Even healthy kids get hurt and sick sometimes. In some cases, you may panic and want to head straight to the emergency room at the nearest hospital. In other cases, it's more difficult to determine whether an injury or an illness needs the attention of a medical professional or can be treated at home.

Ultimately, different problems require different levels of care. And when your child needs some sort of medical help, you have many options:

• Handle the problem at home. Many minor injuries and illnesses, including some cuts, poison ivy rashes, coughs, colds, scrapes, and bruises, can be handled with home care and over-the-counter (OTC) treatments.
• Call your doctor. This is a good option in most cases. If you're unsure of the level of medical care your child needs, your doctor — or a nurse who works in the office — can help you decide what steps to take and how.
• Visit an urgent care center. An urgent care center can be a good option for non-emergencies at night and on weekends when your doctor may not be in the office. At these clinics, you can usually get things like X-rays, stitches, and care for minor injuries that aren't life threatening yet require medical attention on the same day.
• Visit a hospital emergency room. An ER — also called an emergency department (ED) — can handle a wide variety of serious problems, such as severe bleeding, head trauma, seizures, meningitis, breathing difficulties, dehydration, and bacterial infections.
• Call 911 for an ambulance. Some situations are so serious that you need the help of trained medical personnel on the way to the hospital. These might include if your child: has been in a car accident, has a head or neck injury, has ingested too much medication and is now hard to rouse, or is not breathing or is turning blue. In these cases, dial 911 for an ambulance.

As a parent, it can be hard to make these judgment calls. You don't want to rush to the ER if it isn't really an emergency and can wait until a doctor's appointment. On the other hand, you don't want to hesitate to get medical attention if your child needs treatment right away. As your kids grow — and inevitably incurs sicknesses and calamities — you'll learn to trust yourself to decide when it's an emergency.

Remember that in cases when you know the problem is minor, it's best to go to an urgent care center, see your doctor, or handle it at home because the more people who show up at the ER with non-emergencies, the longer everyone has to wait for care.

But whenever you're unsure, call your doctor.

Should I Go to the ER?

It's best to go to the ER if your child:

• has some difficulty breathing or shortness of breath
• has had a change in mental status, such as suddenly becoming unusually sleepy or difficult to arouse, disoriented, confused, not making sense
• has a cut or break in the skin that is bleeding and won't stop
• has a stiff neck along with a fever
• has a rapid heartbeat that doesn't slow down
• accidentally ingests a poisonous substance or too much medication
• has severe bleeding or head trauma

Other situations may seem alarming, but don't require a trip to the ER. Call your doctor if your child has any of these symptoms:

• high fever (above 104° Fahrenheit, 40° Celsius)
• ear pain
• pain in the abdomen
• headache
• rash
• mild wheezing
• persistent cough

When in doubt, call your doctor. Even if the doctor isn't available, the office nurse should be able to talk with you and determine whether you should take your child to the ER. Even on weekends and evenings, doctors have answering services that allow them to get in touch with you if you leave a message.

Urgent Care Centers

Sometimes an injury or an illness isn't life threatening but needs medical attention on the same day. If that's the case, consider going to an urgent care center.

Urgent care centers, also known as fast tracks, usually allow you to walk in without an appointment, just as you would in an emergency room. But they're equipped and staffed to treat minor, non-life-threatening issues. Patients usually will be seen by a doctor, and also may be able to get X-rays or blood drawn.

Most of these clinics offer extended hours on evenings and on weekends for patients to receive treatment when the family doctor is not available. Some are open 24 hours a day every day.

Cases where you might take your child to an urgent care center include:

• cuts
• minor injuries
• vomiting or diarrhea
• severe ear pain
• sore throat
• infected bug bites
• mild allergic reactions
• suspected sprain or broken bone
• minor animal bites

The doctors who work at freestanding urgent care centers often are ER doctors or family physicians who focus on treating adult and pediatric diseases. Some urgent care centers are also staffed by nurse practitioners and physician assistants. In many children's hospitals, the emergency rooms have special sections for treatment of minor injuries and illnesses that might be treated at an urgent care center.

Find out about the urgent care centers near you — before a situation comes up where you need to go to one. Your doctor may be able to recommend facilities in the area. In general, you want to find a clinic that meets any state licensing requirements and is staffed by doctors who are board certified in their specialties, such as pediatrics, family medicine, or emergency medicine. Some of these clinics, in addition to accepting walk-in patients, allow you to call ahead to be seen. You might also want to ask if the center accepts your family's insurance plan.

Talk with your doctor before your child gets sick about how to handle emergencies and the doctor's policy on addressing medical needs outside of office hours. Having that information ahead of time will mean one less thing to worry about when your child is sick!

Reviewed by: Kate M. Cronan, MD
Date reviewed: April 2006