A PARENT'S GUIDE TO UNDERSTANDING INJURY AND ILLNESS

Nothing is more frightening to parents than thinking something might be wrong with their child's health. Parents can easily become overly cautious about their child's health, calling their pediatrician every time they hear their baby cough. But how does a parent know whether a child's illness is minor or if the child needs to go to the pediatrician or even to the hospital? Lise Christensen, M.D., emergency medical physician at East Tennessee Children's Hospital, offers the following advice about when a child should see a pediatrician and when a child should be taken immediately to the Children's Hospital Emergency Department.

There are certain signs and symptoms to look for in children that are definitely a reason to call a pediatrician. Some typical symptoms of illness differ depending on the child's age. A pediatrician's office needs to be immediately contacted if a child has any of the following symptoms listed in his or her age category:

Birth to 3 Months

• A temperature of 100.4 degrees or higher
• "Pink eye"
• Redness or tenderness around the navel area
• Vomiting that continues for more than six hours
• Diarrhea that occurs more than eight times a day
• Stops feeding normally
• Uncontrollable crying for an abnormally long time

3 Months to 1 Year

• Temperature of 101 degrees in infants 3 to 6 months, or 104 degrees in children 6 months or older
• Child refuses to eat and misses several feedings
• Unusual crankiness and irritability or unusual sleepiness
• Any blood in the stool

Infant to Adolescent

• High fever
• Chills and full-body shaking
• Extreme sleepiness or unexplained lethargy
• Unusual excitement or hysterical crying
• Sudden weakness or paralysis of any part of the body
• Seizures or severe headache
• Earache, fluid discharge from the ear or sudden hearing loss
• Severe sore throat, especially with trouble swallowing or speaking
• Vomiting for 12 hours or more or vomiting of blood
• Intense or unusual abdominal pain or a swollen or abnormally large abdomen
• A sudden rash, crop of blotches or blisters, especially over a large area of the body

Whenever your child has a symptom that concerns you, you should not hesitate to call your child's pediatrician, even if the symptom does not appear on this list, and any of the above circumstances would merit a trip to the Children's Hospital Emergency Department if a child's pediatrician is not available, but it is important to keep in mind that emergency departments are equipped to care for all children from those with minor illnesses to those with life-threatening injuries. Because of this, patients with a less severe problem usually will have to wait until more critically ill patients are treated. The emergency department is also more appropriate than a doctor's office for sudden and serious situations such as these:

• A head injury that has caused loss of consciousness, vomiting or problems with balance or coordination
• An injury that has caused numbness and tingling or paleness in an extremity
• An injury that will likely need an X-ray and casting
• Complications related to a chronic medical condition such as diabetes or asthma
• Difficulty breathing, gasping for breath
• For an infant from birth to three months, any change in color, especially paleness or bluish color around the mouth and in the face

Although a trip to a hospital's emergency room is usually unexpected, there are a few things parents can do to prepare for a visit. Be sure to always have a child's Social Security number, current medication (dosage and schedule), and insurance information. A parent will be asked to provide this information about a sick or injured child.