BC Children's Hospital releases guidance on when to bring kids to emergency department

As cold and flu season takes hold here in B.C., experts are warning emergency room waits are about to become even longer if nothing is done to mitigate the rapid spread of viruses in children. As Kamil Karamali reports, some doctors say we're already at a crisis point.

As reports of long hospital wait times continue to pour in, the BC Children’s Hospital has released guidance on when it’s time to bring your child to the emergency department.

The province is grappling with the “triple threat” of COVID-19, influenza and respiratory syncytial virus (RSV).

The BC Children’s Hospital is experiencing “high volumes,” and on Wednesday, estimated wait times exceeded 4.5 hours, with expected stay lengths over nine hours.

Read more:

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According to the hospital, half of the top reasons patients visit its ED may not actually require emergency care.

Nasal congestion, a cough, common cold symptoms, mild asthma or wheezing that responds to regular puffers are not considered emergencies, it said. Breathing problems that include respiratory distress, pale skin, whitish or blue lips, or asthma that is not responding to prescribed medication, however, may necessitate a visit.

Parents should also consider a trip to the ED if children under three months old are vomiting, have a fever, or have diarrhea. For children above that age, the hospital said emergency care may not be needed if the child is vaccinated and otherwise healthy, or if the vomiting or diarrhea takes place less than five times a day.

Diarrhea may last up to two weeks after the stomach flu, it added, but dehydration with dry mouth or no urine for more than 12 hours is a red flag.

Parents may also skip the ED for recurring rashes or skin problems, rashes paired with cough and cold symptoms, and mild hives that respond to antihistamines without difficulty breathing or throat and tongue swelling. Fever with a rash that looks like blisters or bruises that don’t turn white or fade with applied pressure, however, may be a sign of trouble, the hospital said.

If children are difficult to awaken or the fever persists for more than five days in children of any age, that’s considered an emergency, as is fever in children with complex chronic health problems or compromised immune systems.

Any parent who believes their child has been poisoned is urged to call poison control at 1-800-567-8911 and visit the ED if directed to do so.

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For physical injuries, the BC Children’s Hospital is concerned about falls from more than five feet, burns that blister and are larger than a loonie, eye injuries, and injuries that cause chest or stomach pain that warrant a trip to the emergency department. It also takes note of injuries that cause an arm or leg to look crooked, decapacitates the limb, or lead to swelling that won’t go down with ice and rest after 48 hours.

Sunburns, scrapes and bruises where the injured body part may still be used, and mild head injuries with no confusion, vomiting or blackout, are not emergencies, it said. Even large forehead bumps may not necessitate an ED visit if normal behaviour resumes within four hours.

Parents should, however, consider emergency care if their child’s head injury comes with confusion, a loss of consciousness, or visible bumps behind the ears, sides of the head, or back of the head. Any head injury with visible swelling in a child less than three months old also causes for concern, as is a cut with gaping edges or persistent bleeding despite direct pressure, said the hospital.

Resources are available for children experiencing a mental health crisis as well, the hospital added, and parents should call 911 or 1-800-SUICIDE if their child is considering ending their life.

Read more:

B.C. government activates pediatric table to address surge in hospital admissions

Acknowledging that long ED wait times have particularly impacted children, on Wednesday, the B.C. government activated a “pediatric table,” led by the BC Children’s Hospital.

The system aims to address the surge in pediatric patient admissions by co-ordinating pediatric resources, improving the triage process, connecting patients with community care options, and hiring additional patient care co-ordinators.

Health Minister Adrian Dix said Wednesday the province has also recently expanded the 811 service and added a few new urgent and primary care centres in communities.

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