Dr. Susan Kressley is a board-certified pediatrician and a fellow of the American Academy of Pediatrics. She has a private practice in pediatrics and adolescent medicine and is Chairman – Department of Pediatrics at Doylestown Hospital in Pennsylvania.
Many parents hate to “bother their doctor” with questions or concerns when they don’t have a scheduled appointment. So how do you know when to pick up the phone and call?
Firstly, you have to divide this into two categories of questions: urgent medical concerns and non-urgent questions.
An urgent medical concern is one that may affect your child’s health today. This should not be confused with an emergency that is a life-threatening or potentially life-threatening medical problem.
If your child is in distress having extreme difficulty breathing, loss of consciousness, bleeding that won’t stop, an obvious broken bone with deformity, major trauma, persistent seizure activity, or another life-threatening emergency, call 911 or go the closest Emergency Room for prompt medical attention. Remember to bring with you important information such as your child’s health insurance card, immunization record, medicines your child is taking, and your child’s favorite toy or security object.
For non-life-threatening emergencies call your child’s physician. Always call first rather than showing up at your physician’s office. She may provide you with critical first aid instruction by phone (e.g., for burns, bites, fractures) and may also tell you if it’s safe to be seen in the office or where to take your child for the best emergency care. In order to cut through red tape, when you call in always state assertively, “This is an emergency.” Do not let the answering service or receptionist put you on hold before talking with you. If you are put on hold, hang up and call back immediately.
For poisoning, or suspected poisoning/ingestion, call the phone number of the nearest Poison Center or the National Poison Center Hotline at 1-800-222-1222. They have a computerized system which can quickly identify ingredients in products and tell you the potential dangers/risks and how best to proceed. I always tell parents to put this number in their cell phone, so it is available wherever you happen to be. Most accidental poisonings/ingestions happen at the home of a friend or relative where medications/poisons may be accessible and children are curious yet feel comfortable.
For urgent medical concerns when your child is sick and might need to be seen today, call your doctor’s office in the morning. You have a better chance of getting a timely appointment. For most pediatric offices, that applies to weekends as well.
If your child is ill enough to be seen over the weekend, call the office/answering service in the morning so the provider can best advise you. If your child is ill and has a fever, do not send them to school. Stay home, phone your physician, and be ready to pick up and go if the office offers you an early appointment.
Before you make the call, make sure you have important information in front of you so that you can answer any questions accurately. Make sure you can state your child’s main symptoms. Have your questions written down. If your child has a chronic disease, be sure to mention it. Make sure you have taken your child’s temperature if she is sick. You should know your child’s approximate weight (for calculating drug doses.) Have handy the names and dosages of any medications your child is taking, as well as your pharmacy’s phone number. Have a pencil and paper close by to take down any instructions and make sure your child is available in case something needs to be checked.
For other questions that are non-urgent (behavior concerns, feeding questions, questions about seasonal allergies, or other topics which likely do not require an office visit today), call your child’s physician’s office later in the day (late morning, early afternoon). If the office staff is busy and can only take a message, ask for an approximate callback time. While waiting for a call back, try to keep your line open. If you will be running errands, provide a cell phone number where you are most easily contacted. If your call isn’t returned within 30-60 minutes of the predicted callback time, phone again.
Above all, have a discussion with your child’s doctor about how they like to handle phone calls. Ask them for a good parent resource for common health advice including common illnesses, behavior problems, and normal development. Different physicians like to use different resources that fit their style of practice. I personally give each family a copy of “Your Child’s Health” by Barton D. Schmitt, MD to use as a reference.
Remember: trust your instincts. No one knows your child better than you. Many childhood illnesses can be handled at home with lots of rest, fluids and TLC. If something doesn’t seem right and you are worried, call your child’s doctor. The only “stupid” question is one that isn’t asked, so it can’t be answered.
Good Luck and Good Health!
Susan J. Kressly, MD, F.A.A.P.
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