Pediatric emergencies in practice

Pediatric emergencies in practice

As a young parent, we are always worried about the health of our baby and we dread the moment when we will have to go to the pediatric emergency room. What are the situations that require going there, should you call 15?, which hospital should you go to? So many questions that we asked Fabienne Kochert, pediatrician.

When you are a parent, and even more so of a baby, health is a subject of concern. “ For parents of infantsthere are many sources of concern: prolonged crying, fever, stuffy nose, difficulty breathing, diarrhea, vomiting, etc. », assures Fabienne Kochert, pediatrician. And therefore, when your child is sick, the temptation is great to take them to the pediatric emergency room of the nearest hospital, or even to the CHU (University Hospital Center) for medical advice and care as quickly as possible. “However, this reflex is not always justified and contributes to the overcrowding of hospital emergencies.“, underlines the pediatrician.

When to go to the pediatric emergency room?

« Emergency services are reserved for serious situations. In most cases, situations felt to be “urgent” can be managed on an outpatient basis by the pediatrician or a general practitioner.“, explains the pediatrician, before adding: “ You should only go to the emergency room if your child’s condition seems worrying to you. However, the smaller the child, the sooner it is necessary to consult“. Fever is a frequent cause of concern for parents. In practice, before 6 weeks, any child with fever or difficulty breathing must be seen in the emergency room. Between 6 weeks and 3 months, an infant must be quickly examined, but it does not necessarily have to be seen in the emergency room.

Emergency symptoms that should alert you

Be careful, whatever their age, if your child is pale, prostrate, apathetic, very limp, has purple spots on the skin in addition to fever (which do not disappear when you press on them), moans, has blue lips, presents involuntary jerks, has rolling eyes or has lost consciousness, his care is a hospital emergency. Other signs that should alert people at any age include, in addition to fever, repeated vomiting of green (bile), red (blood) or black (digested blood), profuse diarrhea with dry lips, sunken eyes, crying in a child. very irritable, inconsolable child, extensive burn, falling on the head with loss of consciousness, pain in the testicles, sudden limping, inability to stand up, etc.

A well-tolerated fever, don’t panic!
Also note that after 3 months, if a child has a fever but remains well colored, has warm extremities, has usual behavior, and is breathing normally, it is not necessary to consult immediately.

Parents: good reflexes before going to the emergency room

Firstly, and to avoid overwhelming hospital emergencies, it is preferable to contact the pediatrician or general practitioner who is treating your child. For our expert, “ If the latter are not available, it is advisable to find out about the organization of unscheduled care in your territory or to contact structures such as SOS Médecins, which also treat children. If necessary, contact 15 before going to the emergency room“.

I call 15 if:
My baby is in vital distress: he has difficulty breathing, a poorly tolerated fever, has unusual behavior, moans, is totally listless, poorly colored (pale, blue lips, etc.).

How pediatric emergencies work

Pediatric emergency services welcome children after they leave the maternity ward and up to the age of 15 years and 3 months. They are most often attached to a hospital or university hospital. Some hospitals offer separate pediatric medical and surgical emergencies. “ There are few offers of pediatric care in private hospitalization structures », specifies Dr Kochert. In all cases, before going to the emergency room of a hospital, it is preferable to call 15. The regulating doctor will direct you to the structure best suited to your child’s state of health.

Caring for young patients in the emergency room

In the pediatric emergency department, the young patient will be cared for by a medical team: pediatrician, general practitioner or emergency doctor, nurse, childcare worker, etc. depending on the care required. Sometimes your child will be examined by a medical intern (postgraduate medical student). There is always supervision by a senior doctor. If your child shows signs of vital distress, he will be treated quickly. In other cases, the processing time and therefore the waiting time can be long (especially during an epidemic).

Depending on the patient’s state of health, the visit to the emergency room will be limited to a consultation with a discharge and return home during the day.. According to Dr. Kochert, “this is the case in 90% of visits to the emergency room“.

When can a young patient be hospitalized?

In other cases, the medical team may decide to hospitalization of your child. « If the doctor who took care of your child decides to hospitalize him or her, it is to provide care that cannot be provided in the city (such as an infusion, an oxygen probe, intravenous antibiotics). intravenous, etc.) or because additional examinations must be carried out quickly (blood tests, radiological examinations, etc.) “, explains the pediatrician.

For a simple additional assessment or short-term monitoring, your child may be admitted to a UHCD (Short-Term Hospitalization Unit) and will return home quickly after being seen by a doctor from the department. For more complex cases, your child will be admitted to a hospitalization department (general or specialized pediatrics or pediatric surgery) or much more rarely to a UPSI (Pediatric Intensive Care Unit).

I’m going to the pediatric emergency room: what should I take with me?
Don’t forget your child’s health record, the results of assessments or examinations already done before, your vital card, the family record book (or your child’s identity document), their comfort blanket and a change, as well as food according to his age.

In the absence of a life-threatening emergency, I am worried about my baby’s health: what should I do?

First, contact the pediatrician who treats your child or your general practitioner. In certain cities, private pediatricians provide on-call care on Saturday afternoons and Sundays as well as on public holidays. If they are not available, inquire about themedical homes or medical structures in which doctors receive walk-ins for pediatric consultations. Finally, for questions that cannot wait and do not require a consultation, the pediatricians of the AFPA (French Association of Ambulatory Pediatrics) offer a chat every evening from 6:30 p.m. to 9 p.m.; a pediatrician answers parents’ questions live.