Children’s health: When to take your child to the emergency department

If your child breaks a bone, struggles to breathe or suffers frightening thoughts that tell them life isn't worth living, will you know how to help them?

These are examples of medical emergencies that parents and caregivers must be ready to manage. A medical emergency is defined as any point when a sudden injury or illness could end a child's life or severely harm their health. Injuries are the number one cause of death among kids in the U.S., so families need to prepare themselves to act when seconds count.

The most common injuries seen in kids and teens include falls, car and recreation vehicle crashes, drowning, poisoning, burns, suffocation, sports injuries, and dog bites. In the U.S., more children and teens die from injuries than from cancer, birth defects and all other causes combined. This is a serious health problem that needs a better approach.

And not all medical emergencies stem from sudden injuries. Children may need emergency care when existing health conditions flare up. For example, a child with asthma or allergies might struggle to breathe, even after rescue medications are given. Kids with diabetes can go into shock when their blood sugar spikes, and children with epilepsy can have severe seizures that call for quick medical attention.

If your child is sick or hurt but doesn't seem to be in serious danger, it's usually best to reach out to their doctor first. Do call 911 immediately if your child or teen is struggling to or can’t breathe, is having a seizure, loses consciousness, is bleeding uncontrollably, sustained a serious burn, ingested something poisonous, or is witness to or the victim of a serious crime.

If you're not sure what's wrong, but you believe your child is in danger, call 911. The operator will ask questions and guide you through the next steps in finding the care your child may need.

An emergency department that is properly prepared to care for any ill or injured child is called “pediatric-ready.” A pediatric-ready emergency department has the ability to stabilize and transfer your child to a trauma hospital. Unfortunately, many U.S. hospital emergency departments aren't fully equipped to care for injured children. They may not have the right sized equipment or training to provide the best and safest care.

In the worst cases, young lives are lost to a lack of resources, training or staff. Children who survive may suffer worse health outcomes than those treated in hospitals staffed and prepared to treat injured children. In addition, many kids face barriers to getting the quick, effective trauma treatment they need.

The American Academy of Pediatrics (AAP) calls for a stronger pediatric trauma care system in the U.S. This starts with injury prevention programs focused on babies, children and teens. Improved emergency response systems — coupled with better hospital treatment, transfers between hospitals when needed, and effective post-injury care — can help all injured kids recover and thrive.

For immediate help over the phone, there are a few phone numbers parents and caregivers should know. 988 is the nation’s Suicide & Crisis Lifeline, where trained counselors are available 24/7 to help anyone facing a mental health crisis. Parents, caregivers and family members can call, text or chat to find urgent care for a child or teen experiencing suicidal thoughts or actions, emotional outbursts, extreme anxiety, or a desire to harm others.

If your child swallows something that could be toxic, call Poison Control at (800) 222-1222 for immediate help, even if they show no signs or symptoms of sickness. Possible poisons include household cleaners and air fresheners, nail polish remover, medicines meant for someone else, yard and garden chemicals, gasoline or antifreeze, liquid nicotine or cannabis from vapes, batteries, especially coin-shaped batteries, and magnets.

Have the package of what your child swallowed in hand when you call. This will help the operator pinpoint potential dangers and advise you how to find care near you. Learn more about Poison Control and first aid for poisoning emergencies at poison.org/.

While you wait for help to arrive, stay as calm as you can. This will help your child manage their own feelings. If your child is not breathing, give rescue breaths. If their heart has stopped, apply CPR or find someone who can. If your child is bleeding, apply steady pressure to the site with a clean cloth. If your child is having a seizure, carefully place them on the floor with their head and body turned to the side. Do not put anything in their mouth.

Once you have called for emergency assistance, do not move an injured child unless they are in immediate danger. Stay with your child until help arrives and bring any medicines they regularly take with you to the hospital.

When you get to the emergency department, share your pediatrician's name and contact information with the emergency team. This helps coordinate care with your child's doctor, which can make a major difference in helping them recover.

To help prepare for the possibility of a medical emergency, parents and caregivers can benefit from learning cardiopulmonary resuscitation, or CPR. The American Red Cross offers CPR training in nearly every community. Additionally, the American Heart Association offers a CPR course geared to the needs of friends and family.

In the U.S., 911 is designated as a universal number for emergencies, meaning it can be dialed from any phone to reach police, fire or medical assistance. However, there are some remote or underserved areas that may have limited 911 coverage.

If you're concerned that 911 calls might not connect where you live, you can make a test call using the non-emergency number of your nearest 911 call center. The operator who answers your test call can offer advice for calling for help in medical emergencies.

• Children's health is a continuing series. This column was provided by the American Academy of Pediatrics. See more at www.healthychildren.org.