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This article originally appeared in the Nov. 4, 2010, edition of the St. Louis Post-Dispatch. 


Even healthy kids get hurt and sick sometimes.  It’s often difficult for parents to know whether they can kiss the injury and make it better, or if a trip to the emergency room is necessary.

Different problems require different levels of care. And when your child needs some sort of medical help, you have many options:

Handle the problem at home. Many minor injuries and illnesses, including some cuts, certain types of rashes, coughs, colds, scrapes, and bruises, can be handled with home care and over-the-counter (OTC) treatments.

Call your doctor. If you're unsure of the level of medical care your child needs, your child’s primary care pediatrician — or a nurse who works in the office — can help you decide what steps to take and how.

Visit a hospital emergency room. An ER — also called an emergency department (ED) — can handle a wide variety of serious problems, such as severe bleeding, head trauma, seizures, meningitis, breathing difficulties, dehydration, and serious bacterial infections. A Level 1 Pediatric Trauma Center, like that found at SSM Cardinal Glennon Children’s Medical Center, is equipped with all the equipment and medical expertise to handle any type of emergency, no matter how serious.

Call 911 for an ambulance. Some situations are so serious that you need the help of trained medical personnel on the way to the hospital.  In these cases, dial 911 for an ambulance.

You should go to the Emergency Department if your child has:

  • difficulty breathing or shortness of breath
  • a change in mental status, such as suddenly becoming unusually sleepy or difficult to rouse, disoriented, or confused
  • a cut in the skin that is bleeding and won't stop
  • a stiff neck along with a fever
  • a rapid heartbeat that doesn't slow down
  • more than minor head trauma

Other situations may seem alarming, but don't require a trip to the ER.  You can save a trip to the hospital but should still call your doctor if your child has high fever, ear pain, pain in the stomach, a headache that doesn't go away, a rash, mild wheezing or a persistent cough.

“Whether the situation is life-threatening or relatively benign, the best thing a parent can do for their child is take a deep breath and try to remain calm,” says Dr. Josh Colvin, an emergency department physician at SSM Cardinal Glennon Children’s Medical Center and Assistant Professor of Pediatrics at Saint Louis University School of Medicine. “If the parent steps up to plate and remains calm, the child will take their cues from them and will have a much better experience.”

When in doubt about the level of your child’s injury or illness, call your primary care physician. Even if the doctor isn't available, the office nurse will be able to talk with you and determine whether you should take your child to the ER. On weekends and evenings, doctors have answering services that allow them to get in touch with you if you leave a message.

It’s best to talk with your child’s doctor before he or she gets sick about how to handle emergencies and inquire about the doctor's policy on addressing medical needs outside of office hours. Having that information ahead of time will mean one less thing to worry about when your child is sick.

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center and is a Professor of Pediatric Medicine at Saint Louis University School of Medicine. If you have a question about your child’s health, go to the “Ask Dr. Bob” section of the Cardinal Glennon Web site at

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