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By Health Promotion Board in collaboration with Dr. Yvonne Ng, Senior Consultant, Department of Neonatology, National University Hospital.

When your child is ill or in distress, you might be tempted to rush down to the emergency room for immediate medical attention. In some cases, that is the right move, but for less serious cases, a visit to the regular clinic doctor will do. Sometimes your baby will get better in a few hours without any medical intervention at all!

Here are some pointers for when to go to the ER, to the clinic, or call an ambulance.

Related: Looking After Your Newborn

Bumps and Bruises

Your child’s just learning to crawl and walk, and some minor bumps and bruises are nothing to worry about. Bring him to the emergency room if your child:

  • is less than six months old and has fallen from a height of more than 90cm
  • loses consciousness immediately or a few hours later
  • experiences a seizure
  • has weakness of his limbs
  • starts vomiting
  • becomes drowsy or very irritable
  • has bruising under the eyes and ears, or obvious signs of injury

Related: The ABCs of Bruising in Children

Vomiting and Diarrhoea

Observe your child. If the vomiting or diarrhoea does not ease up in 24 hours, bring him to the emergency room, especially if:

  • There is blood or bile (green substance) in your baby’s vomit
  • Your child refuses to eat anything or constantly vomits everything he has been fed
  • Your child shows signs of dehydration: dry mouth, crying without tears, less frequent urination, sunken eyes, and a sunken soft spot on his head
  • Your child shows serious signs like listlessness, clammy skin and high fever (38 degrees Celsius and above)

Related: 9 Common Issues Babies Face

Cuts

If your child suffers a cut, bring your child to the ER if bleeding does not stop after five minutes of direct pressure on the wound, or he has suffered a deep and big wound.

For minor cuts and scrapes, mums and dads can treat them at home: rinse the cut under cold running water, clean with sterile gauze swabs, and apply a plaster or bandage.

Do bring your child to the doctor if there are sand particles or wood splinters in the wound, the cut was caused by a rusty object or an animal, or your child develops an infection (e.g. pus, swelling, persistent redness, and/or pain in the wound, fever).

High Fever


Bring your child to see a doctor immediately if he has a fever above 39 degrees Celsius and any of the following symptoms:

  • He is not eating well or can’t keep food down due to vomiting
  • He has difficulty breathing
  • He is lethargic and drowsy
  • He has abdominal pain and discomfort
  • He has a rash
  • He is dehydrated 

Babies under three months old will need immediate medical attention if they have fevers above 38 degrees Celsius.

Related: Common Childhood Conditions—Fever

Unusual Breathing

Runny or blocked nose and slightly fast breathing caused by a cold is usually no cause for concern. You can visit the doctor for some medications that can help your child feel better. However, if you observe these symptoms in your child, bring him to the emergency room:

  • Irregular or fast breathing
  • Laboured breathing (e.g. flared nostrils, sucking in his chest/ribs)
  • Grunting or wheezing 
  • Appears pale or cyanosed (i.e. blue discolouration of lips/tongue)
  • Listlessness and lethargy

Related: Keeping Your Child Safe

When to Call an Ambulance

Call an ambulance when your baby needs urgent and critical medical care, and your baby needs to be transferred to the hospital safely and quickly. Dial 995 and provide the operator with as much information as you can about your child’s condition.

Some cases of emergency are:

  • Your child’s airway is obstructed, for example, choking or anaphylaxis (an extreme allergic reaction).
  • Your child has stopped breathing or is struggling to breathe. Signs include high-pitched wheezing, raspy breaths, rapid breathing, gasping, and sucking in his chest and ribs when breathing.
  • Your child’s skin and lips are turning blue, purple, or gray, or he is unusually pale and clammy.
  • Your child is unresponsive or unconscious. He might be unusually limp, weak or lethargic, or have seizures.
  • Your child is seriously injured, e.g. a cut that is large and deep enough that it exposes flesh and/or bone; a cut to the head, chest, or abdomen; broken limbs; head and neck injuries; large burns.

Trust your parental instincts: you know your little one best. If his distress and discomfort seem out of the ordinary and severe, the best bet is to take him to the hospital for immediate care.


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References

  1. Audrey Paul, MD, PhD, FACEP; Karen Goodman, MD; and Catherine Verow, MS, CCLS. When to Take Baby to the ER. Retrieved November 2018 fro https://www.thebump.com/a/when-to-take-baby-to-emergency-room
  2. Rachelle Vander Schaff. When Should Your Child Go to the Hospital?. Retrieved November 2018 from https://www.parents.com/baby/injuries/first-aid/when-should-your-child-go-to-the-hospital/
  3. When to go to the Emergency Room. Retrieved November 2018 from https://www.thechildren.com/when-go-emergency-room-0