When Things Go Bump: When To Call The Paediatrician And When To Go To Hospital

Visiting The Paediatrician vs Visiting The Hospital

One of the most common medical-related questions I get asked by fellow mama-friends is whether or not their sick or injured child should be taken to an emergency room. An ill child is any parents worst nightmare and when it happens after hours (and most of the time, it does) it makes the situation even more difficult. Parents have to choose between spending hours (and many dirhams) in an emergency room, sometimes unnecessarily; and staying at home waiting for morning, scared that their child’s condition maybe warrants emergency care.

Another question I frequently get asked, is which hospital to go to. This is actually an impossible to answer as it has so many influencing factors. Just note that your child will likely be seen by an emergency physician in the emergency department first, but all hospitals will have a paediatrician on call that can give advice telephonically or come out to see the sick child if the situation warrants it.

I can give the following advice to guide you.

To decide which hospital to go to speak to your insurance provider. Find out which hospitals are covered under your plan, as this will guide your decision. If you don’t have insurance, Latifa hospital is your best bet for paediatric care. Whether you have insurance or not, Latifa hospital is your go-to hospital for animal bites from strange animals (meaning where the animal’s vaccination history is unknown), as they stock the rabies vaccine for children. In case of serious trauma (for example motor vehicle accident) the ambulance will likely go to Rashid Hospital first. Once your child is stabilised you can request a transfer to private hospital of choice.

I would also like to highlight the importance of finding the right paediatrician/family doctor for your child and family. Once you have found a practitioner that you trust, discuss emergency care with him/her. Perhaps the clinic has an emergency number you can call, and some doctors are available via Whatsapp after-hours. Make sure of their opening hours, some clinics are open until late at night and some even on a Friday. They might also have a hospital they prefer, which would make admission and follow up care easier. Also find out if their clinic provides radiological services and if they do suturing. If they do not, it would be better to go straight to hospital in case of injury.

Your usual paediatrician will always be the best person to see your child. They know your child’s history and personality, and that makes the need for unnecessary tests and investigations less. So if you feel there is a way your child’s care can wait until morning, please do so.

The following conditions need to be seen urgently:

– Gastro-enteritis: but only if there are signs of dehydration (dry mouth, sunken eyes or soft spot on head, no tears when crying) or child is vomiting persistently, not tolerating even water.

– Possible fracture of limb: especially if bone is protruding through skin, or nearby body part is pale or numb.

– Coughing or throwing up of blood; or frank blood in nappy

– Serious burn wound

– Any wound that might need suturing needs to be seen within 24 hours, sooner if there is active  bleeding. If your child is very young, best to take him/her to hospital as suturing might need to be done under general anaesthesia.

– Ingestion of drugs/medication or any possibly toxic substance (and phone Poison Control). Remember to take the container with you so that the doctor can see exactly what and possibly how much your child consumed.

– Sudden weakness or paralysis of limbs

– Sudden onset of drowsiness, confusion

– High fever: if baby is less than three months, they do not respond to medication or is associated with severe headache, vomiting, neck stiffness and rash

– A new rash that does not whiten when you press a glass against it (especially if accompanied by fever, as said above)

– Allergic reaction with difficulty breathing, swelling of lips and hives

– Fainting spell

– Head injury with vomiting, drowsiness and change in pupil size

– Drowning and near drowning

– Lower abdominal pain radiating to right side, especially if paired with appetite loss and nausea

– Shortness of breath, with or without coughing and wheezing (unless your child is a known asthmatic and you are able to treat symptoms effectively at home)

Disclaimer: Please use your discretion. Most of above mentioned scenarios need to be seen in hospital regardless of the time of day. Others can be seen safely at your usual clinic within a reasonable amount of time if it occurs during office hours. If you feel the situation is life threatening, please go straight to hospital or phone an ambulance.

Most other things can be treated at home and seen at your usual clinic in a more convenient time, as long as you feel comfortable with your child’s condition.

In conclusion: Find a paediatrician/GP that you trust. This doctor should always be your first option to evaluate your little one when they are ill, unless it is a life threatening emergency. This will avoid unnecessary tests (not to mention the time and money you will save!). Secondly, your most valuable asset is your mama bear instinct. You know your child best and if something is bothering you, get some advice, preferably from a health care professional. Remember, nobody is going to think less of you if you take your child to hospital and it turns out nothing is wrong. We have all been there (myself included!) – better safe than sorry.