6 Reasons to Take Your Grandchild to the ER—Stat!

Not sure when to call 911? Know the signs of serious injury.

By Lambeth Hochwald

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Don't Panic

Despite your best efforts to keep a close eye your grandkids, sometimes they get hurt. No need to panic. Just be sure you know what to do in the case of an accident or injury.

“If you’re concerned about your grandchild, then I am, too,” says Christopher Amato, MD, a pediatric emergency room physician at Goryeb Children’s Hospital in Morristown, New Jersey. Read on for the six reasons you should call 911 and get your grandchild to the emergency room ASAP.

#1: He's having trouble breathing.

Call 911 if:

He has asthma and can’t get relief from his inhaler or a nebulizer. “If he’s wheezing and can’t get a breath, we need to see him,” says Evan Weiner, MD, a pediatric emergency room attending physician at St. Christopher's Hospital for Children in Philadelphia.
He is having an allergic reaction and his lip and/or tongue are swollen and/or he is developing a rash. “Don’t put him in the car and drive over,” he says. “Call 911 first as they’ll be able to treat him on the way to the hospital.”
He is choking and can’t talk or speak. “Every adult should know how to do the Heimlich and CPR,” he says. “Even if you don’t know how to do it, call 911 immediately and they will talk you through how to dislodge whatever he is choking on. They can talk you through CPR while sending someone to help you.”

#2: She won’t stop bleeding.

Nosebleeds are one of the main reasons kids end up in the ER, but those and other bleeding problems don’t require an ER visit, unless:

She hasn’t stopped bleeding after five minutes. If you’ve covered the wound with gauze or a clean T-shirt, held pressure for five minutes and the bleeding hasn’t stopped, call 911.
She is gushing blood. If you’re holding pressure and the bleeding is now gushing, call 911. “This means an artery is involved,” Dr. Weiner adds.

#3: She has been burned.

Splash burns from hot soup or cocoa are up there on the list of reasons kids arrive at the ER with burns. Here’s what to do if this happens:

Apply cold water (never ice) on the burn. “Don’t put any ointments or butter on it either,” Dr. Weiner says.
Know the difference between burns. A first degree burn (the most minor) is red and can likely be treated at home with ice and a clean (dry) dressing. “If the burn blisters, that’s a second degree burn and someone should look at it,” he says. “If it looks white and leathery and it’s not painful, it’s a third degree burn and it’s a deep one. That must be seen.”
Look at where the child has been burned. “If your grandchild has been burned on the face, she needs to be seen,” Dr. Weiner says. “If she has been burned on her private area, IE if a bowl of soup has landed on her groin, we need to see that, to make sure she can pee. And, if the burn involves a significant area, say her back and trunk is covered, call 911 immediately.”

#4: He ingested a chemical.

Unfortunately, little kids often end up in the ER after ingesting their grandparent’s medication, but they can also get into household chemicals, like bleach, toilet bowl cleaner and, even, rat poison. Here’s what you must know:

Tell Poison Control (800-222-1222) about your meds. They will tell you what to do next. “If you’re not sure what medication your child has swallowed, tell the expert exactly what you’re taking, whether it’s blood pressure medication or your diabetes medication,” Dr. Weiner says.
Describe the chemical he has swallowed. “Household bleach is fairly benign,” he says. “It’s irritating but won’t hurt you. Drinking Windex may make you wheeze if you’re asthmatic. But toilet bowl cleaner, which has lye as a base, will burn you inside. No matter what chemical it is, that child needs to be taken to the ER right away but, in the meanwhile, Poison Control will tell you the antidotes the child might need. For example, in certain cases, a glass of milk may help lessen the effects of some chemicals.”

#5: He may have broken a bone.

You’ll be able to tell right away if your grandchild is really hurt, if he has difficulty walking. “If he has a bruise, but starts running around, the injury can wait,” Dr. Weiner says. “If he injures his arm and can’t move it, it should be examined right away.” Here, other reasons to visit the ER:

He can’t move his limb.
His arm or leg looks deformed or out of place.

#6: He has hit his head.

The first things to look for are dizziness, vomiting, or disorientation.

“If he’s sleepy or acting odd, that’s a concern,” Dr. Weiner says. “If he fell a couple of feet from the sofa to the floor, that's generally less concerning than if he fell from significant height, like a flight of stairs or from the jungle gym. We see a lot of kids who have had significant falls and that’s a reason to call 911 and have the child brought to the ER.”

Be prepared

If you’re watching a child for a day or a week, it always helps to have his medical history ready. “This list is almost as good as having you bring in the bag of medications the child is on,” says Dr. Amato. “I need to know what dose of medication the child is on and, even, who prescribed it. This is essential during an ER visit.”

Consider creating a list that includes your grandchild's:

Pediatrician information, including name, phone number, and the hospital affiliation
Medical history
Known allergies (and what occurs after taking the medication IE rash, hives)
Current medicines, including dosages