5 signs your child needs medical treatment at the A&E department

One of the most stressful situations parents face is dealing with a child who is unwell, and in need of prompt medical attention. In such instances, right decision and judgment call has to be made in the spur of the moment, with limited time to spare.

For many, the accident and emergency (A&E) department of the hospital located closest to their home seems like the most logical destination to race to. But that is not necessarily the case always, as not every A&E is equipped to handle pediatric emergencies.

Here are the top five A&E scenarios according to Dr Sangeetha Isaac at Gleneagles Hospital, and suitable courses of action:

Conditions/symptoms: Asthma, croup, bronchitis or chest infections, which results in laboured, shallow or fast breathing, nasal or chest congestion.

First aid: Sit your child upright and administer four puffs from an inhaler (if the child is on inhaler prescribed by your doctor previously) for some relief.

Ideal transport mode: Ambulance. Initial treatment, such as administering oxygen and close monitoring, can begin enroute hospital. The ambulance team can also relay information about your child's condition to the hospital team, so they can be ready to receive you.

Conditions/symptoms: Vomiting or diarrhoea, high fevers and poor oral intake can lead your child to dehydration. This results in cold and clammy skin, weakness, listlessness and lethargy.

First aid: Give fever medication to control the temperature. Do not start antibiotics unless advised by your doctor. Encourage oral hydration at home and if child is unable to tolerate orally, seek medical attention early to prevent dehydration.

Ideal transport mode: Private car or taxi

Conditions/symptoms: Serious allergic reactions to food or medicine, causing swelling of the tongue, lips or eyelids; wheezing, difficulty breathing, choking sensation, dizziness, vomiting or diarrhea.

First aid: Remove child from the offending agent/environment. If the child has had previous episodes of anaphylaxis and has standby epi-pen, administer the adrenaline using epi-pen. Loosen tight clothing. If the child is vomiting, turn child to his side to prevent choking. Antihistamine which helps alleviate allergic symptoms are insufficient to manage anaphylaxis. Seek immediate medical attention.

Ideal transport mode: Ambulance. Initial treatment, such as administering oxygen and close monitoring, can begin enroute hospital. The ambulance team can also relay information about your child's condition to the hospital team, so they can be ready to receive you.

Conditions/symptoms: Fits can present with uncontrollable jerking movements and spasms, loss of consciousness, tongue-biting and drooling.

First aid: Clear your child's mouth of any vomit, and loosen her or her clothing around the neck. If necessary, lay him or her on the side to prevent choking. Your child should be protected against hurting himself or herself.

Ideal transport mode: Ambulance, where medical staff can make your child as comfortable as possible

Conditions/symptoms: Head injury, fall from height, cuts, lacerations, bleeding, broken bones, sprains

First aid: Apply pressure over wounds to stop bleeding, and keep the affected area elevated. Give medication to ease pain and keep the child comfortable.

Ideal transport mode: Ambulance- in the event of serious head injury, open fractures and ongoing bleeding. Private car or taxi - in the event of minor injuries.

Upon arrival, there are specific A&E procedures to expect - the first of which is registration. Make sure you have your child's birth certificate or NRIC ready to expedite the process.

The child will undergo an initial assessment by an A&E trained nurse to gather crucial information such as temperature, heart rate, blood pressure and level of consciousness. This is critical in determining the priority of your child's medical issue. Priority assigned could be one, two or three - with priority one applying to the most urgent.

Consultation with an A&E doctor will follow. The doctor will assess the child and initiate treatment specific for your child's condition. In certain circumstances, the pediatrician may have to be called to A&E to manage further. In those circumstances, you will be updated on the child's progress and the need to involve specialist in care, before any specialist is called in.

Once the initial treatment is administered, and critical symptoms are dealt with, hospital admission may be considered. At this point, specialists (pediatrician, orthopedician or surgeon) will take over care of the child. In instances where the child has been treated appropriately in A&E and is considered safe for home, the child will be discharged with oral medications and appropriate follow up.

In a medical emergency, call Gleneagles Hospital's 24-hour A&E helpline at 6470-5688 or visit Gleneagles' A&E and 24-hour walk-in clinic at 6A Napier Road. For more information on its A&E services, click here.

Choose your location wisely
Don't assume the nearest hospital is the best option for treatment. Not all hospital A&E departments are equipped to attend to children, and you may end up being advised to make your way to another hospital - causing a delay in treatment and more stress. Gleneagles' medical specialists are well-trained to handle emergencies for both adults and children. Also ask yourself if the original location is convenient for follow ups.

Expect to wait at least 30 minutes
Medical staff practice prioritisation known as triage, which refers to the assignment of priorities to a medical situation. Parents need to understand that different children have different emergencies, and that medical staff are in the best position to allocate prioritisation. At Gleneagles Hospital, the average wait time is 30 minutes.

Find your zen
While waiting for your child to be attended to or receive a diagnosis, anxiety can build up. But it's important not to panic because it does no one any good. Maintain your cool, and keep your child as comfortable as possible. If you see his or her condition worsening, notify the nearest medical staff member immediately.

Communicate clearly
As worried and flustered as you are, it is important to articulate your concerns clearly and explain specifically why you have brought you child to the A&E department. Panicking can lead to unintentional miscommunication, where important facts are left out.