This post is sponsored by AdventHealth.

It was 7:15pm on a school night and we were just finishing up our bedtime routine. Stories were read, both girls were bathed, and we were approaching the finish line with brushing our teeth.  My eldest daughter ran excitedly into the bathroom acting out the heroin from story time, she slipped on the tile in the bathroom landing on her arm.  When I tried to inspect the arm, she screamed and pulled her arm away in pain.  I didn’t see anything out of the ordinary with her arm, but she was inconsolable, which made me nervous, and I didn’t know what to do next.

I thought to myself, if she’s in this much pain, there must be a break or fracture. I didn’t want her to be in pain all night, so I didn’t know what else to do but go to the emergency room.

We have all been there. When a child is sick or injured, the natural reaction of many parents is to immediately go straight to the emergency room. In some cases, though, taking your child to urgent care or even waiting to see a pediatrician before heading directly to the ER may be the better choice! But… how do you know which one is the appropriate option?

We had the chance to chat about this topic with Dr. Madejczyk (pronounced: muh-day-check) pediatric Emergency Department Medical Director at AdventHealth Daytona Beach.  Dr Medejczyk shined some light on the topic that we are excited to share with our friends and family.  

“It’s all a spectrum and its all about how ill they appear” and sometimes there is a “grey zone.”

Dr Medejczyk

Not every situation is clear-cut, but when deciding where to take your child, here are some tips to know where to go.

When a Child Should See Their Pediatrician 

Your pediatrician can see your child for almost all medical problems. They can perform basic lab work, check from Strep, and check for the flu.  However, they cannot do blood work or X-rays.  

“If your child is sick but looks OK, the first person to reach out to is your pediatrician, because they know them the best!”  Things most parents don’t know according to Dr. Madejczyk, “most pediatricians have a pediatric doctor on call after hours and they [pediatricians] usually are good about getting the child into the office within the same day or the next day.”

Here is an example scenario from Dr. Madejczyk:

A child has fever and sniffles, but they are playing and looking ok, they are drinking and they are not in distress. So you may be left worried about the fever and whether it is something to worry about or not very serious. For instance you may not know be able to differentiate between a cold, ear infection, or pneumonia, but the child looks good. Call your pediatrician especially if the fever just started.  A fever means your body is working to fight off an infection. So it means your body is doing what it is supposed to do. The fever itself, and how high the fever is, is not as important as how your child looks.  If the child is playing and running around after medication, you can call the pediatrician to schedule a visit.

Often the pediatrician can offer advice over the phone, and they may advise you against  an urgent care or emergency room visit. Your doctor’s office is truly the best place to start for all medical care related to your child. All AdventHealth pediatric offices offer a doctor on-call after hours.

When a Child Should Go to Urgent Care

Generally speaking, urgent cares are designed to save unnecessary trips to the ER, and are usually easier to access, have shorter wait times and cost less than an ER visit.  Urgent cares such as Centra Care are the middle of the ground where they can perform more labs including blood work and xrays.  AdventHealth Centra Care performs X-rays and has pediatric-themed rooms to help put children at ease!

Here is an example scenario from Dr. Madejczyk

If the child falls, and the arm looks a little swollen or puffy, you can head over to an urgent care. They can give you a cast, splint or sling. They can educate you ‘ok the bone is not broken’ so it’s a sprain.  

When a Child Needs to Go to the ER 

ERs are best suited for true emergencies – as they can do everything. These facilities are equipped to provide immediate evaluation and care for complicated illnesses or injuries.

Example scenario from Dr. Madejczyk:

  • If the child has a fall, and the arm is clearly broken, not just a littlepuffy and the child says “owie it hurts,” but you see a deformity, you should probably go to the ER because the child may need to be sedated.  
  • If the child has a fever and they like look the limp wet noodle; miserable and lethargic even after the fever has come down – go to emergency room. If the fever comes down and they still look sick, that’s the child I’m worried about.
  • A fever in a newborn is serious, and you must go to the ER. 100.4 or greater for a newborn – you have to go to the ER regardless of how the baby looks.

The Bottom Line

Kids can’t always communicate what is wrong, leaving parents to make some very important decisions.  In the end, your choice between urgent care and ER may depend on proximity of facility or a gut feeling.  “There is no wrong decision and worst case scenario you’ll be delegated to a higher level of care as needed.” Our biggest takeaway: it’s all a spectrum. It comes down to how the child looks or is acting as opposed to just the symptoms.

Whether you take your child to Centra Care or the Emergency Room it’s helpful to look for a healthcare system that is focused on pediatrics and is staffed by board-certified pediatricians and pediatric nurse practitioners. AdventHealth Daytona Beach has a dedicated pediatric ER and inpatient unit in case a child needs to be admitted making it fully prepared with people and equipment that can help make a bad situation, better, for your child. 

Stay safe friends, but just in case, be prepared with where to go! 

For more, check out Thanksgiving: A Reminder To Practice Gratitude