Infants Under 3 Months: Should We Run to the ER at the Slightest Warning?
They have been the happy parents of a baby for a few weeks so small and so fragile under your responsibility. Huge happiness, of course, but with its share of questions, particularly concern or even panic that something is about to happen to this baby. Afever, endless crying, strange breathing… Should these signs warn you and take you to the emergency room? for dr Toubib, pediatric emergency doctor, experienced in on-call service and author of Emergencies or not Emergencies: pediatric survival manual (First Edition), there is one age criterion that must be observed above all.”Under 6 weekslet’s not ask ourselves the question: it must be a child with a fever or other signs taken to the children’s emergency room for advice.” A rule that applies Up to 3 months of the child: If he is not feeling well, we will consult quickly.
When do you take your child to the hospital with a fever?
On the other hand, from 3 months of age, the decision to take your baby to the emergency room is more of an observation than a number, even if the thermometer is in the red and reads a temperature of 39.5 degrees. “The number doesn’t matter,” confirms the emergency doctor, “even with very small children, What matters is toleranceas he bears it.” In practice, this amounts to taking the baby’s fever, with a Rectal or ear thermometer (the frontals are not precise enough) to administer Doliprane and monitor his reactions in case of fever 30 minutes later.
Control the CCR to make its decision
Apply after 30 minutes the CCR rule to assess the baby’s tolerance:
- It’s like children coloring : is it very pale, does it have blue extremities?
- It’s like behave of the child: Apart from tiredness (normal for a sick child), do you worry about the baby’s behavior? Is he completely amorphous, sleepy? Is he responding to your communication?
- R like breathing : has baby difficulty breathing, is he fighting? Do you see indentations under the ribs or on the back of his neck when he breathes?
“Just one of those characters confirmed, must make you consult quickly without waiting for the complete table”, the doctor specifies. However, if the baby tolerates his fever normally, without any of these signs, there is no reason to panic. Stay at home and consult See a family doctor or pediatrician if the fever persists after 5 days.
The glass test for fever and skin rash
If fever is accompanied red rash in the baby this can produce a (rare) sign of gravity. How do you know and don’t panic? Again, there’s a very simple test to make sure: “If you notice a rash, take a (clear) glass and roll it over the rash itself. If the purple skin turns white under the pressure of the glass, if that is the case.” no need to worry. if the spot remains crimsoncall 15.” A fever with a rash can actually be a sign of one purpura fulminansa major pediatric emergency.
Baby is Covid positive: when should we go to the emergency room?
Since 2020, a new source of concern has entered the daily life of parents: Covid-19, which affects even the youngest of us. For the emergency doctor no reason to panic “If your baby is Covid positive, the adoption reaction is exactly the same as with fever: if it is only a few weeks old, consult. When he has more 3 months and supports its condition wellThere are no reason to go to the emergency room“ he recalls. The only focus that needs to be monitored for this disease is breathing. “But in the event of a respiratory problem, regardless of the cause, it is always necessary to consult quickly.”
The special case of PIMS syndrome
Difficult to detect and diagnose that pediatric multisystem inflammatory syndrome (PIMS) does not meet any specific criteria for parents to judge for themselves. “What you need to remember is the period when the child tested positive: when baby Fever again after 2 to 3 weeksand also suffers from it digestive problems longer than 3 days, then you need to see a doctor,” he concludes.
Should a baby be taken to the pediatric emergency room for seizures?
A child with seizures is not necessarily at risk. On the other hand, this requires an opinion from Center 15, which in most cases decides on a consultation in the emergency department.
With a febrile seizure
This is the most common case of seizures in children from 1 to 6 yearsbut also a situation that is very impressive for parents… who believe their child is going to die. “Easier said than done, but in this case you have to try not to panic and follow simple steps,” says the specialist:
- Place the child in safety side (without putting anything in the child’s mouth, it’s useless and dangerous!) and shout the 15th to find out how to proceed.
- Check your watch to know when the seizure starts and when it ends (the time criterion is important and will be queried)
For seizures without fever
If the spasm is not related to the onset of fever, a call to 15 or an emergency consultation is required to determine the cause (fall, brain abnormality, epilepsy, etc.).
When to bring baby to the gastro emergency room?
