Seven Reasons to Take Your Child to the ER

The Children’s Hospital of San Antonio has three emergency departments dedicated to caring for children experiencing a medical emergency.

Jendi Haug, M.D., Emergency Services Physician

Sometimes it is easy to know when to go to the ER – a broken bone or a cut that needs stitches. But often parents struggle with the decision of whether to take their child to the ER for other reasons.

The Children’s Hospital of San Antonio now has three emergency centers just for children. They are open 24 hours a day, seven days a week, all weekends and all holidays.

Pediatric ERs are special emergency rooms that treat children from birth until age 17. The nursing staff, advanced practice providers such as nurse practitioners and physician associates, and physicians understand that children are not just little adults. Children have their own unique physiology that is different from adults.  Their illnesses and injuries are oftentimes not treated in the same manner as an adult with similar symptoms.  In a medical emergency, your child needs to see a doctor who only specializes in treating children.

At The Children’s Hospital of San Antonio, we know children are not little adults. They require the expert care of doctors and nurses specially trained in emergency pediatric medicine. Taking a wagon ride to get an X-ray is just one way we ease a child’s fears!

Here are some examples of major and minor instances when you should go directly to your nearest pediatric emergency room:

  1. Newborn with a fever: Any infant 30 days old or younger with a temperature of 100.4 degrees or higher needs medical attention. No matter how you take the baby’s temperature (armpit, forehead, frontal sensors, or rectally), a temperature of 100.4 warrants an assessment by a physician or APP.  Infants born premature or with underlying medical conditions are at an even higher risk of serious infection and should continue to come in even at older ages.
  2. Difficulty breathing:  Abnormal breath sounds like wheezing or stridor can be associated with bronchiolitis or croup or pneumonia. They can be scary and cause kids to breathe fast. Kids may start working to breath- belly breathing, sucking in the skin between their ribs or refusing to lie down. These are worrisome symptoms and need to be immediately evaluated.
  3. Extremity or bony deformity:  When there is an obvious deformity along with swelling or pain, they should be seen that same day for assessment of any possible fracture or dislocation.
  4. Abnormal/unusual behavior or altered mental status: You know your child and are the best gauge of your child’s behavior and their typical baseline. If something is not quite right, they need to see a medical provider for a complete evaluation.
  5. Open wounds not healing on their own: Wounds can be common for kids after a fall or other injury.  Wounds that are large enough to be considered lacerations should be repaired soon in order to obtain better wound healing and less scarring. In addition, good cleaning and irrigation will help to prevent infections.
  6. Prolonged vomiting and diarrhea: Infants and young toddlers can rapidly become dehydrated, so even a few hours of symptoms can make them sick.  Lack of a good amount of wet diapers or failure to urinate for a prolonged amount of time is a worrisome sign of dehydration for any child.
  7. Fainting or seizure activity: These symptoms should be assessed by a physician or advanced practice provider to determine why these episodes might be happening, especially if they are frequent or prolonged occurrences. A trip to the ER is warranted if your child has not been previously evaluated for fainting or seizures by a pediatric cardiologist or neurologist. Sometimes these symptoms are harmless, but they could also be related to serious medical conditions.

While this list is not exhaustive, these are just a few reasons why your child might require a visit to one of our emergency rooms.  When available, discuss any questions you might have regarding the need for emergency care with your child’s pediatrician.

The Children’s Hospital of San Antonio Emergency Center – Stone Oak is open and ready to help in any emergency medical situation.

To better meet the needs of our community, The Children’s Hospital of San Antonio recently opened a freestanding emergency center in north-central San Antonio at 1434 E. Sonterra Boulevard, near Highway 281.

In 2015, we opened the city’s first freestanding children’s ER at Westover Hills located at 11130 CHRISTUS Hills, Medical Plaza 3 (located off Highway 151).

The main campus of The Children’s Hospital of San Antonio is one of the largest pediatric emergency rooms in the city. It is located at 333 North Santa Rosa Avenue in the heart of downtown San Antonio.

At The Children’s Hospital of San Antonio, we care deeply about the children in our community and want to help your child during a medical emergency. Please visit our website to learn more about our three emergency department locations.

Keep calm and parent on

By Nancy Kellogg, MD, Child Abuse Specialist, and the team at the Center for Miracles at The Children’s Hospital of San Antonio

The COVID-19 pandemic has created a new work force: stay-at-home parents who are faced with the 24/7 job of child care.   The additional stresses of isolation, buying food, and keeping children happy and safe can be exhausting and frustrating.  Here are a few tips:

1. Try to keep a routine for mealtimes and activities so children are engaged and less likely to get bored and irritable. 

