Is this a "no-no"?

Wise Woman RN · Feb 19, 2008

I would have called my doctor, and asked for advice prior to going to the ER. I have done this when my kids were little, and there was never any problem with this.

mandasueRN · Feb 19, 2008

I've taken my kids once or twice to the ER with an ear infection in the same situation. I even called their doctor and tried to get something called in and they refused to do it stating they could not diagnose over the phone and that if I felt that my child needed medical attention after office hours I needed to go to the ER. I didn't care if I got on the ER staff's nerves or not--my kid was in pain and needed treatment. No one wants to see a kid suffer. Now I would never take my kid to the ER for a simple runny nose as I have seen parents do in the past. I don't think anyone would think badly of you for wanting to get treatment for your legitimately sick child.

chip193 · Feb 19, 2008

Ear infections – well, most of them are caused by a virus. Using antibiotics immediately out of vogue per AAP and most of our ER docs are sending parents home with a prescription to be filled in two days if no better. Decongestants are sometimes given immediately as are pain medication and eardrops.

As for visiting the ER for a child screaming in pain on a Friday night – well, we always see them. As a Dad of a two year old, I understand why parents are there. So do most of the staff – as they’re Moms or Dads.

What causes great amounts of stress in the ER is the patient who has multiple visits for the same or similar complaints. Ignoring the discharge instructions that say “see your doctor in two days” or something similar causes a problems. Multiple visits for vague complaints of pain (dental, back, headache, etc.) cause concern in the ER.

Blee O'Myacin, BSN, RN · Feb 19, 2008

I've read alot of threads here about irritation with people who come in for non urgent issues- and I also intend to work in an ED when I graduate in May.... but now I'm wondering...
There have been multiple times in the past where I have brought one of my 3 kids into the ER because of I knew they had an ear infection and it was like a friday night when they came down with symptoms- fever, pretty bad ear pain, and knew they needed antibiotics- but their dr's office wasn't open until Monday, and there is no urgent care center here. So I'd take them into the ER so they could get started on antibiotics and not have to suffer through Monday. (and sure enough every time I ended up there, they had an ear infection) I think this has happened maybe 3 or 4 times.
Now I wonder if everyone was annoyed with me because its not a technically "urgent" thing. (Though IMO it was urgent- I didn't want them to suffer longer than necessary)

I'm never put out by helping a child in pain. Now if you didn't give that kid tylenol or motrin so that we could "really see the pain", then I'd see a need to educate the parents, but not be irritated or short with the child.

Blee

beachbum3 · Feb 19, 2008

Ear infections - well, most of them are caused by a virus. Using antibiotics immediately out of vogue per AAP and most of our ER docs are sending parents home with a prescription to be filled in two days if no better. Decongestants are sometimes given immediately as are pain medication and eardrops.
As for visiting the ER for a child screaming in pain on a Friday night - well, we always see them. As a Dad of a two year old, I understand why parents are there. So do most of the staff - as they're Moms or Dads.
What causes great amounts of stress in the ER is the patient who has multiple visits for the same or similar complaints. Ignoring the discharge instructions that say "see your doctor in two days" or something similar causes a problems. Multiple visits for vague complaints of pain (dental, back, headache, etc.) cause concern in the ER.

I didn't know that ( the virus thing) and never suspected it was viral as my kids always improved significantly after receiving antibiotics for 24 hours. It has been a few years though...

chip193 · Feb 19, 2008

I didn't know that ( the virus thing) and never suspected it was viral as my kids always improved significantly after receiving antibiotics for 24 hours. It has been a few years though...

Was it the amoxicillin or the time that did it?

beachbum3 · Feb 19, 2008

I've taken my kids once or twice to the ER with an ear infection in the same situation. I even called their doctor and tried to get something called in and they refused to do it stating they could not diagnose over the phone and that if I felt that my child needed medical attention after office hours I needed to go to the ER. I didn't care if I got on the ER staff's nerves or not--my kid was in pain and needed treatment. No one wants to see a kid suffer. Now I would never take my kid to the ER for a simple runny nose as I have seen parents do in the past. I don't think anyone would think badly of you for wanting to get treatment for your legitimately sick child.

That was always the response of my dr's office... and I had, IMO the BEST dr ever- he was fantastic- we had him as our PCP for 6 years until he moved out of state. I was so bummed when he moved. When he found out I was in nsg school anytime I brought my kids in he'd show me abnormal findings and take the time to teach me about it. He was great!!

beachbum3 · Feb 19, 2008

Was it the amoxicillin or the time that did it?

Considering when he spiked a fever with ear pain as his only symptoms I'd have him at the dr and immediately started on antibiotics there's no way to know which. I personally feel like the antibiotics were what helped.. and I'm not, nor have I ever been, one of these people who thinks antibiotics are a cureall.

beachbum3 · Feb 19, 2008

Ah ha! I've found the answer... I went googling AAP studies and found the studies and recommendations- antibiotics are indicated in children with severe illness- defined as temp >39 C (102.2 F) and moderate to severe pain. My son always, ALWAYS had a fever over 103- sometimes even over 104 and severe ear pain with abrupt onset.

scribblerpnp · Feb 19, 2008

Ear infections - well, most of them are caused by a virus. Using antibiotics immediately out of vogue per AAP and most of our ER docs are sending parents home with a prescription to be filled in two days if no better. Decongestants are sometimes given immediately as are pain medication and eardrops.
[/size]

Well, it sort of depends. Though the AAP does recognize many OM's are viral, the age of the child and personal history determines the watch and wait approach (as well as the severity of the OM).

In general: Under 6 mos, you treat. 3 and up watch and wait (unless pt history is + for OM and symptoms severe), 6 mos to 3 years , determines history and severity (meaning will it perf the TM or not and other things)

Here is an AAP statement on the use of abx in treating OM (and yes, it is short):

http://www.aap.org/advocacy/releases/aomqa.htm

Hopefully that clears things up a little! :yeah:

To the OP, if it was Friday night and you have no urgent care or a PCP who will call in abx (and most won't), I don't think going to the ED is frowned upon. You do what you gotta do sometimes.

MAISY, RN-ER, BSN, RN · Feb 19, 2008

As someone who was a frequent sufferer of middle ear infections, when you are in that pain....it is an emergency!

No one knows how bad this can get, without actually experiencing them.

Several years ago, I had an ear infection, saw the PMD....SUFFERED!!!!!...FINALLY, after two days of abject misery....called doctor who say me at 11pm....sent be to the ER....saw specialist who had to drain my horribly hurting ear....THIS PAIN WAS WORSE THAN NATURAL CHILDBIRTH and I had two that way!

So, anyone who says an earache isn't an emergency....I say pain is what the patient says it is....if I say 10/10 that's an emergency!

Now, I just walk into specialist's office if problem brewing....I will not wait....am pushy enough to do it....many cannot.

Maisy;) (ER nurse)