Ochpas reflect on his ED visit

Here is the #doctormommy guide to the ED.

Firstly, if it is life or limb threatening emergency, none of this applies. Ring 999. Secondly, if you are not sure if your child should go to the ED, try to ring GP or OOH GP first. Alternatively, depending on your child’s illness or injury and/or time of day, consider HSE injury units, CHI urgent care service, or private urgent cares if you have insurance. For purposes of this scenario, you’ve been directed to the ED by your GP:

1. If your child has pain, fever, or injury, it’s okay to give Calpol or nurofen like you usually would at home before they attend ED. They will be more comfortable. That urban myth about not “masking” pain or fever needs to go. They will ask you about it specifically in triage and take it into account.

2. Try to keep to just one parent/guardian-one child. I know it’s hard, but so important if at all possible for so many reasons.

3. Grab a bag – big enough so it as a small bit of extra space. Handy for keeping holding mittens, hats, shoes, teddies, etc. as you go along. What to take? medical card, GP details, payment method for parking, GP letter if you have one. If your child takes regular medications or a new recent prescription (such as started antibiotics 2 days ago), take a list. Either put medications in a bag, take the printout from chemist or just take a photo of packages with your phone clearly showing name of drug and dose.

4. In bag for child: Comfort objects such as soothers, favourite cuddly, and a blanket are key. Your child will likely dose off during your time there, especially if they are ill. Usual nappy bag items including Kleenex, nappies, wipes. Add usual change of clothes for infants/small children.

5. phone/tablet/headphone/chargers

6. Everyone should wear comfortable clothing and shoes to protect their feet. Children who can walk should wear shoes of some sort or if carried in, at least bring them in that bag to protect their feet later.

7. Consider putting emergency snacks or bottle of water in bottom the bag only if you 1) do not let your child know they are there until you offer them if needed 2)do NOT feed your child in ED without checking with medical staff first (sometimes it’s better to have empty tummy)

8. Hardest job: stay calm and positive. That’s for your child (though the staff will appreciate it, too). Yes, it’s stressful from the waiting, seeing your child sick, childcare pressure for others at home, letting work know, arranging transport in and out, crowded waiting rooms, uncomfortable seats for 3 hours…it’s all misery.

9. It’s hard, but do your best to be kind to those around you. The children or parents next to you may be vulnerable. Clean hands. #MaskUpButtercup and remind your older child mask as well. Remind/help your child to cover coughts/sneezes with their elbow.

BONUS round: You knew all that? Great, ready for master class level for small children: Did you bring Teddy or Bábog? Great. Little bit of play therapy while you wait both entertains little ones AND may ease the next step. While we were on a trolley waiting to see the doctor, we pretended beloved Octopus “Ochpas” was the one who was sick. We talked about how how he was sick, the doctor would check him, and give him special medicine to make him feel better. We had Ochpas say “Ah!”, tried to check Ochpas’ ears (we couldn’t’ find them) and put Ochpas’ tentacle on the oxygen monitor.

10. Lastly, Discharge time? Fantastic! Make sure you are clear on: medications, doses, instructions. What to look out for? What signs mean to bring the child back? Do you need follow-up? If you aren’t clear, ask. You can also ask for written instructions if you are tired/stressed/having trouble taking it in. Most paed ED have pre-printed handouts to help. I was delighted when I offered 3 pages worth of discharge yesterday morning after being awake 24 hours (yes, I’ve been awake 24+ hours many a time as a doc. I know when I get to that point though I write EVERYTHING down.) Don’t leave if you aren’t clear or still have worries. Take 2 minute and just ask. ED staff know it’s much easier for you and them to go through it right then and there rather than have you ring back later after shift change or have to come back concerned later that night.