Injuries and acute illness can be scary for parents, but it's important that pediatricians counsel them on when and why to seek emergency medical attention.
According to the Centers for Disease Control and Prevention (CDC), accidents and unintentional injuries are the leading cause of death in children aged younger than 14 years. Falls, animal bites, burns, poisoning or other accidental ingestions, and motor vehicle crashes are among the top causes of injury, and many times these patients are brought right to the emergency department (ED). When injuries are more minor, however, there might be a better path, but it depends on how prepared the parent is.
A new C.S. Mott Children’s Hospital National Poll on Children’s Health reveals that many parents of young children commonly use the ED for minor illnesses or injuries that could be handled at home. Although there are benefits for these parents in terms of the reassurance they receive from medical staff at the ED, there is also a high cost at stake. Traveling to the ED could take up valuable time that would be better spent with quick intervention at home; for example, in the case of dislodging an object from a choking child's mouth at home versus traveling for medical care. Mott experts also caution about the high cost of emergency care, as well as the resources minor cases could take away from true emergencies.
Many parents who took the poll indicated that their first action in an urgent situation would be to call their physician or a medical service for advice. "This is a sound strategy that allows parents to avoid an unnecessary ED visit, but still obtain guidance from a healthcare professional," according to a statement from Mott on the poll. "The child’s usual healthcare provider is a common source of telephone advice; however, not all clinics have trained health professionals answering calls. It is important for parents to understand clinic policies related to telephone advice so they don’t waste time in an urgent situation waiting for a provider to return their call."
The study polled parents of children aged 0 to 5 years about how they make decisions in medical emergencies. Parents were given hypothetical scenarios and asked by researchers how they would respond. Some parents took appropriate action, however, many may have overreacted, according to the poll.
In regard to a scenario for a child with a minor burn, 71% of parents reported being confident in how they would handle the situation, yet 11% stated they would take their child directly to the ED and 5% would call 911. The most common response, given by 83% of parents, was to put something on the burn such as cold water, ice, or a cream.
Another scenario was presented to the parents about choking. Forty-eight percent of parents were confident that they knew what to do if their child was choking, and 69% reported that they would immediately try to dislodge the object blocking their child’s airway. A quarter of the parents polled stated that they would turn their child upside down, 29% stated they would call 911, and 11% would take their child to the ED.
Poisoning is another concern that pediatricians can address with parents, as children commonly ingest medications and other household substances. Pediatricians should make parents aware of the resources available through Poison Control and know how to reach them.
Half of parents polled stated that they were confident they would know what to do if their child ingested a medication, with 53% stating they would remove the medication, and 26% stating they would induce vomiting. Sixty-one percent said they would call Poison Control; 32% would take their child directly to the ED; 26% would call 911; and 5% would call their pediatrician, according to the poll.
After-hours or on-call services at pediatric offices can be helpful, but poll co-director Gary Freed, MD, MPH, professor of pediatrics at C.S. Mott Children's Hospital, Ann Arbor, Michigan, says first-aid classes are invaluable. "Pediatricians should encourage parents to take first-aid classes because one never knows when they'll need it," Freed says. "Those parents who take first-aid classes are certainly more confident in their ability to handle minor emergencies."
According to the poll, 10% of parents reported receiving first-aid training within the past year; 24% within the previous 5 years; and 23% had received first-aid training more than 5 years ago. Nearly half—43%—of parents, however, reported no first-aid or medical training at all.
"Parent should be made aware of Poison Control hotlines and be instructed on important, time-sensitive first aid for choking and stopping bleeding," says Freed.
Pediatricians should be educating parents on appropriate emergency responses and connecting them with training where available. According to the poll, training and education in first-aid strategies can help parents feel more confident to handle common medical issues. Pediatricians could keep a list of resources and refer parents to appropriate training programs, according to Mott's experts.