To the ER or Not to the ER: A Guide for Parents on When to Seek Emergency Care

March 16, 2023

Visiting the emergency room can be a real lifesaver, but it can also be a tough call to make. You're faced with a new team of medical professionals who don't know your child's health history and hours in the waiting room where infectious germs can spread. So, what is a parent to do?

There are no strict rules about when to visit the ER. However, there are times when seeking emergency medical services is the right and necessary choice. We’ve put together some common situations that may require emergency medical attention, as well as those that you can likely treat at home or with a scheduled visit to your doctor or medical team. Please keep in mind that these are just guidelines, and if you're unsure, it's best to seek advice from your medical professional.

Breathing Problems

What’s an emergency? 

  • Respiratory distress (working hard to breathe or breathing faster than normal) 
  • Pale skin, whitish or blue lips
  • Asthma or wheezing and not responding to prescribed medications

Not an emergency

  • Nasal congestion and cough (even if it interrupts sleep) 
  • Symptoms of the ‘common cold’ 
  • Mild asthma or wheezing that responds to the usual inhaler or medication

Fever

What’s an emergency?

  • Fever in a child less than 3 months old 
  • If your child has immune system problems or complex chronic health problems
  • If your child of any age is very sleepy or difficult to wake for more than 5 days 

Not an emergency

  • Fever in healthy and vaccinated babies 
  • Or in children who appear generally healthy and well

Vomiting or Diarrhea

What’s an emergency?

  • In a child less than 3 months old 
  • Repeated vomiting and your child is unable to keep liquids down 
  • Vomiting or diarrhea containing a large amount of blood 
  • Vomit is a bright green colour
  • Dehydration with a dry mouth or no urine for more than 12 hours

Not an emergency

  • Vomiting or diarrhea less than 3-4 times a day
  • Ongoing diarrhea after the stomach flu, which can last up to 2 weeks

Injuries

What’s an emergency?

  • A head injury with loss of consciousness (passing out) or confusion 
  • Head injury with a visible bump behind the ears, sides of the head, or back of the head 
  • Head injury with visible swelling and your child is less than 3 months old
  • A fall of more than 5 feet or 1.5 metres 
  • Cuts with gaping edges or that continue to bleed despite direct pressure 
  • Burns that blister and are larger than a Loonie 
  • Injury to an arm or leg that looks crooked, causes inability to use the limb, or creates swelling that does not go down with ice and rest over 48 hours
  • Eye injuries 
  • Injuries causing chest or stomach pain

Not an emergency

  • Minor head injuries - no loss of consciousness, no confusion and no vomiting
  • Mild head injuries with normal behavior within 4 hours of injury and bumps (even large) to the forehead 
  • Scrapes and bruises where the injured part can still be used 
  • A sunburn

Rashes

What’s an emergency?

  • A fever with a rash that looks like blisters or bruises and that don’t turn white or fade when you push on them

Not an emergency 

  • Recurring rashes 
  • Rashes with cough and cold symptoms, if the child looks well otherwise 
  • Mild hives that respond to antihistamines without difficulty breathing or any swelling of the throat and tongue

Poisoning

What’s an emergency?

If your child ingests a chemical, medication, or poison, call the poison control centre at 1-800- 567-8911. Go to the ER if directed by poison control (they will give you instructions).

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References

A Guide to Prepare Brave Little Ones (and Parents!) for Medical Procedures

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