McMaster University

McMaster University

Sickest children are seen first in emergency departments

The Hamilton Spectator - House Calls Column
November 10, 2011
Dr. Tony D'Souza

Q: My five-year-old son was sent home from school with flulike symptoms. He seems to be content and is active, although his symptoms are worsening. Should I take him to the emergency department?

A: Prescribing when a parent should bring their child to an emergency department is difficult. Parents may bring their child to the emergency department at any time — without an appointment — if they feel their child needs immediate medical care. By the same token, if a child needing immediate medical attention cannot be safely transported to the hospital, parents are advised to immediately call 911.

Often, children have difficulty expressing how they're feeling, and that makes it difficult for parents to understand whether the situation is serious or not. Similarly, ill children can and do get much sicker rapidly. When your child is sick, it can be difficult to determine whether his or her symptoms warrant a trip to the emergency department or your family doctor. When unsure, the best first step is to call your family doctor, or the Telehealth Ontario hotline at 1-866-797-0000.

Parents who are concerned should always feel free to bring their child to the emergency department to be seen. It is intended for all children, open 24 hours a day, seven days a week. The emergency department at McMaster Children's Hospital has specialists trained in children's care. If you believe the situation is not urgent and your doctor is available, or the situation can wait for the doctor the following day, that is one avenue to take.

The emergency department is equipped to deal with both serious and less severe illnesses and injuries and will treat all children. Families who arrive at the McMaster Children's Emergency Department will experience varying wait times depending on the severity of the child's illness. Regardless of the method of arrival, each child will be greeted and assessed by a specialized pediatric nurse, who assigns a score that reflects the relative severity of the child's illness. Contrary to urban mythology, coming in by ambulance does not get you to the front of the line. At all times, the sickest children will be seen first. However, a child's status can change while waiting to see a doctor. It is important to communicate with the triage nurse if your child's status changes.

As mentioned, whenever you are unsure about where to take your child and when, you should call your family physician. If your family doctor is unavailable, call Telehealth Ontario for advice. Remember, in the case of an emergency, the first number you should call is 911.

House Calls is written weekly by experts at Hamilton Health Sciences. Dr. Tony D'Souza is chief of pediatric emergency medicine at McMaster Children's Hospital.

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