Emergency

How To Use The Children's Emergency Wisely

The Children's Emergency is crowded everyday. However, many of the children are attended to for less serious medical conditions. When doctors and nurses have to deal with so many less serious cases, children with real emergencies may risk getting less immediate attention.

Common Misconceptions About Services At The Children's Emergency

1. My child will be seen earlier if I bring him to the Children's Emergency for a flu or fever.

Fact: Our trained nurses will do an initial assessment/triage when the child arrives at the department. Children with life-threatening conditions will be attended to first at the Children's Emergency. Patients are NOT seen on a first-come-first-served basis. Children with minor and non life-threatening ailments may have to wait, sometimes for several hours.

2. Doctors at the Children's Emergency are better than the family or polyclinic doctors.

Fact: The Children's Emergency is run by a team of trained doctors. There is always a senior paediatric specialist on the floor to review more complex and difficult cases and attend and manage children with life-threatening conditions.We do not provide routine paediatric specialist consultations. Your polyclinic or family doctor are trained and qualified to treat common medical conditions in young children. Indeed, many of them were trained and have previously worked in KKH before! They can also refer your child to KKH if necessary.

3. The medicines prescribed at the Children's Emergency are more effective.

Fact:Medicines are prescribed according to the needs of the individual child. Medicines given for fever, flu or diarrhoea are similar to those available at the polyclinics and the family doctors.

4. My child needs an X-ray or other investigations, and it's easier to get these done at the Children's Emergency.

Fact: Many polyclinics or family doctors offer X-ray facilities and laboratory services for non-emergency conditions.

5. I bring my child to the Children's Emergency because it is open after office hours and on weekends and public holidays. I am not free otherwise.

Fact: It is during these periods that the Children's Emergency is most crowded. Waiting time is also the longest for less serious cases. It might therefore be better for your child to be seen by your family doctor first. Many clinics are open during weekends in the morning. One should know the nearest GP or polyclinic near your house which are open 24 hours or on weekends.

What Are Non Emergency Conditions/Less-Serious Conditions?

Minor ailments like the common cold, viral fever, mild gastroenteritis and minor injuries may be adequately treated by your family doctor. How high a fever is does not necessarily indicate the severity of an illness. One has to balance the duration of the fever with the other associated signs and symptoms in the febrile child as well as the age of the child. Learn how to control the fever to make your child more comfortable.

Your child may be treated by the family or polyclinic doctor if he is observed to be:

• Alert, fairly active, able to interact with caregivers, able to play (at least in between febrile episodes)
• Feeding adequately or able to retain oral fluids
• Not having any of the symptoms stated in the list of emergency conditions

Other examples of non-emergency conditions which can be treated by the family doctor or referred to a specialist on a non-emergency basis include:

• Chronic rash on an otherwise healthy and well child (e.g. diaper rash)
• Chronic constipation
• Poor weight gain, poor growth
• Chronic cough in a child who does not have fever or breathing difficulty

If your child has a non-emergency condition, see your family doctor or a doctor at the polyclinic. It is faster, cheaper and your child will still get the relevant treatment.

As the main caregiver, you know your child best. Decide if your child has an emergency or non-emergency condition and seek treatment at the right place.

The KKH Urgent Paediatric Advice Line (UPAL) is a new pilot online service available from 8.00am to 11.00pm daily for parents and caregivers to seek advice for common paediatric conditions (for children below the age of 17 years) such as fever, cough, diarrhoea, vomiting and common injuries.

• The KKH UPAL service is not meant to replace consultation with qualified medical practitioners.
• The accuracy of advice given depends on input provided by the users, and the advice may not be all encompassing.
• For concerns not addressed by this service, seeking prompt consultation with qualified medical practitioners is strongly recommended.
• If your child needs urgent medical attention, please proceed to the nearest paediatric emergency department.
• In the event of an emergency, please call 995.

For certain pre-existing or chronic medical conditions, it is not recommended to seek advice from KKH UPAL as your child may require more specialised care.

At the Children's Emergency

Upon registration, a specially trained and qualified nurse will first assess your child. The doctors in Children's Emergency will then attend to your child as soon as possible.

PRIORITY IS GIVEN TO CHILDREN WITH SERIOUS AND LIFE-THREATENING CONDITIONS.

An emergency is an illness or injury which could result in serious disability or death if it is not treated immediately.

Some emergency situations in infants and children which require prompt or immediate evaluation and treatment at the Children's Emergency include:

• Major accidents like road traffic accident, fall from a height
• Near drowning
• Deep cuts or wounds
• Head injury
• Suspected broken bones, dislocated joints
• Suspected poison ingestion
• Foreign body ingestion or inhalation
• Foreign body in the throat, ear or nose
• Loss of consciousness
• Seizures
• Difficulty in breathing, wheezing, noisy breathing; and breathless to talk, drink or play
• Inability to swallow and drooling
• Child looks pale, ashen or blue
• Poor feeding or persistent vomiting (not able to retain fluids)
• Drowsiness, irritability, persistent crying, confusion, disorientation
• Fever or illness in an infant less than 3 months old
• Blood in the stools or vomitus, green vomitus
• Persistent acute abdominal pain
• Acute headache or giddiness, neck stiffness
• Acute illness or deterioration in a child with a known chronic illness