What to expect in the emergency room
Here is everything you need to know about arriving at a hospital's emergency room.

It usually isn’t until you’ve had a child that one thinks to find out about the finer points of emergency medical care – and even then it usually isn’t until you’re in an emergency situation that you realise there’s a whole lot of information you’ve never been given. Here is some medical advice that will save you time, money and could even save your baby’s life!

In the emergency room

Having to take your baby to the emergency room is a harrowing experience. What you may not realise is that despite the fact that this is the biggest medical emergency of your life so far, there is a strict protocol that nurses and doctors in the ER have to follow which may not include attending to your child as soon as you walk in. This can be very confusing and frustrating.

Here’s what you can expect when you take your child to the emergency room:

Your child may not be treated immediately

“Emergency rooms (also referred to as trauma departments in hospitals) use a triage system to sort through patients in order of ‘emergency’,” says Mande Toubkin, National Trauma Manager of Netcare South Africa.

What this means is that each of your child’s symptoms is scored according to severity. These are then added up and the total indicates the “code” of your child’s illness on the triage scale. Depending on the seriousness of your child’s condition she will be coded as red, orange, yellow or green.

Code reds are very serious and need to be treated immediately; code oranges are less serious but do need to be treated within 10 minutes; while code yellows can be treated within an hour. Code greens can wait up to 4 hours to be seen by a doctor in the emergency room, so be prepared to wait a while if your child falls into this category.

“Code greens are essentially cases that can be seen by the family’s GP. Parents should remember that emergency rooms are for emergencies and your child’s high temperature might be lower on the list of priorities than the man who was stabbed in the stomach,” adds Mande.

“It is important to note here that in terms of emergency room medicine, a high temperature (of between 35°C and 38.4°C) is not necessarily a cause for emergency treatment. This goes for a rash as well, except for cases of convulsions or a purpura rash.” This is a rash of red or purple spots that don’t disappear when you press on them.

If your child has been unwell with an uncontrollable temperature during the day (particularly if it’s Friday), don’t wait until evening when the situation usually worsens to have it seen to (and a visit to the ER is your only option). See your GP or paediatrician during the day.

If you do have to go to the ER it may be helpful to ask your doctor or paediatrician to meet you there. In doing so you make sure that you go directly to your doctor for any follow-up visits, rather than having to go to the ER again (and possibly having to wait).

You may not see a paediatrician

There are different doctors on duty in the emergency room, so the type of doctor you see depends on who is on duty at the time. For instance, you may be taken to the emergency room with kidney failure and be treated by a gastroenterologist. On Your Baby’s Mom to Mom forum, Liezl Veldman (a sister at a private hospital) wrote: “Paediatricians need to be called out, or your child needs to be referred to one.”

Mande agrees with this statement. She adds that if your child does need to see a paediatrician and the hospital you went to doesn’t have one on call, you will be transferred to another hospital. If you are taking your child to the emergency room for a follow-up visit after your initial emergency, you won’t see the doctor you saw before.

A broken arm is not an emergency

Hard to believe, but the truth – a fractured (or broken) arm is only considered a code red if the bone has pierced through the skin. If the bone has broken, but is not protruding through the skin, your child will be given a lower code of orange.  

Pain control is a right

If your child is in pain or is traumatised you can insist on pain medicine to calm her down. Mande says, “Medical care need not be a bad experience. Don’t allow your child to be hurt any more than she already is. There are many products on the market that can help your child be more comfortable, for instance if she needs to have blood drawn and is scared of the needle, the nurses can apply a local anaesthetic so that she doesn’t feel it.”

Emergency rooms have rush hours

Our roads aren’t the only places that experience especially busy times during the day. Mande says that emergency rooms are very busy between 4pm and 10pm, as there are usually a lot of accidents when people drive home after work. Most heart attacks occur during this time too. “As it is a very busy time for triage departments, you will have to wait if your child has a code other than red,” says Mande.

Remember your documentation

It can be very frustrating to get to the emergency room and not have a vital piece of information with you. Always remember to take the following:

  • your medical aid card
  • ID book
  • any medication your child may be on
  • some cash as you may have to pay an admittance fee upfront or pay for prescription medication. Remember that you may also have to pay the doctor that you saw separately from the hospital.
  • It’s also important to know your child’s weight, as the dosage of medications is worked out according to weight and not age. If you don’t know how much she weighs ask the nurses to weigh her for you rather than guessing.

The most important things are to keep emergency numbers in your cellphone and to stay calm in the face of an emergency.

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