Are emergency rooms more dangerous for children during a Covid surge?

“Be careful. I don’t want to have to take you to the emergency room.

It’s a warning that almost every carer has at some point delivered to their children. For good reason – no one wants an injury or a trip to the hospital. But during the Covid-19 pandemic, the warning came with a darker edge.

Many parents have heard nearly two years of calls to flatten the infection curve to help preserve hospital capacity. They read harrowing stories of how Delta, then Omicron, broke healthcare workers.

Is it any wonder then that the monkey bars have taken on a menacing look?

Fortunately, interviews with medical professionals indicate that concern about whether it is safe to go to the emergency room during the coronavirus pandemic is overblown. Emergency care is still not a pleasant activity on Saturday afternoons, but it’s also no reason to avoid normal childhood activities, say these experts, especially if the activities in question are taking place. outside.

The more serious the injury, the shorter the wait.

The bottom line is this: If you need emergency care, don’t hesitate to go to the emergency room, says Dr. Kelly Fradin, a pediatrician in New York City who runs the AdviceIGiveMyFriends Instagram account. But be prepared to wait.

Traumatic injuries will always be treated faster than more minor ones, says Dr. Alexis Halpern, attending physician in the emergency department at NewYork Presbyterian/Weill Cornell Medical Center. “It’s just because we have to make sure no one dies,” says Dr Halpern.

Hospitals have national benchmarks for how long it takes for patients to be admitted after arriving at the ER for things like car accidents (or heart attacks for adults). During the pandemic, those criteria were still being met, Dr. Halpern says — even during Omicron. Wait times have, however, increased for less serious injuries such as nurse’s elbow or a sprained ankle.

Is it any wonder the monkey bars took on a menacing look?

Most childhood injuries are caused by falls (34%) and motor vehicle accidents (40%), according to data from the National Injury Data Bank’s Pediatric Annual Report 2016 (the most recent year for which data are publicly available). The median wait time to be treated for a fall was 84 minutes that year. That time has likely increased in the pandemic, Dr. Halpern says.

Romper spoke with parents whose children needed emergency care over the past few months, and their stories confirm this dynamic of longer waits while still having access to quality care.

There is Covid at the hospital, of course, but it is also at the grocery store.

The prospect of waiting in an emergency room or urgent care may raise concerns about exposure to Covid, but both doctors expressed confidence in hospitals’ strict mitigation measures. The best thing families can do is get everyone who is eligible vaccinated.

“The emergency room isn’t necessarily a higher-risk place than your grocery store or movie theater,” says Dr. Fradin.

Wearing a mask is ubiquitous; staff generally have high-quality N95 masks and other protective equipment. There is good ventilation, supported by HEPA air filters, and in many places almost all staff are vaccinated.

“I want people to feel comfortable that doctors and nurses are very careful. And you should never give up the care you need because you’re afraid to go there.

For medical needs that are clearly not life-threatening, some caregivers may try using an outpatient facility such as an urgent care department instead of a hospital. When Katie Gutierrez’s 16-month-old son fell and split his chin open in January, she immediately knew he needed more than a bandage. Gutierrez took her son to a pediatric emergency department in San Antonio, where she lives. The nurse there told Gutierrez that they regularly see large numbers of children with Covid. After about two hours of waiting where the wearing of the mask was strictly enforced, Guitierrez’s son was seen and his chin glued. None of them contracted Covid-19 during their visit.

Dr. Fradin also suggests taking advantage of a nurses’ helpline, often provided by insurance companies and pediatricians’ offices. Caregivers can call and get advice on the type of medical care needed. These options may be useful outside of normal business hours and when trying to determine the level of care required – perhaps that injury can be safely treated by an urgent care center or can wait the hours. normal opening hours of a pediatrician.

Of course, not every family has a primary care physician, says Dr. Halpern. If this is the case and you’re unsure of the severity of an injury or other physical reaction, it’s always best to err on the side of it and get the care you need. In other words, go to the emergency room.

“Obviously there is Covid in the ER,” says Dr Halpern, adding that it is understandable that people are afraid of having to go there. But, she says, “I want people to feel comfortable that we’re being very careful. And you should never give up the care you need because you’re afraid to go there.

Wear seat belts and helmets and let the rest go.

In a pandemic where children have experienced many restrictions and upheavals, Dr Fradin and Dr Halpern insisted that parents should not restrict outdoor activities like skiing, playgrounds or ice skating. ice only for fear of needing emergency care.

ER doctors and pediatricians agree: let the kids have fun where they can. Just wear a helmet.Getty

Outdoor physical activities are valuable for a number of reasons, including that they can replace indoor activities that carry a higher risk of contracting Covid-19. Although some activities carry an inherent risk of injury, wearing the proper protective gear will greatly reduce this risk.

According to the NTDB report, only 5.7% of pediatric injuries in 2016 occurred in children who wore helmets. About 79% of children with traumatic injuries did not have protective equipment, either because it was irrelevant or because they were not wearing it. Neither car crashes nor falls are easy to prevent, but wearing seat belts and helmets will go a long way to avoiding serious injuries, the two doctors said.

“Don’t go skiing because you’re worried about going to the emergency room,” says Dr. Halpern. “Please do not limit the activities of these children any more than they have already been during this pandemic.”

Experts:

Dr. Kelly Fradin, New York-based pediatrician

Dr. Alexis Halpern, attending physician and assistant professor in the Department of Emergency Medicine at NewYork-Presbyterian/Weill Cornell Medical Center

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