Before You Take Your Kid To The E.R. For COVID Symptoms, Listen To Pediatricians

Schools are shutting down, daycares are closed, and the last place you want to be right now is the emergency room. A recent study in the Journal of Rural Health found that while more than 100 million Americans head to the E.R. annually because it’s open 24/7, it’s available to uninsured patients and because people (this reporter included) tend to freak out a bit when they or their kids are sick — it can actually be detrimental to your health to go there, especially in the middle of the novel coronavirus outbreak.

In a 2017 study published in the American Journal of Infection Control, researchers examined four Cleveland-area hospitals and found that 22% of the floor areas were positive for MRSA, a Staphylococcus strain, 33% were positive for vancomycin-resistant enterococci, 72% of floor sites were positive for C. difficile, and 24% of high-touch objects were contaminated with more than one pathogen.

And let’s not even try to figure out what’s covered in coronavirus germs, COVID-19 or otherwise.

“On an average day, the E.R. is full of sick people with other viral and bacterial infections, so waiting in the triage area and being in an exam room are opportunities for us to either breathe in viruses or touch contaminated surfaces and become infected,” says Chad Sanborn, M.D., a pediatric infectious disease physician with KIDZ Medical Services.

So despite having robust infection control procedures in hospitals and within the emergency rooms, these can still be places where you can leave with an infection you didn’t enter with, says Jay Lovenheim, M.D., a pediatrician with Lovenheim Pediatrics in West Orange, New Jersey.

While you should always go to the emergency room if there’s an actual emergency — difficulty breathing, severe allergic reaction, broken bone pushing through the skin — you have options for most other health issues, Lovenheim says.

You also run the risk of spreading your illness or infection to those around you who may be older or at a higher risk than your child.

If your child has a mild illness which may include a fever but is unlikely to need hospitalization, there is no need to go to the E.R., Lovenheim says.

And here’s the biggie: “It is not recommended to go to the E.R. just to find out if your child has the coronavirus,” he says. As the virus spreads, hospitals anticipate a crunch on beds, equipment, and medical staff, and “it will not help those who truly need emergency care if beds are being taken up with people who do not need them.”

'The smartphone is the biggest medical advance of the past decade,' Ticho says. 'Many diagnoses are made visually, and, with guidance, most parents can take an adequate picture.'

Since there’s no treatment for COVID-19 besides supportive care, which can be done at home under your own care in most cases, skip the hospital, Lovenheim says.

A whopping 71% of emergency department visits could have been treated in an urgent care clinic or primary care setting, or didn’t require urgent care, according to a study by Truven Health Analytics. With the average cost of an E.R. visit being $1,233, you may want to think twice about heading in.

At home, give your child ample fluids, provide fever reducers like Tylenol or Ibuprofen, use a saline spray in the nostrils to help congestion, and make sure your child has adequate rest.

Another option is to send photos to your physician, says Benjamin Ticho, M.D., a pediatric ophthalmologist with Ticho Eye Associates University of Illinois Eye & Ear Infirmary.

“I frequently say that the smartphone is the biggest medical advance of the past decade,” Ticho says. “Many diagnoses are made visually, and, with guidance, most parents can take an adequate picture.”

Combine that with an appropriate history and simple home-based tests such as temperature taking, and it’s usually simple to diagnose via the phone, he says. Ticho says that most insurers will recognize remote care billing codes, but this isn’t always true, so compensation remains a concern and can vary by physician.

There are also national telemedical networks that are available to anyone with or without insurance, 24/7, for a per-call fee (physician consultations including therapists are $60 while nurse consultations are $40), says John Farhangui, CEO and founder of Sami-Aid.

“Parents need to know that they have a new way of getting immediate medical help and prescriptions without leaving their home rather than visiting an ER once they notice kids are experiencing flu-like symptoms or showing signs of a non-life-threatening illness,” Farhangui says.

The doctors on Sami-Aid can also prescribe medicine.

If you feel like your child is not improving or is showing signs of a more severe infection, then it’s appropriate to head to the emergency room — but touch base with your pediatrician first to make sure the visit is necessary, Lovenheim recommends.

If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all of Romper’s parents + coronavirus coverage here, and Bustle’s constantly updated, general “what to know about coronavirus” here.

Experts:

Chad Sanborn, M.D., pediatric infectious disease physician, KIDZ Medical Services

Jay Lovenheim, pediatrician, M.D., Lovenheim Pediatrics

Benjamin Ticho, M.D., pediatric ophthalmologist, Ticho Eye Associates University of Illinois Eye & Ear Infirmary

Studies referenced:

Greenwood-Ericksen, M., Kocher, K. (2019) Trends in Emergency Department Use by Rural and Urban Populations in the United States. Journal of Rural Health, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2730472

Deshpande, A., Cadnum, J., Fertelli, D., et al. (2017) Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens? American Journal of Infection Control, https://www.ajicjournal.org/article/S0196-6553(16)31014-8/fulltext

(2013) Study: 71% of ED Visits Unnecessary, Avoidable, Truven Health MarketScan database, https://www.beckershospitalreview.com/patient-flow/study-71-of-ed-visits-unnecessary-avoidable.html

Editor's Note: An earlier version of this article misnamed Dr. Chad Sanborn. It has been corrected.