Confessions of an A&E Veteran Mom
The little boy is running a fever, so we are all waiting to see what develops while spending an afternoon at home recuperating.Over the past 46+ months of being a Mommy, I have gleamed a couple of useful medical tips from multiple visits to children's A&E, PDs and GPs.
Caveat: I am not a medical professional. This is purely based on my experience as a Mom accompanying my kids on various "expeditions" to medical professionals' clinics.
1. Don't panic when your kid runs a fever.
You know how the older generation used to scare us with the saying that high fevers might bring on brain damage?
Well, there is a medical plausibility of bacterial meningitis but this is rare.
Low grade fevers (hovering 38 degrees) for us, are indicative of teething (usually between 6 - 20 months) or post-vaccination responses.
High grade fevers (those exceeding 38.5 degrees) are usually brought on by virals.
We have learnt to be watchful and cautious when we get past 38.5 degrees, especially if the fever fluctuates for more than 3 days.
2. Wait and See.
Over the years, we have learnt not to send the child to the PD/ GP on the same day they run a fever, if there are no accompanying symptoms.
This is because any virus/ bacteria tends to show up in blood tests only after 3 days.
So if you send the child to a doctor, the doctor can only prescribe kids paracetamol or brufen if there are no accompanying symptoms.
While the good doctors can speculate possible underlying causes based on accompanying clinical symptoms, most will just tell you it's a viral fever (which could lead to a whole host of things like Roseola, HFMD or nothing innocuous at all!)
I will balance this by saying that if my child coughs violently, turns blue or cries continuously in the middle of the night from pain, I will brave the 4-hour wait at A&E just to get a medical opinion and a peace of mind!
** we have been known to queue at A&E for constipation discomfort or a suppository that immediately lowers the child's high fever (respite from constant crying!)
3. Be Watchful.
Watch for any changes in your child's behavior - irritability tends to be common when the kids are unwell, but you would know best (as a parent) when something feels "off".
Immediate red flags would include altered state of consciousness, seizures, extreme lethargy.
Other tell-tale signs would be cringing/ acute crying while peeing, or decreased diaper output (for younger babies).
This was how I determined that Sarah had a recurring UTI before we even did a dipstick test.
Similarly, you will want to be able to describe changes in the child's behavior/ recent spots and rashes on the body when you visit the doctor's.
4. Be Cautious - because virals are easily infectious with 2 young kids in close proximity.
When either child runs a fever, we stop sharing drinks/ food between adult and child.
I have learnt this the hard way when I got HFMD from Sarah, by sharing the same cup of chin-chow drink!
Also, we have put in place a segregation protocol.
1 parent cares for the sick child exclusively - washing poopy bums, handling mucus/ vomit- to reduce careless cross-contamination.
Needless to say, a lot of constant hand-washing takes place when we have 1 bug-infected child in the house.
5. Google is your best friend.
It is immaculately funny to include this (seemingly irrelevant) tagline, but Google has indeed made me a more enlightened parent.
When spots start to appear on either kids, I brace myself to review photos of "rashes" web images to try and figure out what the likely culprit is. The sharing on the Internet has educated me on distinguishing Roseola (clustered dots, flat with pinkish appearance), HFMD (singular spots, red/ raised and itchy, usually appeared on extremities first) and hives (generally large raised patches that could "move around", but generally on torso first).We also look for whether the rash appears at one spot only (generally indicative of contact hives) or is spread over various patches (differentiating a drug/ food allergy).
When dents started appearing on Sarah's fingertips, I trawled the net to see if there were calcium deficiencies or wider health concerns. An interesting forum sharing (by overseas Moms) led to my discovery of Beau's lines, which totally clicked because she had recovered from HFMD 5 weeks back and the same lines were beginning to show on my fingernails!
New things we learn everyday.
As our kids are still fairly young (not always able to describe their pain or discomfort), it is also important for us to find doctors we can trust for a professional opinion.
We have been quite fortunate in this regard, to have 2 knowledgable and prudent PDs on our calling list and a neighborhood GP we all love (he's reallygood with the kids - J never fails to associate "see doctor" with his GP's name).
Other useful things to say:
KKH and NUH are the only 2 locations with children's A&E.
We personally prefer NUH's because there are fewer sick kids at the waiting bay and the area is generally calmer than KKH's environment.
BUT, food and entertainment options are very much limited at NUH (I love the Mothercare, McDs and other knick-knack shops at KKH), so bring lots of coins for the vending machine and your trusty iPad.
Be prepared for a long wait
The waiting times at both locations have been fairly similar for us. Whilst KKH sees a larger patient flow through, they also have more doctors. NUH is typically staffed by 1 or 2 doctors on call.
Both departments follow a protocol.If your child presents more urgent symptoms (e.g. seizures or open wounds), they may be prioritized to the front of the queue after triage assessment.
Most of the time though, the waiting time is anything between 90 - 180 minutes. Be prepared with water bottle/ milk powder, jacket for the kid and extra change of clothes.