How to Survive the ER with Your Child

In my role as an emergency-room physician, I'm sensitive to my patients' needs. As a mother, though, I have a whole new appreciation for just how devastating a child’s injury or illness can be. There is an unavoidable parental instinct that leaves us desperate to protect our children from suffering of any kind. And we know that children all handle things differently—some are brave and stoic, and some are like my youngest child, who recently howled hysterically for 45 minutes after a skinned knee, while demanding a “pedaticeen.” (An ER doctor was not acceptable for this crisis, apparently.)

We do try really hard to keep things moving as fast as possible in the ER. As you can imagine, the continual flood of mayhem and carnage makes this challenging. Patients are seen according to the severity of their complaints, not the order in which they arrived. That being said, there are things you can do to make the (possibly) excruciating wait and ordeal of treatment easier for you.

Avoid an Evening Visit if Possible

In general, evenings are heinous. Everyone from the teenager with a socially crippling zit to the unresponsive coding 70-year-old comes in at night. Meanwhile, you and your irate little guy with the ear infection are withering away from boredom and irritation. If it’s not emergent, talk to your pediatrician’s office before you come (they usually have someone to answer phone questions 24/7). You might be able to avoid a night-time ER visit with some guidance from your doctor or nurse.

That being said, most of you are in the Emergency Department because you have no other options. You may, however, have some choices regarding the actual treatment. Good examples: dermabond versus sutures, and observation versus a CT scan. If you are uncertain about something, it doesn’t hurt to ask, “What happens if we don’t do this?”

Come Well Prepared for A Wait

As the mother of little ones, I always keep an activity bag in the car. Coloring books, alluring toys, stickers, handheld computer games, whatever your little darlings are likely to find interesting. If you have time to grab a laptop loaded with movies, even better. Think of it like the 4-hour plane ride to Grandma’s house with ornery toddlers: Go for whatever allows you to get through it.

Even if you're too rushed to get playthings and snacks together, you may not be out of luck. Once in the exam room, if there still might be a delay until you are seen, staffers sometimes can bring you warm blankets, drinks (if they are approved--see tip #1 below) and even toy. Part of our job is to make your unfortunate experience as pleasant as possible. Of course, it helps to realize that the doctors and nurses are often incredibly busy. There are shifts where I keep having to delay seeing a patient who has been there forever, as one ambulance after another arrives with something urgent. I hate to wait in doctor’s offices as much as the next person, so I really do sympathize. 

Take Advantage of Time-Savers

The good news is that there are often plenty of things you can do to cut down on the amount of time you spend in the ER. These savvy strategies can all help:

1. Don’t feed the patient. There are some injuries and illnesses which require sedation. Doctors worry that during sedation the contents of the stomach could whoosh up from the esophagus into the lungs—an occurrence called aspiration—which can cause all kinds of badness. Sometimes sedating someone with a full stomach is unavoidable, and sometimes the risk is judged to be low, but check with the triage nurse for an okay before you give food or drinks to any child waiting to be seen in the ER.

2. On a somewhat related note, check with the same nurse before your child goes to the bathroom, in case a urine sample might be needed. This could save you hours later on.