When to take your child to the Emergency Department


 

It is open 24/24 all year. 

A child is often the object of worry and concern, especially when they are sick or injured. Below you will find some suggestions on how to behave in all the various circumstances, and some information to help you handle the different problems.

Of course, family pediatricians remain parents' best interlocutors, as they know the medical history of the child. However, in emergency situations and when it is impossible to contact the family pediatrician, the hospital emergency room – open 24 hours a day – represents the structure able to give all necessary assistance. 

For non-acute care, the Bambino Gesù Hospital also provides an outpatient pediatric office, with the following opening hours: 

Rome - Gianicolo: seven days a week, from 7.30am to 7.30pm, at the ground floor of the Spellman Building. 
You will have to register at the administration counters before getting to the appointment. Administration counters are open until 6.45pm. 

Rome - San Paolo: from Monday to Friday, from 7.30am to 7.30pm, and on Saturday from 7.30am to 2.00pm. Closed on Sunday. 
You will have to register at the administration counters before getting to the appointment. Administration counters are open until 6.45pm from Monday to Friday and until 12.15pm on Saturday.

N.B. For outpatient pediatric appointments a reservation is not necessary, and you will not need to bring a medical prescription. 

You will find below some information on the most common pediatric disorders, which may help you evaluate whether or not to take your child to the Emergency Department. 


What to do in case of fever 

High fever in children is a reason of concern for all parents, but it is important to always evaluate the child's general conditions, and the associated signs and symptoms.

It is also important to take into consideration the age of the child. Children below age 3 months must be taken immediately to the family pediatrician, or, if this is impossible, to the Emergency Room, even when fever is not associated with any other symptoms.

For older children, an urgent medical appointment is necessary only when fever is high and persistent, with a poor response to medications, and there are associated symptoms, such as vomiting and severe headache, which do not improve after administration of antipyretic and/or pain-relieving medications.  

When a child with fever presents with seizures, they need to be taken immediately to the Emergency Room, especially if aged under 1 year. 

What to do in case of vomiting

Children need urgent care when they have repeated vomiting episodes (more than 5 in few hours) and cannot take in liquids. They also need urgent care when vomiting is associated with other symptoms, such as diarrhea and fever (more than 5 discharges in few hours), which can induce dehydration. 

Warnings of dehydration in children, especially below 1 year of age, are: 

- dry skin and oral mucosa;

- dark-circled eyes;

- lack of tears;

- reduced urine output after the onset of symptoms.

A child, especially if below 1 year of age, who has been vomiting and has not evacuated the bladder for 24 hours needs to be seen by a doctor urgently. 

Children with blood in the vomit or with dark green or coffee colored vomit must be taken to the Emergency Room urgently. 

 

What to do in case of diarrhea

Children need to see a doctor when they have diarrhea for more than 24 hours, with 5-6 discharges a day, they cannot take in liquids, and present with signs of dehydration.

When diarrhea is with blood in the stool, or with "red currant jelly" stool, it becomes very urgent to have the child evaluated by a doctor. 

What to do in case of abdominal pain 

Children often complain of "tummy ache". This symptom needs to be taken seriously when the child has not stooled for over 24 hours and presents with vomiting and mild fever, and when pain is located in the low right abdomen (appendicular region).  

Moreover, children need to be urgently seen by a doctor when abdominal pain occurs after a trauma in the abdominal region. 

 

What to do in case of traumatic brain injury 

All children with traumatic brain injury (TBI) must immediately undergo evaluation in the Emergency Room. Afterwards, if clinical conditions allow discharge, home-based observation can be implemented.

If the child loses consciousness at the moment of the impact (concussion), or if, some hours after the impact, they present with vomiting, excessive sleepiness, inconsolable cry, squint, problems of ambulation, headache, they must be seen by a doctor as quickly as possible.

If the child vomits or cries for long,  immediately after the trauma it is not so much alarming. 

What to do in case of Headache 

You should take your child to the Emergency Room when headache with or without vomiting does not improve after administration of common painkillers.

Severe headache with fever is alarming when it does not improve with the decrease of fever, and it is associated with repeated vomiting. 

What to do in case of cough

It is recommended to go to the emergency room when cough is associated with the following symptoms:

the child breathes with difficulty, seems to be in pain, "breaths with the tummy", has indentations  at the level of the ribcage and at the soft spot above the breast-bone, is pale, has apnea, has sudden coughing fits sounding like a barking seal, inhales with difficulty, and presents with high fever and drooling (sialorrhea). These are symptoms of epiglottitis, a potentially life-threatening condition; this is why it is extremely urgent to have the child seen by a doctor. 

What to do in case of burns

Burns need to be evaluated and treated in the Emergency Room, as it is necessary to take into consideration some characteristics, such as location, extent and depth, which determine their severity. 

What to do in case of inhalation of foreign body

Children, especially in the age range 6 months to 2 years, can accidentally inhale foreign bodies, such us nuts, fragments of toys, etc. 

Thus, if your child is suddenly chocking and presents with cyanosis and coughing, after eating something, or even if you believe that they may have inhaled something, you should have them seen by a doctor in the Emergency Room. 

What to do in case of ingestion of chemical substances


Not all chemicals are toxic. 

CHEMICALS WITH LOW TOXICITY:

Hand washing dish detergents (powders and liquids); laundry detergents both for hand-washing and washing machine; coil or plug-in mosquito repellents; powder or spray insect repellent containing allethrins or pyrethrins; ironing starch; ink of fountain and ballpoint pens; watercolors or tempera colors; matches; shampoo; bubble baths; shaving lather; creams; mascara. 

VERY DANGEROUS CHEMICALS 

Insect repellents containing phosphate esters (against ants and beetles); drain cleaners; antirust; all kinds of stain removers; surface detergents; dishwasher rinse aid.  

If your child has ingested a substance of which you don't know the composition or the harmfulness, you would better contact a Poison Control Center and follow their indications. 

Poison Control Centers of the Lazio region:

- Bambino Gesù Children's Hospital tel. +39.06.6859.3726-2765

- Policlinico Gemelli   tel. +39.06.3054343

- Policlinico Umberto I   tel. +39.006.490663    

If your child has ingested a toxic or caustic substance, you must urgently go to the Emergency Department bringing with you the packaging of the ingested substance.

What to do in case of insect bites or stings

Adverse reactions to bites or stings by a wide range of insects are extremely variable, and go from a simple local skin reaction to the anaphylactic shock, this last being actually rather rare. 

Children who, after an insect bite, present with pallor, perspiration, dizziness, cough, irregular breathing, loss of consciousness, diffuse hives, eyelid edema, need to be urgently taken to the Emergency Department. 

 

What to do in case of dog bite

The dog bite generally causes a skin lesion of variable extent and depth. It is always recommended to go to the Emergency Department, in order to: 

suture the wound, if needed, and verify the need of undergoing antibiotic and anti-rabies treatment.