upon discharge.
So there you have some great advice from a parent and medical staff on the front line. We hope your child never needs to go into an Emergency Dept but if they do now you know the best thing to do to make it the smoothest experience possible.