Medical emegencies may occur at any time. Certain serious emergencies require the use of 911 services. Please call 911 should any of the following conditions occur with your child:

• Loss of respiration (not breathing)
• Loss of consciousness
• Convulsions or seizures
• Significant difficulty breathing
• Severe bleeding or significant blood loss
• Broken bone in which the bone is exposed
• Poisonings (then immediately call Poison Control at 800-222-1222)
• Large burns
• Alcohol or drug overdose
• Severe abdominal pain

Don't worry about obtaining authorization from your insurance company or the office in a 911 emergency situation. Please notify the office within 48 hours of the Emergency Room visit so we may obtain a post-ER/911 authorization for you.

Emergency Room Visits

Use emergency services wisely. In life-threatening situations, emergency services are invaluable. However, for routine and minor illness care, emergency rooms charge 2-3 times more than your doctor's office and waits frequently last as long as 3-4 hours. Furthermore, your medical records are not available, so Emergency Room doctors have no information on your medical history. ERs are set up to handle trauma and life-threatening situations. They are not set up to handle routine illnesses. Please use good judgment in deciding when to use emergency medical services.

Most insurance companies require pre-authorization from your primary care phusician before you take your child to an emergency room. Except in instances requiring 911 calls (cited above), or when you feel your child is threatened, please phone our office or after-hours answering service before you take your child to an ER. Often our physician will provide you with some measures to help your child through until we can see him or her in the office. If the illness is assessed as a true emergency we will send your child to the ER. In some instances, if the insurance company feels that the illness was not an emergenvy and you did not obtain pre-authorization from your physician, you will be responsible for ER charges.

Below are some examples that are usually NOT considered emergencies:

• Anxiety
• Joint pain
• Bronchitis with no difficulty breathing
• Menstrual problems
• Colds
• Minor burns
• Constipation
• Minor cuts
• Cramps
• Nausea and vomiting
• Dental pain
• Dermatitis (rashes)
• Sprains
• Ear ache/ear infection
• Sore throats
• Fever under 102
• Vaginitis
• Flue or viral syndrome
• Warts

Out of Town Emergencies

The same policies apply to out-of-town emergencies and obtaining out-of-area medical care as to local emergencies and care. Please check your healthcare policy handbook for particulars on how to obtain care when traveling. If you are unsure as to your policy or have a question as to the severity of an illness, please call the office or our triage service. We will generally request that you have your child seen at a nearby medical facility. We are unable to treat your child over the phone, but we will offer advice. We cannot call in prescriptions to other states. Please ensure that you take all medications and equipment with you if your child has any chronic illness.

Poisonings

Should your child ingest, ear, inhale, spill, or come into contact with any substance that is harmful, please call Poison Control at 800-222-1222. Poisonings may include medications, cleaning products, household chemicals, shampoos, conditioners, and plants. Children will drink just about anything; if in doubt, assume the worst.

Prevention
Poison prevention habits should be practiced before your baby is born, and most certainly before he or she begins crawling. Nearly 80% of poisonings occur in children ages one to four.

• Never leave a poisonous product unattended, even for a moment.
• Lock all drugs and medications away from children, preferably in a safer place than a medicine cabinet, such as a kitchen cupboard above the stove.
• Do not keep household chemicals such as drain opener, dishwasher detergent, oven cleaner or plant food under the kitchen sink.
• Keep products in their original containers so the labels are available. Never use food containers, even for temporary storage.
• Use safety latches on your cabinets.
• Use "Mr. Yuk" stickers and teach children to recognize them.
• Keep syrup of Ipecac in the house.
• Post the Poison Control number next to your telephone.

Treatment

• Call Poison Control immediately
• Do not induce vomiting if the person is:
  • having convulsions
  • unconscious
  • has a burning sensation in the throat
  • has swallowed a corrosive chemical or petroleum product such as lye, bleach, drain opener, floor wax, grease remover, disinfectant, gasoline, furniture polish, oil-based paints
• IF you are instructed by Poison Control to induce vomiting, use syrup of Ipecac.