Fever, Fussiness and Falls

Top Tot Complaints in the ER

By Aneema Van Groenou, M.D.

As an emergency room doctor, I see a lot of kids – especially in the middle of the night. What makes parents worried enough to bundle up their little ones, sit patiently in hard waiting room chairs (sometimes for hours) and seek the advice of a physician? The top complaints I hear from toddlers and their parents in the ER are fever, fussiness and falls.

Judging the seriousness of an injury or illness can be very difficult, especially when a young child can't really communicate what he is feeling, when it started and what makes it better or worse.

Children can look terrible when they are sick or hurt. For example, when a child or infant has a fever, her entire personality is affected. Parents respond intuitively to the fussiness, decreased appetite and decreased energy levels of their children, which are some of the most obvious signs that a child is ill or injured. As a doctor, I rely on the parents' description of their child's behavior – so be specific about what symptoms made you worried.

In the ER, hospital staff immediately check on your child's temperature, respiratory rate and oxygen levels. These "vital" signs and the overall appearance of the child are the first clues to how ill he really is. For example, a child who is having difficulty breathing because of a severe asthma attack will be breathing quickly and may even have a low oxygen level. Your child's age also affects how we interpret those vital signs.

The nurse and doctor will also want to know if your child is up to date on all immunizations. It is very helpful if you bring your immunization card with you. Be honest if you haven't made it back to the office for the last set of shots because this may affect what illnesses your child is susceptible to.

If you've been giving your child any medications, let the doctor know how much and how often you've been giving them. Also, be sure to mention other treatments such as placing poultices on a rash or trying his sister's inhalers to see if they would help. Acetaminophen (such as Tylenol) and ibuprofen (such as Advil) will lower a child's temperature, so a recent dose may make a child seem free of a fever – and consequently happier – despite high temperatures all day.

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• Talk about it!