2. Invent some new activity/game. For example, older children may enjoy a different scavenger hunt each day for a favorite toy. There are plenty of websites to explore ideas: https://time.com/5803373/coronavirus-kids-at-home-activities/

3. Limit screen time for yourself and your children.  Social media content is more stressful now and children need to stay healthy and balanced with physical and interpersonal activity. Play outside whenever possible.

4. If you use a babysitter, be sure you speak to references first and ask for frequent updates when you are away. Make sure your children know to call you if they ever feel uncomfortable or scared.

4. Know your triggers.

*A baby who won’t stop crying. Put him in the crib, walk away, and take a few minutes of “time out” for yourself in another room

*A toddler with tantrums. Distract her, redirect attention, and use time out so everyone can calm down.

*Potty training.  Have lots of patience and if it is too stressful for you or your child, stop.

5. Be kind to yourself and others.  Everyone has been affected by COVID-19.           

6. Video chat with friends and family or try a hotline: Counselors are available 24 hours a day at Childhelp’s National Child Abuse Hotline: 1-809.4.A.CHILD

To report suspected child abuse: 1-800-252-5400

Diez razones por las cuales los pediatras dicen: “la leche materna es mejor”

Por Danielle Roberts, M.D.
Residente de Pediatría, PGY2
Baylor College of Medicine
The Children’s Hospital of San Antonio

En la vida, darle la bienvenida a un bebé al mundo puede ser una de las experiencias más emocionantes y también aterradoras. Muchos padres planean la llegada de su hijo por meses, desde cómo anunciarán el embarazo a los familiares, cuándo será la licencia materna y paterna, preparar el cuarto del bebé…y la lista continúa. Llegará una boquita más para alimentar y es muy importante pensar en qué va a comer el nuevo bebé. Es posible que usted haya escuchado de los muchos beneficios de la leche materna; ¿sabía que hay docenas de maneras en la cuales la leche materna puede ayudar a los bebés y a sus padres?

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Ten reasons why pediatricians say, “Breast is best!”

August 1 – 7 is celebrated each year as World Breastfeeding Week.

By Danielle Roberts, M.D.
Pediatric Resident, PGY3
Baylor College of Medicine
The Children’s Hospital of San Antonio

Welcoming a new baby can be one of the most exciting and sometimes scary experiences in a lifetime. Parents may plan for months, starting with pregnancy announcement ideas, scheduling maternity and paternity leave, preparing baby’s room… the list goes on. With one more precious mouth to feed, it’s also important to think about what the baby will eat. You may have heard about some of the benefits of breastfeeding—did you know there are dozens of reasons why breastfeeding is recommended over formula?

Continue reading “Ten reasons why pediatricians say, “Breast is best!””

Dear Parents: Let’s celebrate National Breastfeeding Month!

By Dr. Ruchi Kaushik, MD, MPH
Pediatric Primary Care Physician
Director, ComP-CaN (Comprehensive Peds for Complex Needs)
The Children’s Hospital of San Antonio

August is National Breastfeeding Month and August 1-7 is World Breastfeeding Week! We all know the many wonderful benefits of breastfeeding for mother and child, so let’s take a moment to provide some validation and calm fears. Breastfeeding can be difficult and exhausting. Just because it is primitive and innate for humans, breastfeeding is not necessarily intuitive. It will sometimes take practice for both you and your baby before it becomes easy and comfortable.

Continue reading “Dear Parents: Let’s celebrate National Breastfeeding Month!”

Tips for treating and preventing diaper rash

By Dr. Theresa Willis
The Children’s Hospital of San Antonio Primary Care
Dominion Crossing

At one time or another, your baby will get diaper rash. First, check with your pediatrician and make sure that the rash isn’t something that needs to be treated by a doctor. Babies and toddlers in diapers can get fungal infections due to the frequently damp and warm area inside the diaper. Bacterial infections and other skin conditions such as eczema are also possibilities that your doctor will look for during an office visit.

If there are no other causes for your baby’s diaper rash, your doctor may tell you that he or she has diaper dermatitis. Diaper dermatitis is a general term used to describe an inflamed rash in the diaper area. It is thought to be caused by the mixing of stool and urine that decreases the pH and prolonged contact then leads to skin breakdown.

The rash can be very uncomfortable and lead to fussy babies and battles over diaper changes because it can be painful when the inflamed area is cleaned.

Continue reading “Tips for treating and preventing diaper rash”