5 Things to Remember When Going to the ER

Today's guest post is by Rachel Berros, PA.

Image courtesy of Paul Brennan

5 Things to Remember When Going to the Emergency Department

Health and medical care can be intimidating, especially if you are more naturally minded. Having a primary care provider that you trust can be a huge benefit in this area (for more about primary care benefits, click here). But, sometimes the emergency department or urgent care are your only, or best, options. Once there, it is important that your voice be heard and desires respected. Not every clinician understands the idea of breastfeeding past 6 months or not desiring antibiotics. Due to their ignorance (not malice), they may not think to ask about these issues. As advocates of your and your child(ren)’s health, please keep these points in mind if you find yourself in an emergency department.

1. Tell the ER provider several times that you are nursing your child, especially if the child is older than 6 months or not currently with you. The clinician may assume older children are no longer nursing and thus not ask, so be sure to volunteer the information. Once you have told them, they still may end up prescribing something out of habit. This medication will most likely be appropriate for the patient’s condition, but may not be ideal while nursing. So, politely advise them of your nursing status during the initial interview, again while discussing the treatment plan, and then when the person (usually a nurse) goes over your discharge instructions. 
2. Include your herbal therapies as medications. Some clinicians may not understand the possible interactions of herbal remedies with prescriptions medications, but many will.  If the herbal therapy is potent enough to have an effect, it may have a side effect or interaction as well. Homeopathic treatments generally do not have a similar issue due to their nature, so generally do not need to be included.
3. Ask if probiotics would be a better treatment—as opposed to antibiotics—if diagnosed with a bacterial infection. Certain infections, such a mastitis (a milk-duct infection while nursing) has been shown to improve as well, if not better, on probiotic therapy as on antibiotics (as described on UpToDate, a respected medical resource site for clinicians). Any time antibiotics are used (including through breast milk) during the first 6 months of life (or before whole foods are eaten and thus normal/healthy bacteria developed in the gut) there are slightly higher risks for stomach issues later in the child’s life. If antibiotics are still recommended, ask about taking probiotics with them, also remember to ask how easily the specific antibiotic will pass into the breast milk.
4. Ask if a chest x-ray for your child is absolutely necessary. A single x-ray will not be harmful, but all radiation exposure adds up over time. Exposure can be especially problematic in the preteen and early teen years when the child’s body is preparing for and going through puberty. 
5. Remember prevention is key, and knowledge is power. Appropriate child restraints, helmets, and other safety gear have significantly reduced childhood trauma rates in the last several decades, but we still have room to improve. Learn about proper safety gear use and insist on it with your child(ren). Also remember most fevers do not require emergent evaluation, vomiting for a day or so will usually not cause significant harm to your child(ren), and colds are almost always viral (meaning they need time, not medications to improve), so skip the trip to the emergency department unless, of course, it is a true emergency. 

Educate yourself from reputable sources, like your primary care provider or pediatrician, or well respected, science based websites, to reduce your need of medical visits. But, as I always tell my patients, if you are scared for you or your child(ren)’s health, seek out a professional evaluation. We will always be happy to tell you your child is fine or not as bad off as you imagined. Most of us enjoy seeing concerned, well informed, and proactive parents and patients. 

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Rachel Berros is a Physician's Assistant and writer. Follow her on Twitter (@berrosrachel) and check out her website (www.rachelberros.com).