Well known to parents, gastroenteritis rages every year and does not spare even the youngest. Fortunately, this virus does not necessarily represent a one-way street to the emergency room: “As for the fever (which he may have, it all depends on the behavior of the child and how he deals with it,” emphasizes the emergency doctor. However, he distinguishes between two cases :
In children under one year
Gastroenteritis becomes a problem when the child is under 1 year old doesn’t drink his bottles anymore, or less than half of what he normally drinks in a day. This is also the case when he vomits whatever he eats or drinks. Finally, if he presents a dehydrated state: inside of the mouth dry dark circlesa baby that no more peeing... It is necessary to consult quickly.
With the older child
With the slightly older child, however, we do not focus on his or her appetite on his hydration : “If he doesn’t eat, it doesn’t matter. The main thing is that he drinks,” reminds the pediatrician, who also gives a tip: We give him a child who has to vomit sweet and fractional things : a sweet fruit juice, syrup in water, a spoonful of compote… in small portions every 15 minutes throughout the day to fight against and rehydrate acetone.
We always stay at home oral rehydration solution, essential, used as soon as the stomach appears to prevent dehydration. “In the event of bottlenecks, it is also possible to use them sports rehydration drinksavailable in sporting goods stores”. A trick to prevent the child from feeling bad and deteriorating.
Baby has stomach pains: should I go to the children’s emergency room?
Another common symptom that can worry parents: baby squirms, cries, seems very embarrassed at belly level. How far do we have to walk to the emergency room? “In the vast majority of cases, abdominal pain in babies is simply colic, who do not need any emergency consultations, just a conversation with their pediatrician, their treating doctor,” the emergency doctor reassured.
The only symptoms where you should take urgent action:sharp and sudden onset of cryingin a child who will everything paleand/or which presents blood in his stool“. This is a very rare case, but all these symptoms can be caused by something called A acute intussusceptiona serious pathology in children as young as a few months old,” specifies the pediatrician. In that case, we run to the emergency room.
The fear of appendicitis in children
In a slightly older child, abdominal pain can indicate appendicitis. But the signs are clear:
- a pain bottom right ;
- constant painwhich increases with time;
- an impossibility for the childattack his right legwrinkles or walking.
The fall, more common than you think, can also raise questions, especially if the baby ends up with an impressive bump on the forehead. Fortunately, not all everyday falls require an emergency consultation. But certain criteria must be taken into account:
- if you watch loss of consciousness in total
- If the child vomits more than once (The shock, even a small one, can cause nausea if he’s just eaten)
- if they are Behavior seems really abnormal to youbeyond the minutes or the child may be a little “stunned”.
- If there is a fall down stairsespecially more than 5 levels.
- Does the child have one? bump that is soft under pressure from your finger, which may indicate a broken bone.
Get advice over the phone doctor at 15 or in the emergency room.
If the bump that appeared is difficult to palpaterest assured everything is normal.
- In case of strange breathing of your baby when this is hissing for example
- When the child shines struggle to breathethat hollows are hollowed out at the level of the neck and ribs
- if you watch Breathing pauses longer than 5 seconds in a baby
In short, if he’s not breathing normally (source 1), he needs to go to the emergency room.
If the situation in the baby leads to suffocation, if a foreign object blocks his airways, you need to act immediately and call for help.
Should you go to the emergency room for a skin rash?
In the vast majority of cases, a skin rash (eczema, occurrence of chickenpox, etc.) can be treated by appointment at his pediatrician or his treating doctor. “Except in the case already mentioned: if the child has a fever and purple rash, and that this eruption remains crimson when a glass is passed over it. In this case, the following procedure is to call 15 as it may be purpura fulminans, an emergency that requires an immediate injection by the SMUR. “
Who to call in a baby emergency? think 15
Finally, it is recommended in case of questions or doubts about the seriousness of a situation to call the switchboard 15, which is not reserved for vital emergencies, as many still think.
“Of course we call 15 (we don’t get in his car) when the child is there unconsciousif he breathes very badly, he has an asthma attack, that it is blue or hypotonic. Help must come, as in the case of a fall with a deformity of a limb”.
But the paramedic reminds us that 15 is too a way to get advice before going to the hospital emergency room. Online, a regulating doctor will ask you questions and assess whether on-site help should come should you leave to an emergency roomor simply if your case requires you to go in a doctor’s office, an on-call medical home or to stay at home. A good reflex to avoid emergency waiting rooms and the associated stress when it is not necessary.