Flash Back Friday - ER
The first time you take one of your kids to the emergency room, it can be a little scary. They will usually have you check in at the desk, then wait to been seen in "traige."
In triage, the nurse will assess your child for skin color, breathing, see if they're extremely tired, check their oxygen saturation level, etc. This is when you make sure to stress that your child has asthma, and list how many times they have already been admitted before (that always seems to catch their attention and lets them know you are serious and know your stuff!)
They then decided who goes back first, according to who is the sickest. I know people don't like to wait in the ER, but kids with breathing problems are put ahead of kids with broken bones, those that need stitches, kids vomiting, etc. The problem is that kids with asthma can stop breathing at any moment. Not good.
I have learned to be a little assertive in the Emergency Room. The last time Son #2 needed to go to the ER, I arrived behind a bunch of college kids who were goofing off at a local Walmart in the shopping cart and they needed stitches. I am NOT going to wait behind them, I interrupted while she was helping them to tell them my son has severe asthma and needed oxygen right away. She didn't look up and wearily told me to talk to the nurse in triage. Which I did, once again interrupting the patient who was there. I had my oxygen saturation monitor with me, and it was attached to my son's finger, so I could show her that his oxygen level was only 87% (it should be closer to 98%)
The nurse asked her patient to step out of the room so she could see my son. Do I feel bad? NO!! I repeat, my son can stop breathing at any time. He needs to be seen right away!
In the ER, they will take you to another room and put the oxygen monitor on your child's finger. Reassure your child that it won't hurt, it just glows red like a little flashlight. They'll listen to your child's lungs, check their skin color and look for retraction (skin sucking in around the rib cage, and collar bone.) Sometimes they can treat your child in the ER and send them home.
They can give your child an injection of Decadron (steroid) that will reduce the swelling in their lungs. They may also be able to give them a breathing treatment, strap on oxygen for a little while and then send them home.Lucky!
Usually, my kids won't show much change after a breathing treatment and oxygen, so they need to be admitted. If that happens, they go upstairs to pediatrics. They will get an IV and will receive Salu-mederol (stronger steroids), oxygen and breathing treatments.
This is where its nice to have the professionals take over. The respiratory therapist will give breathing treatments and listen to their lungs, the nurse will watch the monitors for changes in breathing, and you-well, you get to watch cartoons with your child in the hospital room! Our pediatrics also has portable video game machines, so we get our own game system in the room.
Anyway, that's just a little glimpse of what it's like to go to the ER. Some people think it sounds like a drastic move, but if your child is having pale skin, dark lips or fingernails, skin is sucking in around the rib cage or collar bone, nostrils are flaring, they're listeless, having a difficult time speaking or seem to be breathing fast and shallow (panting) head to the ER! If it's too far away, call 911. Remember, I'm not a doctor, I have just learned a lot over the last 11 years of dealing with asthma with 3 kids.
So, always ask your doctor what he wants you to do and when. They will usually give you guidelines of when they want you to go to the emergency room. I know we all want to keep our kids alive, and that usually takes extra effort for kids with asthma. Doctors, emergency rooms and hospitals can help you do that.