Do you know when to take your child to the ER?

Debbie Steward of Carol Stream knows a thing or two about sticks and stones and broken bones.

The mother of four is an expert at handling scrapes, scratches, cuts and bruises. She also has spent her fair share of time in the local emergency room with one or another of the children needing emergency care for broken bones, sprains, and strains.

While eldest daughter, Brie, 16, and 4-year-old Keiley haven't required emergency room care, the twins — 10-year-old Shelbie and Joey — are another story.

“It was a scooter incident and a basketball practice injury that sent Shelbie to the ER twice for a broken wrist,” she recalls. “Another time it was an accident in a bouncy house which landed her in the ER and resulted in surgery to fix a broken elbow.”

Twin brother Joey needed stitches to close a laceration from a sliding closet door and suffered a broken foot in his own family room as he was trapped by a recliner.

The Steward family's experience isn't unusual, say local emergency room doctors, who label orthopedic injuries and household accidents as one of the most common reasons kids are seen in the ER.

Sticks, stones & broken bones

“Orthopedic injuries are big,” says Dr. Todd Zimmerman, medical director of pediatric emergency medicine at Alexian Brothers Medical Center in Elk Grove Village, and St. Alexius Medical Center in Hoffman Estates.

“Sports injuries, sledding, bikes, skating accidents and falls all bring kids to the ER for evaluation and treatment,” states Zimmerman, who heads the Alexian Brothers' EmergiKids pediatric emergency care program, treating 18,000 children and teens annually at both sites.

He says trampolines and bouncy house injuries also are soaring, with nearly 100,000 people per year injured. The American Academy of Pediatrics cautions that parental supervision and protective netting aren't adequate to prevent these injuries.

“Injuries to muscles, joints and bones are common causes for emergency room visits for kids of all ages,” states Zimmerman, who welcomes extended EmergiKids hours from 10 a.m. to 2 a.m. seven days a week beginning in early April.

Concussions

Head injuries are especially worrisome. It doesn't even have to be a direct blow to the head, say experts who note that even a ding, getting “your bell rung” or what seems like a mild bump or blow to the head can be serious.

According to the Centers for Disease Control and Prevention, every year in the United States, emergency room doctors treat as many as 3.8 million children and teens with sports and recreation-related concussions.

“Children and teens don't have to become unconscious to have a serious concussion,” says Zimmerman, who notes “we're paying more attention and are more aware of brain injury symptoms and the need to seek specialized concussion care from a pediatric neurologist.”

Be on the lookout for signs including: headaches, photo and noise sensitivities, nausea, dizziness, amnesia, behavioral changes, difficulties with balance and delayed word recall like forgetting a sibling or favorite pet's name.

Hot, hot, hot!

Fevers top the list of reasons why children under 15 are seen in the emergency room, according to CDC statistics and local experts.

There's no rule of thumb for gauging how high a fever should be before parents become concerned, says Dr. Neal J. Edelson, chief medical officer at Presence St. Joseph Hospital in Elgin.

“Moms and dads know their child best,” says the emergency physician, whose busy ER sees more than 30,000 patients each year. “Sometimes with a viral illness, a high fever is common. Other times in the case of possible meningitis, even a low grade temperature can be cause for concern.”

The take-home message, according to Edelson, is “if you are worried, come in immediately,”

Be on the lookout for: signs of dehydration, a child not eating or drinking, shortness of breath, head, neck, or abdominal pain, and sudden onset of symptoms.

When to go to the ER?

Respiratory infections of the nose and throat, vomiting, ear aches and infections, abdominal and stomach pain, cramps, rash, and headache all make the list of top reasons for pediatric emergency visits.

“Go right away with any shortness of breath or sudden pain onset,” advices Edelson. “On the other hand, if it's not urgent, a quick call to the pediatrician often can alleviate fears.”