What is an emergency?

An emergency is when you believe a severe injury or illness is threatening your child's health or may cause permanent harm. In these cases, a child needs emergency medical treatment right away.

Discuss with your child's doctor in advance what you should do and where you should go in case of an emergency.

Emergencies can result from medical illnesses. In an emergency, your child may show any of the following signs:

• Strange or more withdrawn and less alert behavior

• Unconsciousness or no response when you talk with your child

• Rhythmic jerking (a seizure)

• Increasing effort or trouble with breathing

• Skin or lips that look blue, purple, or gray

• Neck stiffness with fever

• Increasing or severe persistent pain

• A cut that is large, deep, or to the head, chest, or abdomen

• Bleeding that does not stop after applying pressure for 5 minutes

• A burn that is large or involves the hands, feet, groin, chest, or face

• Any loss of consciousness, ongoing or worsening confusion, headache, or vomiting after a head injury

Many emergencies involve sudden injuries. These injuries are often caused by the following events:

• Bicycle or car crashes

• Falls

• Burns or smoke inhalation

• Choking

• Drowning

• Firearms or other weapons

• Electric shocks

• Poisoning*

*Call Poison HELP line at 1-800-222-1222 at once if your child has swallowed a suspected poison, another person's medicine, a button battery, or a magnet—even if your child has no signs or symptoms.

Call 911 (or your local emergency number) for help if your child is not breathing, your child is unconscious or having a seizure, or you are concerned that your child's life may be in danger or that your child is seriously ill or injured. Call your child's doctor if you think your child is ill or have a question about an injury or illness.

In addition, every parent should be prepared. Part of preparation includes learning CPR (cardiopulmonary resuscitation) and basic first aid. For classes near you, contact your child's doctor, the American Red Cross, the American Heart Association, or a national or local organization that offers training.

In case of an emergency

• Stay calm.

• Start CPR if your child is not responsive.

• Give rescue breaths if your child is not breathing.

• Call 911 if you need immediate help. If you do not have 911 service in your area, call your local emergency ambulance service or county emergency medical service. Most cell phones can reach 911, but you will have to tell the operator where you are.

• Apply continuous pressure to the site of bleeding with a clean cloth.

• Place your child on the floor with her head and body turned to the side if she is having a seizure. Do not put anything into her mouth.

• Do not move your injured child unless he is in immediate danger (eg, from a fire).

• Stay with your child until help arrives.

Bring any medicine your child is taking with you to the hospital. Also, bring suspected poisons or other medicines your child might have taken.

After you arrive at the emergency department, make sure you tell emergency staff the name of your child's doctor. Your child's doctor can work closely with emergency department doctors and nurses and can provide them with more information about your child.

It is important to have an Emergency Information Form or similar form for each of your children. It should include cell phone numbers for parents, an emergency contact other than the parents, and health care needs of the child, including medicines and allergies. This form is available from the American Academy of Pediatrics (www.aap.org>) and the American College of Emergency Physicians (www.acep.org). Attach the Emergency Information Form to a filled in copy of the Emergency Contact Information form (see end of this publication), and give it to the first emergency care person who sees your child.

It is important that babysitters and child caregivers have these numbers and know the following steps to take in an emergency:

• How to dial 911 or your local emergency number

• Whether 911 can be reached from a cell phone in your area

• Your home address, directions to your home or current location, and a phone number (An emergency operator would ask for this.)

• Location of a spare car safety seat

• Location of your child's Emergency Information Form and key rescue medicines (such as an inhaler) in your home

• The phone number and address where you (the parents) can be located

• A neighbor who could respond to an emergency

Remember, for nonemergency conditions, first call your child's doctor. If you believe an injury or illness is threatening your child's health or may cause permanent harm, call for an ambulance. If your child is seriously ill or injured, it is safer for your child to be transported to the emergency department by ambulance.